Htn Pharm 7/6/06

Front 1

in most pts with high BP, there is no obvious cause; this is called?

Back 1

essential HTN

Front 2

pathogenesis of HTN?

Back 2

1) > sympathetic activity
2) Na retention
3) > circulating volume
4) > vasucular rigidity and reactivity
5) > circulating catecholamines
6) > activation of the renin-angiotensin-aldosterone system
7) abnormal baroreceptor responses

Front 3

as a general rule, elective surgery should be delayed if the resting DBP is greater than?

Back 3

110 mm Hg

Front 4

anti-hypertensive medications

Back 4

1) diuretics (thiazide/loop)
2) ACE-inhibitors
3) Ca antagonists
4) direct vasodilator (Hydralazine)
5) beta-blockers
6) alpha 1-receptor antagonist (Prazosin)

Front 5

anti-hypertensive drugs dose should be titrated against the response, because rapid falls in BP can cause?

Back 5

1) reduced cerebral perfusion
2) infarction

Front 6

Tx for severe HTN?

Back 6

1) Lavetalol (Trandate)
2) Hydralazine (Apresoline)
3) Na nitroprusside (SNP, Nitropress)

Front 7

Labetalol blocks?

Back 7

both alpha-1 and beta adrenergic receptors

Front 8

the ratio of alpha: beta activity?

Back 8

1:5

Front 9

Labetalol is used for?

Back 9

1) emergent tx of severe HTN
2) pre-eclampsia
3) to provide hypotension for certain Sx procedures

Front 10

half-life of Labetalol?

Back 10

3-6 hrs

Front 11

Labetalol can cause?

Back 11

hepatic damage

Front 12

Hydralazine (Apresoline) is?

Back 12

1) an arteriolar vasodilator
2) so, reduces SVR

Front 13

Hydralazine cause?

Back 13

reflex tachycardia

Front 14

onset of action?

Back 14

may be up to 20 min.

Front 15

side effects of Hydralazine?

Back 15

1) headache
2) N/V
3) flushing

Front 16

the use of Hydralazine in pts with ischmic heart disease can cause?

Back 16

angina

Front 17

Hydralazine is used for?

Back 17

pre-eclampsia pts to keep the BP below 170/110 mm Hg

Front 18

Sodium Nitroprusside acts directly on?

Back 18

vascular smooth muscle

Front 19

Sodium Nitroprusside causes?

Back 19

both arteriolar and venous dilation

Front 20

What's the difference between Hydralazine and SNP?

Back 20

Hydralazine dilate only artery, but SNP act on both artery and venous

Front 21

similarity on both Hydralazine and SNP?

Back 21

both cause reflex tachycardia

Front 22

SNP: onset and duration?

Back 22

1) very rapid onset
2) duration, only a few min.

Front 23

SNP produce toxicity by production of?

Back 23

cyanide

Front 24

all volatile agents depress?

Back 24

myocardial contractility

Front 25

all volatile agents except for halothane will decrease?

Back 25

SVR
(cause <BP, and reflex tachycardia)

Front 26

halothane anesthesia will cause?

Back 26

1) bradycardia
2) nodal rhythms
(due to vagal stimulation)
3) no change in SVR
4) sensitizes the heart to the arrythmogenic effects of catecholamines

Front 27

high levels of circulating catecholamines can cause?

Back 27

1) V-tac/V-fib
(esp. in the presence of hypercarbia, which can occur in a pt spontaneously breathing halothane)

Front 28

Ether causes?

Back 28

1) sympathetic stimulation
2) catecholamine release
3) vagus nerve blockade
4) > CO, HR, SVR
(BP is well maintained)

Front 29

Thiopental cause a reflex tachycardia mediatied by?

Back 29

the barareceptor reflex

Front 30

Propofol will cause?

Back 30

1) marked fall in BP, SVR, and HR

Front 31

Versed and Valium are associated with?

Back 31

cardiovascular stability
(only high doses will cause CV depression)

Front 32

Etomidate (Amidate) provides?

Back 32

1) the most CV stability
2) has little effect on myocardial O2 balance