How can we help?

You can also find more resources in our Help Center.

87 terms

Anti-Hypertensive Questions

STUDY
PLAY
What is hypertension defined as?
anything >= 140/90
What are the stages of hypertension defined as?
4 stages: +20mmHg systole, +10mmHg Diastole
What is essential hypertension?
dx when no primary cause for BP elevation is identified, +inherited predisposition for development; other contrib factors: high salt intake, excessive weight, emotions, sedentary lifestyle, smoking, alcohol, elevated LDL and VLDL and lower HDL cholesterol
What is secondary hypertension?
Pheochromacytoma, hyperaldosteronism, preeclampsia, renal stenosis
What are the risk of hypertension?
causes atherosclerosis in large, medium and small arteries
In general what do anti-hypertensives do?
decrease BP to result in decreased CO & vascular resistance
What is the first approach to tx hypertension?
non-pharmacological therapy- effective in maj of pt's w/ distolic btw 90-105mmHg, most effective if pt is overweight, uses tobacco prods, has >1 alcoholic drink/day, & is inactive
Diuretic used for hypertensive treatment
Thiazides- Chlorothiazide
MoA of Chlorothiazide
act on kidney to incr NA, H20 excre; decr BV, CO, BP
What do you want to avoid in pharmacological tx of hypertension?
Avoid combos of drugs that act on same site or by similar mechanism, also drugs that produce similar side effects
Uses of chlorothiazide in hypertension tx
monotherapy for Stage 1&2, edema, fluid retention; adjunct to other hypertensives; elderly & black populations (incr plasma renin)
Adverse effects of chlorothiazide
most pt tolerate well; primary complaint is Ms weakness & general feeling of being tired;Na & K loss; K loss directly affect ms's-- muscle cramps, cardiac arrhytmias, Ms weakness
Loop diuretics uses in tx of hypertension
prevent Na loss
K-sparers use in tx of hypertension
prevent K loss
ACEI's used to tx hypertension?
"-pril's" - Captopril
MoA of Captopril
blocks ACE, decr vasc resistance, BP; prevents bradykinins from converting to inactive peptide
Renin-angiotensin system (RAS)
angiotensinogen->AgI (renin from kidney); AgI -> AgII (active component, done by ACE); AgII acts on Ag receptors on VasSmMs (vasoconstriction) & adrenal glands (stim/synth of aldosterone, incr Ca, incr renal absorption of H2O, incr activity of CNS, incr SmMs cell growth
Uses of Captopril in hypertension tx
monotherapy for stages 1,2,3 of hypertension, adjunct w/ thiazide diuretics, Ca channel blockers, or beta-blockers for stage 4
Contraindication of Captopril
Pregnancy, causes renal damage in fetus causing fetal death
Adverse effects of Captopril
Dry cough, kidney problems, 1st dose effect (probs first time but better after)
ARB's used to tx hypertension
"-artan's"- Losartan
MoA of Losartan
blocks AgII binding to AT1 receptor mostly on BV & kidney, decr vasc. Resistance, decr BP; in addt'n blocks break down of bradykinin (causes dry cough)
Contraindication of Losartan
Pregnancy, causes renal damage in fetus causing fetal death
Beta-blockers used to tx hypertension
"-lol's"- Atenolol, Propranolol
MoA of Atenolol & Propranolol
compete for NE or EPI binding site (hypertension, angina, MI, arrhythmias, HF), presynap beta-1 receptor on heart blocked causing decr HR &CO
Adverse effect of Losartan
renal damage to fetus leaded to fetal death, don't use in pregnant Pt
Uses of Atenolol & propranolol in hypertension tx
monotherapy for Stage 1&2, adjunct for later stages
CI of atenolol & propranolol
elderly & black populations
Adverse effects of atenolol & propranolol
myocardial depression b/c muscle receptor on heart tells heart to beat stronger, other: fatigue, tiredness, bradycardia, asthma, incr plasma cholesterol, impotence
Dizziness SE of losartan is a direct result of _________
vessel effects
alpha-blockers used to Tx hypertension
"-osin's"- prazosin
MoA of prazosin
alpha-1 receptor in vessel walls blocked causing incr vasc resistance, decr BP
Uses of prazosin in hypertension tx
monotherapy for stage 1, adjunct w/ diuretics for stage 2
Adverse effects of prazosin
venous pooling-> orthostatic hypertension b/c vessel doesn't provide pressure therefore not enough P to push blood out of microcirculation-> not enough blood to brain; 1st dose effect, edema, nasal stuffiness, delayed ejaculation, tachycardia, dizziness, headache, incontinence
Beta-1 action vs. Alpha-1 action
B1 in heart, A1 in vessel
Ca Channel blocker effects in hypertensive tx
prevents muscle contraction
Vasodilator SEs in hypertensive tx
minoxidil causes a hair growth side effect
Diazoxide uses in hypertensive tx
used for hypertensive emergencies
What is diazoxide?
used in hypertensive emergencies, very potent, selective arterial vasodilator for major arteries, acts by opening K channels, given by IV injectino
CI's of diazoxide?
Angina pectoris, MI, aneurysm, pulmonary edema, diabetics
What is hypertension defined as?
anything >= 140/90
What are the stages of hypertension defined as?
4 stages: +20mmHg systole, +10mmHg Diastole
What is essential hypertension?
dx when no primary cause for BP elevation is identified, +inhereited predisposition for development; other contrib factors: high salt intake, excessive weight, emotions, sedentary lifestyle, smoking, alcohol, elevated LDL and VLDL and lower HDL cholesterol
What is secondary hypertension?
Pheochromacytoma, hyperaldosteronism, preeclampsia, renal stenosis
What are the risk of hypertension?
causes atherosclerosis in large, medium and small arteries
In general what do anti-hypertensives do?
decrease BP to result in decreased CO & vascular resistance
What is the first approach to tx hypertension?
non-pharmacological therapy- effective in maj of pt's w/ distolic btw 90-105mmHg, most effective if pt is overweight, uses tobacco prods, has >1 alcoholic drink/day, & is inactive
Diuretic used for hypertensive treatment
Thiazides- Chlorothiazide
MoA of Chlorothiazide
act on kidney to incr NA, H20 excre; decr BV, CO, BP
What do you want to avoid in pharmacological tx of hypertension?
Avoid combos of drugs that act on same site or by similar mechanism, also drugs that produce similar side effects
Uses of chlorothiazide in hypertension tx
monotherapy for Stage 1&2, edema, fluid retention; adjunct to other hypertensives; elderly & black populations (incr plasma renin)
Adverse effects of chlorothiazide
most pt tolerate well; primary complaint is Ms weakness & general feeling of being tired;Na & K loss; K loss directly affect ms's-- muscle cramps, cardiac arrhytmias, Ms weakness
Loop diuretics uses in tx of hypertension
prevent Na loss
K-sparers use in tx of hypertension
prevent K loss
ACEI's used to tx hypertension?
"-pril's" - Captopril
MoA of Captopril
blocks ACE, decr vasc resistance, BP; prevents bradykinins from converting to inactive peptide
Renin-angiotensin system (RAS)
angiotensinogen->AgI (renin from kidney); AgI -> AgII (active component, done by ACE); AgII acts on Ag receptors on VasSmMs (vasoconstriction) & adrenal glands (stim/synth of aldosterone, incr Ca, incr renal absorption of H2O, incr activity of CNS, incr SmMs cell growth
Uses of Captopril in hypertension tx
monotherapy for stages 1,2,3 of hypertension, adjunct w/ thiazide diuretics, Ca channel blockers, or beta-blockers for stage 4
Contraindication of Captopril
Pregnancy, causes renal damage in fetus causing fetal death
Adverse effects of Captopril
Dry cough, kidney problems, 1st dose effect (probs first time but better after)
ARB's used to tx hypertension
"-artan's"- Losartan
MoA of Losartan
blocks AgII binding to AT1 receptor mostly on BV & kidney, decr vasc. Resistance, decr BP; in addtn blocks break down of bradykinin (causes dry cough)
Contraindication of Losartan
Pregnancy, causes renal damage in fetus causing fetal death
Beta-blockers used to tx hypertension
"-lol's"- Atenolol, Propranolol
MoA of Atenolol & Propranolol
compete for NE or EPI binding site (hypertension, angina, MI, arrhytmias, HF), presynap beta-1 receptor on heart blocked causing decr HR &CO
Adverse effect of Losartan
renal damage to fetus leaded to fetal death, don't use in pregnant Pt
Uses of Atenolol & propranolol in hypertension tx
monotherapy for Stage 1&2, adjunct for later stages
CI of atenolol & propranolol
elderly & black populations
Adverse effects of atenolol & propranolol
myocardial depression b/c muscle receptor on heart tells heart to beat stronger, other: fatigue, tiredness, bradycardia, asthma, incr plasma cholesterol, impotence
Dizziness SE of losartan is a direct result of _________
vessel effects
alpha-blockers used to Tx hypertension
"-osin's"- prazosin
MoA of prazosin
alpha-1 receptor in vessel walls blocked causing incr vasc resistance, decr BP
Uses of prazosin in hypertension tx
monotherapy for stage 1, adjunct w/ diuretics for stage 2
Adverse effects of prazosin
venous pooling-> orthostatic hypertension b/c vessel doesn't provide pressure therefore not enough P to push blood out of microcirculation-> not enough blood to brain; 1st dose effect, edema, nasal stuffiness, delayed ejaculation, tachycardia, dizziness, headache, incontinence
Beta-1 action vs. Alpha-1 action
B1 in heart, A1 in vessel
Ca Channel blocker effects in hypertensive tx
prevents muscle contraction
Vasodilator SEs in hypertensive tx
minoxidil causes a hair growth side effect
Diazoxide uses in hypertensive tx
used for hypertensive emergencies
What is diazoxide?
used in hypertensive emergencies, very potent, selective arterial vasodilator for major arteries, acts by opening K channels, given by IV injectino
CI's of diazoxide?
Angina pectoris, MI, aneurism, pulmonary edema, diabetics
What is hypertension the major cause of?
CVD morbidity, but only 1/4 adequately treated
A reduction in CVD M&M can be achieved through ___________
hypertension control
Impt features of Diuretics for antihypertension
decr blood vol, good for older & black pt's, Adv rxn: hyperlipidemia & K loss
Impt features of ACEI's
decrease vascular resistance; Adv Rxn: renal damage, fetal death
Impt features of ARB's
decrease vascular resistance; Adv Rxn: renal damage, fetal death
Impt features of Beta-blockers
decrease HR & CO; Adv Rxn: myocardial depression
Prototypic beta-blocker for antihypertensives
propranolol