Test Android StudyStack App
Please help StudyStack get a grant! Vote here.
or...
Reset Password Free Sign Up


incorrect cards (0)
correct cards (0)
remaining cards (0)
Save
0:01
To flip the current card, click it or press the Spacebar key.  To move the current card to one of the three colored boxes, click on the box.  You may also press the UP ARROW key to move the card to the Correct box, the DOWN ARROW key to move the card to the Incorrect box, or the RIGHT ARROW key to move the card to the Remaining box.  You may also click on the card displayed in any of the three boxes to bring that card back to the center.

Pass complete!

Correct box contains:
Time elapsed:
Retries:
restart all cards



Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

USMLE - Pharm

Kaplan Section 3 Chapter 3 AntiHypertensive Drugs

QuestionAnswer
Name the 4 strategies to combat HTN with drugs 1. reduce blood volume 2. reduce SANS tone 3. reduce vagal tone 4. relaxation of vascular smooth muscle
What are the 4 determinants of BP? 1. CO - heart rate (not enough vagal tone --> HR too fast), 2. CO - contractility (too much SANS tone, B1), 3. peripheral resistance (too much SANS tone, a1), 4. body fluid volume (edema, too much renin, or too much ANGII --> too much Na and H2O retention
What are the drugs that combat the 4 determinants of BP? 1. CO - heart rate (B blockers, CaCB's), 2. CO - contractility (B blockers), 3. peripheral resistance (anti-adrenergics, CaCB's, direct vasodilators, diuretics), 4. body fluid volume (diuretics, ACEi, ANGII antagonists)
What are the three anti-hypertensives that actually prolong survival? Live longer by ACEing THe Bank. 1. ACEi's, 2. thiazide diuretics, 3. B blockers
Name the sympathoplegics used in antiHTN therapy a2 agonists: a-methyldopa, clonidine; dec NE release: reserpine, guanethidine; a1 blockers: prazosin, doxazosin, terazosin; B blockers - propranolol
Name the direct-acting vasodilators used in anti-HTN therapy. Hydralazine, Nitroprusside, Minoxidil, Diazoxide
Hydralazine activate NO/EDRF pathway --> arteriolar dilation --> dec TPR (esp cerebral, coronary, renal); used in mod to severe HTN.
Side effects of hydralazine headache, flushing, sweating, fluid retention (use diuretic), reflex tachy (use B blocker), if slow acetylator --> SLE-like syndrome
Nitroprusside pro-drug --> sulfonation --> opens K+ channels --> membrane hyperpolarization --> arteriolar vasodilation; inc renin --> renal vasodilator. Used in mod to severe HTN.
Side effects of nitroprusside headache, flushing, sweating, fluid retention (use diuretic), reflex tachy (use B blocker), pulm HTN due to volume shifts, hypertrichosis (excessive hair growth).
Diazoxide K+ channel opening --> arteriolar vasodilation --> reflex tachy, inc CO, inc renin. Used IV for HTN emergencies, used to treat insulinoma (dec insulin secretion), relaxes uterine sm musc.
Side effects of diazoxide fluid retention (use diuretic, but not thiazide), tachy (use B blocker), dec insulin release --> hyperglycemia
What is the difference between captopril and losartan? Captopril = ACEi. Losartan = AT-1 receptor antagonist. Losartan blocks downstream from Captopril so that it avoids affecting bradykinin.
Why should you use ACEi or AT-1 antagonists for diabetics? Both dec vasoconstriction and BP --> dec glomerular efferent resistance --> slow development and progression of nephropathy.
What are the adverse effects of ACEi and AT-1 antagonists? hypotension, hypovolemia, dry cough (with ACEi's), hyperkalemia, acute renal failure (if have renal artery stenosis), angioedema.
What population should avoid ACEi's and AT-1 antagonists? pregnant women. Teratogen --> fetal hypotensio, renal failure, skull and renal malformations.
What is recommended for the initial drug treatment fo mild to moderate HTN? B blocker or thiazide diuretic as DOC's.
If angina and HTN, use what? B blockers, CaCB's
If Diabetes and HTN, use what? ACEi's, AT-1 antagonists
If Heart failure and HTN, use what? ACEi's, AT-1 antagonists
If post-MI and HTN, use what? B blockers
If BPH and HTN, use what? a blockers
If dyslipidemias and HTN, use what? a blockers, CaCB's
Created by: Missy Kratz Missy Kratz on 2008-02-05



Copyright ©2001-2014  StudyStack LLC   All rights reserved.