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79 Cards in this Set
- Front
- Back
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What sympathetic activation increases heart rate and contractility?
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Beta I
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What do beta II’s do?
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What does Alpha I do?
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vasoconstrict
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Normal BP is systolic less than ________ & diastolic less than ________?
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120mmHg & 80mmHg
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High BP is systolic great than ________ & diastolic greater than ______?
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140mmHg & 90 mmHg
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What type of hypertension has no identifiable cause?
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Primary
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Why is BP control so important?
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High BP will eventually lead to heart disease
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Restriction of what can enhance hypotensive effects of drugs?
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Sodium
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What are the three regulatory systems for BP?
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Sympathetic nervous system, RAAS, Kidney
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BP is elevated via activation of what?
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Beta I
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Baroreceptors in people that have HTN have a high set point. When do the baroreceptors become reset & a lower level?
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When BP is suppressed with drugs over time
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What are 4 ways to deal with RAAS?
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Beta Blockers, ACE inhibitors, Angio II, Adolesterone receptor blockers
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Where do antihypertensive drugs act?
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Brainstem & sympathetic ganglia
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What do terminal of adrenergic nerves decrease?
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Norepinephrine
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Beta 1 adrenergic receptors prevent sympathetic stimulation of the heart & lead to a decrease in what?
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HR & myocardial contractility
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Do Alpha 1 adrenergic receptors lead to dilation of arterioles or veins or both?
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Both all blood vessels
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What are the main therapy for HTN?
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Diuretics
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Thiazide diuretics are commonly used diuretics, what 2 mechanisms do they reduce BP by?
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What are the adverse effects of Thiazide diuretics?
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Hypokalemia, dehydration, hyperglycemia, gout
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Why should Spironolactone not be used with ACE inhibitors & ARB’s?
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enhance s/s of hyperkalemia
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Do Thiazides or Loop Diuretics produce greater diuresis?
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Loop Diuretics
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What are the 2 adverse effects of Loop Diuretics?
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Hypokalemia, hearing loss
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What drugs work on the sympathetic Nervous System?
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Sympatholytics (Antiadrenergic Drugs)
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Do Sympatholytics suppress or increase the Sympathetic NS?
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SUPPRESS the NS of the heart, blood vessels, & other structures
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What are the 5 Sympatholytic sub categories?
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Beta blockers, Alpha1 blockers, alpha/beta blockers, centrally acting alpha 2 agonists, adrenergic neuron blockers
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What do Beta Adrenergic Blockers end in, name a few?
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‘LOL’, Propanolol, Metoprolol
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Blockade of Beta I do what?
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Decrease HR, contractility, & CO
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How do Beta Blockers contribute to CCB?
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Suppress CCB adverse side effect by suppressing reflex tachycardia
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What pts. Should not use beta blockers?
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Pts with asthma (bronchoconstriction), hypoglycemia, Diabetes
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What selective Beta blocker can be used for patients with asthma?
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Metaprolol
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What do Alpha 1 blockers do?
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Prevent arteriole & vein vasoconstriction
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What are the adverse effects of Alpha I blockers?
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Orthostatic hypotension
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Name 2 Alpha/Beta Blockers?
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Labetolol & Carvediol
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Centrally acting Alpha 2 agonists result in vasodilation &?
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Reduced CO
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What happens if Alpha 2 agonists are stopped abruptly?
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Rebound HTN
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What do all Alpha 2 agonists cause as an adverse effect?
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Sedation & dry mouth
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Adrenergic Neuron Blockers inhibit the release of what causing a decrease in sympathetic stimulation?
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Norepinephrine
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What are the adverse effects of adrenergic Neuron blockers?
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Severe orthostatic hypotension
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Name to Direct Acting Vasodilators that promote arteriole dilation?
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Hydralazine, Rogaine
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What is the newest class of antihypertensives, name one?
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Renin Inhibitor (Aliskiren)
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What is Heart Failure characterized by?
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Progressive disorder of ventricular dysfunction, reduced CO, insufficient tissue perfusion & sings of fluid retention
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What are the 2 underlying causes of HF?
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Chronic HTN & MI
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With HF the heart undergoes remodeling: the ventricles dilate called?
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Hypertrophy
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What word describes remodeling?
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Fibrosis
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When the heart fails the heart dilates to compensate, how does this help?
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It Increase venous pressure & reduced contractile force
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How does increased sympathetic tone compensate for HF?
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Increase HR, contractility, decrease CO
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What are the first line drugs for pts experiencing fluid overload from HF?
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Diuretics
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ACE Inhibitors are a good HF tx. because they improve what?
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Functional status & prolong life
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What are the adverse effects of ACE inhibitors?
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Hypotension, hyperkalemia, cough
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What are the Adverse effects of Aldosterone Antagonists?
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Gynecomastia & hyperkalemia
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How do Beta Blockers help tx Heart Failure?
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Decrease work load, filling time
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What are the only 2 BB drugs approved for HF?
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Metaprolol
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What are the three Inotropic Agents?
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Cardiac glycosides (DIG), sympathominetics, phosphodiesterase inhibitors
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Name two Inotropic Sympathominetic (Catecholamines) drugs?
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Dopamine & Dobutamine
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Dopamine is a sympathominetic drug that activates what receptors in the heart?
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Adrenergic receptors
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In high doses Dopamine activate Alpha I adrenergic receptors, in medium doses it?
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Is an inotropic and affects Beta I
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What is the best Inotropic drug?
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Dobutamine
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How does the inotropic drgu Phosphodiesterase inhibitors work?
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Build up of cyclic AMP
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Dig is used in the tx of HF and what other abnormality?
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Dysrhythmias
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What are the three signs of Dig toxicity?
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Yellow hallow lights, n/v, bradycardia
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How does Dig work as an inotropic drug?
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Increases force of ventricular contraction & increases CO by inhibiting ATP
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What does dig do to urine production & rennin release?
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Increase urine (increase CO) & decrease RAAS system (from increased arterial pressure)
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Dig increases contractility & CO strengthening Cardiac contractions, but decreases what?
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HR & AV node conductions (fast dysrythmias)
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When should Dig be held?
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Bradycardia (decreases HR) >2.0 Dig level
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How is Dig reversed?
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What drugs should be used in stage C of HF?
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Diuretics, ACE inhibitors, Beta blockers
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Which would not be good drug choices for someone in stage C of HF?
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CCB (decrease contractility, NSAIDS (increase preload)
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What should total cholesterol be?
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Below 200 mg/dl
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What drugs are best to treat High cholesterol with?
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Statins (Lipitor)
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What should statins not be combined with?
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Fibrate
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What cho reducer has an adverse effect of major flushing & itching?
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Niacin
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Does Niacin reduce LDL or HDL?
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LDL
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Fibrates help increase HDL’s do they decrease LDLs?
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No
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What Cholesterol therapy is used as an adjunctive by blocking dietary cholesterol?
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Zetia
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What are the 2 goals of angina?
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Prevent M infarction & M ischemia
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Name the 3 antianginal drugs used?
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Organic nitrates, beta blockers, CCB
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What is the drug of choice for treating acute anginal attacks?
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Nitrates, acts directly on VSM to promote vasodilation & decreases O2 demand
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Name the t3 adverse effects of Nitroglycerin vasodilator for angina?
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Headache, othro hypo, & reflex tachycardia
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Can Viagra cause life threatening hypotension?
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YES
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