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43 Cards in this Set
- Front
- Back
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Normal hypertension
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<120 AND <80
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Prehypertension
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120-139 or 80-89
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Hypertension I
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140-159 or 90-99
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Hypertension II
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> 160 or >100
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Essential hypertension
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Unknown cause, a description not diagnosis
30% CAUSED BY GENETICS |
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SPECIFIC "SECONDARY" HYPERTENSION
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HIGH BP IS NOW SECONDARY TO AND NOW THE CONDITION TO ANOTHER DISEASE. CAUSED BY TUMORS OR KIDNEY DISEASE
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DETERMINANTS OF PERIPHERAL BP
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BP= CO x PVR
CO= HR, SVR--> CONTRACTILITY AND PRELOAD---> VENOUS TONE AND INTRAVASCULAR VOLUME ---> THIRST AND NA/H20 RETENTION SVR: DIRECT INNERVATION CIRCULATING REGULATORS AND LOVAL REGULATORS |
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ANATOMIC SITES OF BP CONTROL
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CARDIAC FUNCTION
VASCULAR FUNCTION RENAL FUNCTION NEUROENDOCRINE FUNCTION |
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BP REGULATION
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SHORT TERM: BARORECEPTORS
LONG TERM: BLOOD VOLUME |
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METHYLDOPA
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CENTRAL ACTING DRUG THAT ALTERS THE SNS
PRODRUG SOA: CNS POSTSYNAPSES: BLOCK RECEPTORS AND PRESYNAPTIC DECREASE NE RELEASE MOA: ALPHA 2 AGONIST STIMULATES VASODILATION AND DECREASES SNS OUTFLOW FROM THE BRAIN WILL REMAIN IN NERVES A LOT LONGER AE: SEDATION, DRY MOUTH, BRADYCARDIA, PARADOXICAL RISE IN BP FOR MOD-SEVERE CASES |
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CLONIDINE
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CENTRAL ACTING DRUG
WORKS ON CNS PRESYNAPSE (DECREASE NE) AND POSTSYNAPTICALLY ( BLOCKS RECEPTOR) AN ALPHA 2 AGONIST WORKS BETTER THEN METHYLDOPA IN A TRANSDERMAL PATCH CAUSES SEDATION, DRY MOUTH, BRADYCARDIA, PARADOXICAL RISE IN BP FOR MILD -MODERATE CASES DO NOT GIVE TO PATIENTS WITH MENTAL CONDITION |
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RESERPINE
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PERIPHERAL ACTING DRUG
AFFECTS THE SNS SOA: SNS NERVE ENDINGS MOA: INHIBITS UPTAKE OF NE INTO NEURONS AE: PSYCHOTIC DEPRESSION FOR MILD TO MODERATE BP |
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PROPRANOLOL
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INDERAL
NON SELECTIVE BETA BLOCKER NO BETA AGONIST ACTIVITY WORKS AGAINST B1 WHICH IS HEART AND KIDNEY AND B2 WHICH IS THE TRACHEA AND BRONCHIOLES; ARTERIOLES INTERMEDIATE HALF LIFE OF 3-8 H AE: SYMTOMATIC BRADYCARDIA AND HEART BLOCK, VASOSPASTIC ANGINA, BRONCHOSPASM, LETHARGY, FATIGUE, DECREASED LIBIDO (IMPOTENCE), ACUTE MENTAL DISORDERS AND WORSENED DEPRESSION, MAY INCREASE TRIGLYCERIDES AND DECREASE HDL USED FOR HTN AND ISCHEMIC HEART DISEASE |
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CARVEDILOL
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COREG
B ADRENORECEPTOR ANTAGONIST NO BETA AGONIST ACTIVITY NON SELECTIVELY BLOCKS BETA 1 (HEART AND KIDNEY) AND BETA 2 (BRONCHIOLES TRACHEA; ARTERIOLES) ALSO HAS ALPHA 1 ADRENERGIC BLOCKING PROPERTIES HALF LIFE: INTERMEDIATE 3-8 H AE: SYMPTOMATIC BRADYCARDIA AND HEART BLOCK VASOSPATIC ANGINA BRONCHOSPASM LETHARGY FATIGUE DECREASED LIBIDO ACUTE MENTAL DISORDER MAY INCREASE TRIGLYCERIDES AND DECREASE HDL FOR HTN AND ISCHEMIC HEART DISEASE |
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LABETALOL
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NORMODYNE
BETA BLOCKER NONSELECTIVE BETA 1 AND BETA 2 ACTIVITY (HEART, KIDNEYS, BRONCHIOLES AND TRACHEA, ARTERIOLES) HAS ALPHA 1 ADRENERGIC BLOCKING PROPERTIES ADMIN IV INTERMEDIATE HALF LIFE AE: BRADYCARDIA AND HEART BLOCK VASOSPATIC ANGINA BRONCHOSPASM LETHARGY DECREASE LIBIDO ACUTE MENTAL DISORDERS MAY INCREASE TRIGLYCERIDES AND DECREASE HDL FOR: HTN AND ISCHEMIC HEART DISEASE |
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NADOLOL
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CORGARD
BETA BLOCKER NONSELECTIVE FOR BETA 1 AND 2 LONG HALF LIFE 9- 10 HR AE: BRADYCARDIA AND HEART BLOCK VASOSPATIC ANGINA BRONCHOSPASM LETHARGY DECREASE LIBIDO ACUTE MENTAL DISORDERS MAY INCREASE TRIGLYCERIDES AND DECREASE HDL FOR: HTN AND ISCHEMIC HEART DISEASE |
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TIMOLOL
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BLOCADREN
BETA BLOCKER NONSELECTIVE FOR BETA 1 AND 2 INTERMEDIATE HALF LIFE 3-8 HR AE: BRADYCARDIA AND HEART BLOCK VASOSPATIC ANGINA BRONCHOSPASM LETHARGY DECREASE LIBIDO ACUTE MENTAL DISORDERS MAY INCREASE TRIGLYCERIDES AND DECREASE HDL FOR: HTN AND ISCHEMIC HEART DISEASE |
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PENBUTOLOL
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LEVATOL
BETA BLOCKER NONSELECTIVE FOR BETA 1 AND 2 HAS SOME BETA AGONIST ACTIVITY INTERMED HALF LIFE 3- 8 HR AE: BRADYCARDIA AND HEART BLOCK VASOSPATIC ANGINA BRONCHOSPASM LETHARGY DECREASE LIBIDO ACUTE MENTAL DISORDERS MAY INCREASE TRIGLYCERIDES AND DECREASE HDL FOR: HTN AND ISCHEMIC HEART DISEASE |
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PINDOLOL
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VISKEN
BETA BLOCKER NONSELECTIVE FOR BETA 1 AND 2 HAS SOME BETA AGONIST ACTIVITY INTERMED HALF LIFE 3- 8 HR AE: BRADYCARDIA AND HEART BLOCK VASOSPATIC ANGINA BRONCHOSPASM LETHARGY DECREASE LIBIDO ACUTE MENTAL DISORDERS MAY INCREASE TRIGLYCERIDES AND DECREASE HDL FOR: HTN AND ISCHEMIC HEART DISEASE |
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ATENOLOL
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TENORMIN
BETA BLOCKER SELECTIVE FOR BETA 1 INTERMED HALF LIFE 3- 8 HR AE: BRADYCARDIA AND HEART BLOCK VASOSPATIC ANGINA BRONCHOSPASM LETHARGY DECREASE LIBIDO ACUTE MENTAL DISORDERS MAY INCREASE TRIGLYCERIDES AND DECREASE HDL FOR: HTN AND ISCHEMIC HEART DISEASE |
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BETAXOLOL
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BETOPTIC
BETA BLOCKER SELECTIVE FOR BETA 1 LONG HALF LIFE 9- 10 HR AE: BRADYCARDIA AND HEART BLOCK VASOSPATIC ANGINA BRONCHOSPASM LETHARGY DECREASE LIBIDO ACUTE MENTAL DISORDERS MAY INCREASE TRIGLYCERIDES AND DECREASE HDL FOR: HTN AND ISCHEMIC HEART DISEASE |
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BISOPROLOL
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ZEBTA
BETA BLOCKER SELECTIVE FOR BETA 1 LONG HALF LIFE 9- 10 HR AE: BRADYCARDIA AND HEART BLOCK VASOSPATIC ANGINA BRONCHOSPASM LETHARGY DECREASE LIBIDO ACUTE MENTAL DISORDERS MAY INCREASE TRIGLYCERIDES AND DECREASE HDL FOR: HTN AND ISCHEMIC HEART DISEASE |
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ESMOLOL
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BREVIBLOCK
BETA BLOCKER SELECTIVE FOR BETA 1 VERY SHORT HALF LIFE 1O MINS AE: BRADYCARDIA AND HEART BLOCK VASOSPATIC ANGINA BRONCHOSPASM LETHARGY DECREASE LIBIDO ACUTE MENTAL DISORDERS MAY INCREASE TRIGLYCERIDES AND DECREASE HDL FOR: HTN AND ISCHEMIC HEART DISEASE |
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METOPROLOL
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LOPRESSOR, TOPROL-XL
BETA BLOCKER SELECTIVE FOR BETA 1 INTERMED HALF LIFE 3- 8 HR AE: BRADYCARDIA AND HEART BLOCK VASOSPATIC ANGINA BRONCHOSPASM LETHARGY DECREASE LIBIDO ACUTE MENTAL DISORDERS MAY INCREASE TRIGLYCERIDES AND DECREASE HDL FOR: HTN AND ISCHEMIC HEART DISEASE |
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ACEBUTOLOL
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SECTRAL
BETA BLOCKER SELECTIVE FOR BETA 1 SOME BETA AGONIST ACTIVITY INTERMED HALF LIFE 3- 8 HR AE: BRADYCARDIA AND HEART BLOCK VASOSPATIC ANGINA BRONCHOSPASM LETHARGY DECREASE LIBIDO ACUTE MENTAL DISORDERS MAY INCREASE TRIGLYCERIDES AND DECREASE HDL FOR: HTN AND ISCHEMIC HEART DISEASE |
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PRAZOSIN
TERAZOSIN DOXAZOSIN |
MINIPRESS
ALPHA ANTAGONIST SOA: ARETERIOLES AND VENULES ALPHA 1 SELECTIVE ANTAGONIST PHIRST DOSE PHENOMENON AE: POSTURAL HYPOTENSION DIZZINESS LASSITUDE USED IN COMBINATION WITH BETA BLOCKERS OR DIURETICS |
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HYDRALAZINE
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APRESOLINE
SOA: ARTERIOLES ADMIN: ORAL, IV, IM AE: HYPOTENSION TACHYCARDIA ANGINA HEADACHE FLUSHING USED FOR HYPERTENSION (CHRONIC AND ACUTE) AND CHF |
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MINOXIDIL
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ROGAINE, REGAINE
CHRONIC THERAPY OF HTN INCREASES K+ CHANNEL PERMEABILITY ORAL ADMIN AE: TACHYCARDIA NA+ RETENTION SOA: ARTERIOLES |
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NITROPRUSSIDE
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HYPERTENSIVE EMERGENCIES ACUTE CHF
SOA: ARTERIOLES AND VEINS MOA: INCREASE cGMP ADMIN IV AE: HYPOTENSION CYANIDE AND THIOCYNATE TOXICITY |
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FENOLDOPAM
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CORLOPAM
FOR HTN EMERGENCIES SOA: ARTERIOLES MOA: D1 RECEPTOR AGONIST ADMIN IV AE: HYPOTENSION INCREASE INTRAOCULAR PRESSURE |
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DIAZOXIDE
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DIRECT VASODILATOR
FOR HYPERTENSIVE EMERGENCIES SOA: ARTERIOLES MOA: INCREASE K+ PERMEABILITY ADMIN IV CAUSES HYPOTENSION AND NA+ RETENTION |
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DIHYDROPYRIDINES
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AMLODIPINE, FELODIPINE, NIFEDIPINE
CA2+ CHANNEL BLOCKER SOA: CARDIAC AND SMOOTH MUSCLE CELLS MOA: INHIBIT CA2+ INFLUX AE: HYPOTENSION AND BARDYCARDIA FOR: HYPERTENSION (RELAX SMOOTH MUSCLE), ANGINA PECTORIS (DECREASE MYOCARDIAL O2 CONSUMPTION AND INCREASE O2 SUPPLY), CORONARY ARTERY SPASM ( CORONARY ARTERY VASODILATION) |
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BENZOTHIAZEPINES
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DILTIAZEM (CARDIZEM)
SOA: CARDIAC AND SMOOTH MUSCLE CELLS MOA: INHIBIT CA2+ INFLUX AE: HYPOTENSION AND BRADYCARDIA CI: HYPERTENSION, ANGINA PECTORIS, CORONARY ARTERY SPASM, SUPRAVENTRICULAR ARRHYTHMIAS (DECREASE CONDUCTION VELOCITY) |
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PHENYLALKYLAMINES
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VERAPAMIL (CALAN, ISOPTIN)
SOA: CARDIAC AND SMOOTH MUSCLE CELLS MOA: INHIBIT CA2+ INFLUX AE: HYPOTENSION AND BRADYCARDIA CI: HTN, ANGINA PECTORIS, CORONARY ARTERY SPASM, SUPRAVENTRICULAR ARRHYTHMIAS |
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DETERMINANTS OF MYOCARDIAL SUPPLY
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O2 CONTENT
CORONARY BLOOD FLOW: 1. PERFUSION PRESSURE 2. VASCULAR RESISTANCE A. EXTERNAL COMPRESSION B. INTRINSIC REGULATION 1. LOCAL METABS 2. ENDOTHELIAN FACTOR 3. NEURONAL INNERVATION |
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DETERMINANTS OF MYOCARDIAL DEMAND
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WALL STRESS
HEART RATE CONTRACTILITY |
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REGULATION OF VASCULAR TONE: CONTRACTION
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CA2 ENTERS CELL --> CA 2 BINDS CaM AND INTERFERES WITH MLCK WHICH INTERFERES WITH MYOSIN LC AND ADDS A PHOSPHATE GROUP WHICH WILL BIND ACTIN MYOSIN CROSS BRIDGES AND CONTRACT
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REGULATION OF VASCULAR TONE: RELAXATION
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NITROUS OXIDE BINDS TO GUANYL CYCLASE WHICH BINDS TO GTP MAKING IT cGMP WHICH BINDS TO MYOSIN LC PHOSPHATASE WHICH REMOVES THE PHOSPHATE GROUP FROM MYOSIN LC CAUSING RELAXATION
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NITRATES
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ISOSORBIDE DINITRATE (OR MONONITRATE)
NITROGLYCERIN WORKS FOR 20-40 MINS (IMMEDIATE RELIEF), ISOSORBIDE WORKS FOR 2-4 HOURS SOA: VASCULAR SMOOTH MUSCLE RELEASES ONO2 WHICH BECOMES NO AND THAT LEADS TO RELAXATION AE: TOLERANCE, DO NOT RESPOND TO TREATMENT, HEADACHES CI: STABLE AND UNSTABLE ANGINA, ACUTE MI, HTN, ACUTE AND CHF |
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NITRITES
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AMYL NITRITE, ISOBUTYL NITRITE
RELEASES NO2 WHICH BECOMES NO AND CAUSES SMOOTH MUSCLE RELAXATION AE: TOLERANCE, DO NOT RESPOND, HEADACHES CI: STABLE AND UNSTABLE ANGINA, ACUTE MI, HTN, ACUTE AND CHF |
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CALCIUM CHANNEL BLOCKERS
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"PINE"
SOA: VASCULAR SMOOTH MUSCLE, MYOCARDIUM MOA: BLOCK L TYPE CA2+ CHANNELS AND DECREASE CA2+ INFLUX WHICH RELAXES ARTERIAL VENOUS BRONCHIOLAR AND GI IN CARDIAC MYOCYTES IT WILL DECREASE CONTRACTILITY THE SA NODE PACEMAKER RATE AND THE AV NODE VELOCITY GOES THROUGH FIRST PASS METABOLISM (EXCEPT FELODIPINE AND AMLODIPINE) NIFEDIPINE HAS A RAPID ONSET OF ACTION AMLODIPINE HAS SLOW ONSET BUT HIGH BIOAVAILABILITY AE: FLUSHING (NIFEDIPINE), CONSTIPATION (VERAPAMIL CLINICAL CONTRAINDICATIONS: BETA BLOCKERS W ITH DILTIAZEM OR VERAPAMIL, NOT FOR HEART FAILURE AND NIFEDIPINE INCREASES THE RISK OF MI |
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BETA BLOCKERS
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ACUTE SET OF MI
DECREASE HR BP AND CONTRACTILITY |
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HEART FAILURE
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OCCURS WHEN THE HEART CANNOT PUMP ENOUGH BLOOD AND ACCUMULATES IN THE VEINS
IN SYSTOLIC FAILURE INJECTION FRACTION AND CARDIAC OUTPUT DECREASE AND IN DIASTOLIC ONLY CARDIAC OUTPUT DECREASES |
