Pharmacology - Midterms Flashcards

It is a sustained, reproducible inc in BP that could lead to cardiovascular problem, renal dse; blindness

It is the most common dse

What are the combination of several abnormalities that causes HTN?

What kind of HTN when Pt in whom no specific cause of HTN?

What are the specific causes of HTN?

normal control of BP - short term

normal control of BP - long term

possible mechanism in essential hypertension

<12 mm systolic; <80 mmHg diastolic

120-129 systolic; <80 mmHg diastolic

130 - 139 systolic or 80-89 mmHg

> 140 systolic; > 90 mmHg diastolic

6 Major Categories of Drugs for HTN

It decreases the plasma fluid volume @ kidneys

It decreases sympathetic influence on: heart &/or peripheral vasculature @ various sites w/in sympathetic division of ANS?

It lower vasuclar resistance by directly vasodilating @ peripheral vessels?

These are ACE inhibitory - prevents conversion of nagiotensin I to angiotensin II receptor blockers.

These dec vascular smooth-mm cxn, dec myocardial force; rate of cxn

MOA: inc formation and excretion fo renal, and inc renal excretion of water; sodium; dec fluid volume lowers blood pressure

what are the 3 classification of diuretics?

It act primarily on early portion of DCT of nephron; inhibit sodium reabsorption

it act primarily on ascending limb of loob of Henle, which inhibits reabsorption of sodium; chloride thus prevents reabsorption of water

this prevents secretion into the distal tubule

diuretic drugs used to treat HTN

loop diuretics for HTN

potassium-sparring diuretics

what are the adverse effect of diuretics?

it is the increase in sympathetic activity may be an underlying factor in essential htn, can be classified according to where and how they interrupt sympathetic activity

it is the mainstay in treatment of HTN, well tolerated by most pt, incidence of side effects are low

this exerts primary effect on heart; dec HR; force of myocardia cxn; general dec sympathetic tone

often complement effects of other anti-HTN

what are the 4 theories of beta blocker - sympatholytic drugs?

specific agents of beta blockers - sympatholytic drugs

beta blockers - selective for beta 1 receptors (cardioselective)

beta blocker - which are partial agonists, intrinsic sympathomimetic activity

beta blocker - which are membrane stabilizing activity

beta blocker - which are peripheral vasodilator and cardiac beta blockade

what are the adverse effects of beta blocker - sympatholytic drugs

this blocks alpha 1 adrenergic receptor on vascular smooth mm, ability to improve blood lipid profiles and produce favorable effect on glucose metabolism; insulin resistance

indication for mild to moderate HTN, which acts directly to tissues - mediate inc BP, peripheral vasculature

can also be used to treat the symptoms of
benign prostatic hypertrophy as they
decrease sympathetic-mediated
contraction of smooth muscle located in
the prostate gland

specific agents: alpha blockers - sympatholytic drugs

what are the adverse effects of alpha blocker - sympatholytic drugs

this is an adverse effect of alpha blocker when peripheral vascular resistance
falls d/t the effects of these drugs,
the baroreceptor reflex often responds
by generating a compensatory
inc in HR

this is an adverse effect of alpha blocker wherein blockade of alpha-1 receptors in
peripheral arteries and veins often
promotes pooling of blood in the LE
when a patient stands up

this are drugs that inhibit release of norepinephrine from presynaptic
terminals of peripheral adrenergic neurons
may be used effectively in some individuals
with hypertension

MOA: : prevent normal physiologic release of
norepinephrine from postganglionic
sympathetic neurons

what are the specific agents of presynaptic adrenergic inhibitors?

This only drug in presynaptic adrenergic inhibitors that is still
used commonly in the United States
to treat hypertensio

adverse effects of presynaptic adrenergic inhibitors

this drug inhibit sympathetic discharge from
brainstem which are similar to alpha 2 agonists; decrease sympathetic outflow

specific agents of centrally acting

adverse effect of centrally acting agents

these are drugs that block synaptic transmission @autonomic ganglia will dramatically; effectively reduce BP by
dec systemic sympathetic activity

essentially nicotinic cholinergic
antagonists, w/c block transmission @the
junction between presynaptic and
postsynaptic neurons in sympathetic and
parasympathetic pathways

most of such drugs are no longer
available clinically because of intolerable
toxicities related to their primary action

MOA:
1. block synaptic transmission at autonomic
ganglia
2. decrease sympathetic activity
3. nicotinic cholinergic antagonists - between
pre and postsynaptic neurons of both
divisions

what is the indication of ganglionic blockers?

what are the specific agents of ganglionic blockers?

what are the adverse effect of ganglionic blockers?

these are drugs that directly vasodilate the
peripheral vasculature will produce an
antihypertensive effect by decreasing
peripheral vascular resistance

these drugs exerts inhibitory effect: vascular smooth-mm cells, inhibit smooth mm cxn by inc intracellular production of 2nd messengers and also inc amounts of cGMP, inhibit fxn of contractile process in vascular smooth-mm cell - leading to vasodilation

MOA:
1. vasodilates peripheral vasculature
2. inhibits smooth muscle contraction due to
increased 2nd messengers (cyclic GMP)

specific agents of vasodilators

adverse effect of vasodilators

this is an adverse effect of vasodilators whi often occurs because the baroreceptor
reflex attempts to compensate for the
fall in vascular resistance that these
drugs produce

involves several endogenous components
that help regulate vascular tone an
regulate sodium and water balance in the
body

an enzyme produced primarily in the
kidneys; when blood pressure falls, renin
is released from the kidneys into the
systemic circulation

a peptide that is produced by the liver and
circulates continually in the bloodstream

MOA: inhibits enzyme that converts
angiotensin 1 to angiotensin 2
(renin-angiotensin system)

it is an indication of mild to moderate HTN; used alone of in combination

what are the advantages of angiotensin converting enzyme inhibitors?

specific agents of angiotensin converting enzyme inhibitors?

what are the adverse effect of angiotensin converting enzyme inhibitors

these are drugs recognized as being beneficial in the treatment of essential HTN where calcium appears to play a role in activating the contractile element in
smooth muscle

MOA:

1. Blocks calcium entry into vascular
smooth muscle cell
2. Decreased vascular resistance
3. Tends to decrease HR and myocardial
contractile force

specific agents of calcium channel blockers

Adverse Effects of calcium channel blockers