Pharmacology Exam 1 Flash Cards

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Title: Pharmacology Exam 1
Description: Antihypertensive Agents
Number of Cards: 45
Save Count: 0
Author: tanishaL227
Created: 2012-01-24
Tags: antihypertensives
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    • Question
    • Answer
    • Side 3
    • Definition of hypertension
    • Any prolonged elevation in BP
    • Normal BP
      Stage IV hypertension
    • 120/80
      220/120
    • Stage II hypertension
    • 160/100
    • Stage I hypertension
    • 140/90
    • Stage III hypertension
    • 180/110
    • Effects of hypertension
    • - Generally asymptomatic until stage 4
      - Increased incidence of injury or death due to stroke, MI, aneurysms, and renal failure
    • T/F Hypertensive drugs can cure hypertension
    • False, they just relieve the symptoms
    • 5-10% of cases where there is clearly a defined cause of hypertension
    • Secondary HT
      - i.e. renal disease, pheochromocytoma, drugs(cocaine, amphetamines, oral contraceptives)
    • 90-95% of cases that have no known causes
    • Primary/essential HT
    • Malignant hypertension
    • Prolonged elevation of BP for 6+ months; will cause death.
    • In the past hypertension was treated with ___.
    • Sedatives
    • In the CNS, NE binding to __receptors causes increased sympathetic outflow while NE bind to __receptors causes decreased sympathetic outflow
    • Alpha 1 receptor; alpha 2 receptor
    • Beta 1 receptors in the heart do what?
    • Increase HR and CO
    • Dopamine 1 receptor causes___.
    • Vasodilation
    • NE acting on alpha 1 receptors in blood vessels do what?
    • Cause vasoconstriction
    • What is renin?
    • It turns angiotensinogen into angiotensin I
    • What is ACE?
    • It turns angiotensin I into angiotensin II. It also turns bradykinin to an inactive product.
    • 3 Things that angiotensin II does
    • 1- Causes release of aldosterone
      2- Vasoconstricts
      3- Causes Na+ retention
    • T/F Any drug that can enter the CNS can cause behavioral effects
    • True
    • Alpha-methyl DOPA (Aldomet)
    • Alpha 2 agonist
      - Prodrug the decreases sympathetic output
      - S.E.: depression, drowsiness, dry mouth, dec ejaculation
    • Clonidine (Catapres)
    • Alpha 2 agonist
      - SE: depression, drowsiness, dry mouth, etc. Sudden withdrawal may lead to hypertensive crisis
      - Used in opiate withdrawal, fibromyalgia, insomnia, Tourrettes
    • What do propranolol, reserpine, and alpha-methyl tyrosine have in common?
    • These are agents that have central and peripheral side effects
    • This drug inhibits tyrosine hydroxyls, the rate limiting step in NE synthesis, and it treats pheochromocytoma
    • Alpha-methyl tyrosine
    • Mecamylamine and trimethaphan
    • Drugs that block transmission at the ganglion
      - Totally block nicotinic receptors
      - Cause severe orthostatic hypotension
    • Reserpine
    • - Effects post ganglionic neuron
      - Depletes catecholamines in peripheral and central neurons
      - SE: depression, drowsiness, diarrhea, extrapyramidal effects (like Parkinsonianism)
    • Alpha 1 Blockers
      (OSIN)
    • - Prevents NE from acting on alpha 1 receptors=> inhibits constriction
      - SE: first dose effect, nasal congestion, inc CHF, nightmares
    • Terazosin, tamulosin, alfuzosin, silodosin are all designed to do what?
    • Tx urinary retention in benign prostatic hypertrophy
    • A unique use for alpha 1 blockers
    • Tx post traumatic stress disorder
    • Beta 1 Blockers
      (OLOL)
    • - Prevents compensatory HR when other anti-hypertensives are used
      - Lowers renin secretion=> decreases BP
      - SE: depression, bradycardia w/ fatigue, impotence, B2 effects can worsen asthma
      - Propranolol blocks all beta receptors while the more selective ones have less B2 effects and don't enter CNS
    • Labetalol
    • Blocks alpha1, B1&2 receptors. Can cause dry mouth and orthostatic hypertension.
    • Carvedilol
    • Combined alpha/beta blocker
    • This is a VERY specific beta 1 blocker w/ vasodilator effects
    • Nebivolol
    • Angiotensin receptor antagonists
      (ARTAN)
    • - Produce vasodilation in vessels and inhibit aldosterone secretion
      - SE: similar to ACE inhibitors, fetal toxicity
    • There is "evidence of risk" in category ___ in FDA pregnancy category.
    • Category D
    • Endothelin Blockers (3 SE)
      (ENTAN)
    • - Used for pulmonary HT
      - SE: hepatic toxicity, fetal toxicity, testicular atrophy
      (bosentan, ambrisentan)
    • These 4 drugs act directly on smooth muscle
    • 1- Minoxidil
      2- Hydralazine
      3- Diazoxide
      4- Nitroprusside
    • Minoxidil
    • - Rogaine!
      - Opens K+ channels on smooth m.=> vasodilation
      - SE: edema and pericardial effusion
    • Hydralazine
      (enzyme activator)
    • - Arterial vasodilator
      - Inc cGMP=> relaxation, EXCEPT in coronary arteries
      - SE: can cause lupus-like syndrome especially in slow acetylators, may cause heart attack due to low blood supply
    • Diazoxide
    • - IV, opens K+ channels
      - Dec insulin secretion
    • Nitroprusside
    • - Drug of choice in HT emergencies
      - IV, dilates ALL vessels in seconds
      - SE: nausea, can cause cyanide poisoning
    • Calcium Channel Blockers
      (IPINE)
    • - Block Ca2+ channels=> dec BP
      - Nifedipine, nicardipine, amlodipine
    • This agent activates dopamine 1 receptors and is used for HT emergencies
    • Fenoldopam
    • Angiotensin converting enzyme inhibitors AKA ACE inhibitors
      (PRILS)
    • - Prevents the synthesis of angiotensin II and breakdown of bradykinin
      - SE: rash from the sulfur, dry cough, angioneurotic edema, altered taste, fetal toxicity
    • This agent is a direct renin inhibitor
    • Aliskiren
    • Combined alpha/beta blockers
    • Labetalol, carvedilol, nebivolol