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44 Cards in this Set
- Front
- Back
What are the beta blockers?
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-olol, propanolol, timolol, neviolol, pindolol, antenolol, labetalol, carvediol, metoprolol, nadaolol
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What is the action of beta blockers?
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decreases output and work on the heart, maintenance therapy in CHF, minimizes symptoms of hyperthyroidism, decreases renin production (decreases blood pressure)
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How does angiotensin 2 promote increase in blood pressure?
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induces increase in aldosterone (increases Na+ and water retention, vasoconstriction, inhibits bradykinin (vasodialation)
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What are side effects of beta blockers?
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fatigue, insomnia, impotence, decreased HDL, increased triglycerides
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What patient population are non-selective beta blockers contraindicated in?
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patients with COPD and asthma
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What are beta one blockers?
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ABEAM--acebutolol, bisoprolol, betaxolol, atenolol, metoprolol
*give to patients with COPD and asthma (no lung effects) |
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What is the MOA of thiazides?
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block sodium uptake in the DCT-->increased Na+ excretion (and water follows)-->decreased blood volume-->decreased cardiac output
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What are the side effects of thiazides?
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hypokalemia, hypercalcemia, hyperuricemia,
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What is the effect of calcium channel blockers?
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vasculature and heart. Nifedipine (vasculature only) verapamil (heart and vasculature)
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What are the side effects of Ca++ channel blockers?
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constipation, vertigo, headache, fatigue and hypotension
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What is the MOA of ACE inhibitors?
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inhibit conversion of angiotensin 1 to 2, thus inhibiting the actions of angiotensin 2 (vasoconstriction, Na+ reabsorption, inhibits bradykinin)
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What are the names of ACE inhibitors?
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PRILS-->capto-pril, lisino-pril, enala-pril
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What are the side effects of ACE inhibitors?
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cough, rash, fever, altered taste, hypotension, hyperkalemia, and angioedema, first dose syncope, fetotoxic
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What is the MOA of alpha blockers and drug names?
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OSINS--praz-osin, teraz-osin
arteriolar vasodialation, decreased peripheral resistance and decreased arterial blood pressure |
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What is the MOA of angiotensin 2 antagonists and the names?
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Losartan, cande-sartan, val-sartan
Block angiotensin 2 receptor-->vasodialationa and decreased aldosterone production |
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How are angiotensin 2 antagonists different from ACE inhibitors?
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ACE-->inhibits ALL production of angiotensin 2
angiotensin 2-->inhibits angiotensin 2, decreases angiotensin 2 production, some is still there |
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What is the MOA of clonidine?
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alpha 2 agonist, depresses sympathetic outflow-->decreases blood pressure by decreasing sympathetic effects on CV system
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What is the MOA of hydralizine?
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smooth muscle relaxant-->vasodialation
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What is the MOA of alpha-methyldopa?
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central alpha 2 agonist
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What does alpha 2 normally do?
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decreases neurotransmitter release from NE, thus if you antagonize you can decrease amt of epinephrine released
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What is the MOA of sodium nitro-prusside?
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vasodialator
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What is the MOA of alpha-methylodpa?
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central alpha 2 agonist
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What is a side effect of minoxidil?
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hair growth (hyper-trichosis)
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Why is nitroprusside dangerous?
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can be poisionous if given orally, hydrolyzes to cyanide
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What is the DASH diet?
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diet rich in potassium, calcium, low in sodium and fat, lots of fruits and veggies
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What is the target blood pressure in someone with artery dz risk (excluding coronary artery dz) ex: stable agina, MI?
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<120/80
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What are the meds recommended for anyone with blood pressure >140/90?
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1. Thiazide
2. Stage 2 HTN BP>160/100 2 drugs + thiazide |
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What is the target blood pressure for someone with high risk for coronary artery dz?
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<130/80
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What are the meds recommended for someone with high risk for coronary artery dz? **Excludes those with kidney dz or diabetics
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1. Thiazides
2. Stage HTN BP >160/100 2 drugs + thiazide 3. Ca++ channel blocker or thiazide |
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What are the meds recommended for someone with high risk for coronary artery dz and has kidney dz or are diabetic?
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1. ACE or ARBs
2. another drug (avoid thiazide) |
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What are the meds recommended for someone with artery dz risk (excluding coronary artery dz) ex: stable agina, MI?
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1. beta blocker + ACE inhibitor or angiotensin 2 antag
2. Ca ++ channel blocker or thiazide **if beta blocker is not tolerated do verapamil or diltiazam (Ca++ channel blockers that work on the heart) |
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What is the blood pressure recommended for people before medication (except those with coronary artery dz or heart problems like angina)?
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<140/90
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What is the target blood pressure for those with CHF?
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<120/80
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What are the meds recommeded for someone with CHF?
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3 drug regimen
1. beta blocker + ACE inhibitor/ACE antag + loop diuretic/thiazide 2. African Americans, add hydralazine or issorbide dinitrate |
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What is the DOC for heart failure?
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Digoxin--increases myocardial contractility, MOA is unknown
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How do we define hypertensive emergency (BP)?
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systolic >210, diastolic >150
**if patient has cerebral hemorrhage or CHF then diastolic >130 |
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What is the treatment for hypertensive emergency?
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sodium nitroprusside, diazoxide, or labetalol
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What is the effect of nitro-prusside?
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vasodialates BOTH arteries and veins, decreases cardiac preload
**if problems, give with sodium thiosulfate IV |
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What is diazoxide?
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direct arterolar vasodialator (similar to hydralazine)
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What are the drugs that are both alpha and beta blockers?
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labetalol and carvediolol
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What are the side effects of alpha blockers?
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reflex tachy and first dose syncope
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Do we use ARBs (Angiotensin 2 receptor blockers, end in -sartan) or ACE-inhibitors for people with respiratory issues?
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**Give ARBs, because bradykinin levels are not increased, no cough associated
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What is the MOA of spironolactone?
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aldosterone antagonist, K+ sparing diuretic
inhibits aldosterone-->inhibits aldosterone mediate N+ and water uptake in the DCT and collecting duct **sodium is not reabsorbed, potassium not exchanged-->don't lose K+ |
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What are the side effects of spironolactone?
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hyperkalemia, metabolic acidosis, hormone related side effects (mentraual irregularities and gynecomastia), structurally similar to sex hormones
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