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Pharmacology II Exam 2 (Lauren) > Antihypertensives 🤯 > Flashcards

Antihypertensives 🤯 Flashcards

1
Q

Once you’re on HTN meds, when can you stop taking them

A

Never

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2
Q

What are the 2 effects of diuretics on BP?

A

Decrease CO by decreasing blood volume

Decrease peripheral vascular resistance
(Probably FYI: by decreasing Na content in smooth muslce cells and activating K+ channels, the muscles are less sensitive to vasopressors)

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3
Q

What kind of drugs are clonidine and Methyldopa

A

Centrally acting sympatholytics

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4
Q

Where do clonidine and methyldopa act

A

On the brain

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5
Q

Will we see reflex tachycardia with clonidine or methyldopa?

A

NO! They act on the CV center in the brain!

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6
Q

When do we use methyldopa most

A

Pregancy

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7
Q

What are the adverse effects of clonidine and methyldopa

A

DRY MOUTH

Sedation (and other CNS effects)

Methyldopa can cause hemolytic anemia if they have a positive Coombs test and you give it to them

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8
Q

What is the MOA of clonidine and methyldopa?

A

They stimulate a2 receptors in the brain, which decreases NE release!

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9
Q

If a patient has a positive ________test, you should NOT give Methyldopa

A

Coombs

Will cause hemolytic anemia

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10
Q

Which drugs are the a1 blockers

A

Prazosin

Terazosin

Doxazosin

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11
Q

Who is the ideal patient for a1 blockers

A

Old man with BPH and HTN

Can help with urine flow

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12
Q

Do we see reflex tachycardia with a1 blockers

A

Yes

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13
Q

What class of drug has the first dose phenomonon

A

a1 blockers

Make sure patient takes first dose before bed since postural hypotension will be intense at first

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14
Q

Do a1 blockers affect lipids or glucose?

A

No

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15
Q

Can you use B blockers for vasodilation

A

NO NO NO NONONO a thousand times NOOOOOOOOOOOOOOO

They are NOT direct vasodilators!!!!!!!!!!!!!!

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16
Q

Do you need to know everything about b blockers

A

Yes

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17
Q

What are the HIP drugs and what do they do?

A

Hydralazine**

Isoniazid

Procainamide

They cause drug-induced SLE in slow acetylators

18
Q

What is the MOA of Fenoldopam

A

Is stimulates D1 receptors to relax arteriolar smooth muscle

19
Q

When do we use fenoldopam

A

Emergency hypertensive situations

IV only

20
Q

What is the MOA of Minoxidil?

A

It opens K+ channels to stabilize membranes and dilate ARTERIOLES

21
Q

Minoxidil dilates (arterioles/veins)

A

Arterioles

22
Q

What is an interesting adverse effect of minoxidil

A

Hair growth!

Topical minoxidil= Rogaine

23
Q

Why do vasodilators threaten coronary perfusion?

A

They TANK your diastolic BP, PLUS your HR goes up so there’s less time between beats =less blood flow and less time between beats for heart to get perfused

24
Q

Do ACE inhibitors cause reflex tachycardia?

A

NO!!!!!!! They lower BP but they ALSO reset the baroreceptors so there is no reflex tachycardia

25
Q

Will ACEs and ARBs cause water and sodium retention?

A

No! Becasue they inhibit the angiotensin II activation of aldosterone synthesis

26
Q

Which drug classes should NOT be combined with digoxin due to the risk of causing arrhytmias? Why not?

A

Thiazides and loops.

Cause hypokalemia

27
Q

Can B-blockers cause atherosclerosis?

A

Yes, becasue they increase LDL and reduce glucose tolerance

28
Q

What is the DOC for HTN in type II diabetics

A

ACEs and ARBs

29
Q

Are thiazides good for diabetics

A

NO!!! They have an inhibitory effect on insulin release

30
Q

What is the least preferred drug for people with:
High physical activity

African heritage

Diabetes

Peripheral vascular disease

A

Beta blockers!

31
Q

When do we use Hydralazine?

A

Severe hypertension (last resort drug)

Hypertensive emergencies in pregnancy

32
Q

When do we use sodium nitroprusside?

A

Emergencies ONLY - IV only**

33
Q

Why is sodium nitroprusside only used in emergencies?

A

Rapid onset

Effect disappears in minutes

Metabolized by liver to thiocyanate (cyanide!)**

34
Q

What is a side effect of the dihydropyridine CCBs

A

Gingival hyperplasia 🦷

35
Q

What is the most common side effect of verapamil

A

Constipation

36
Q

What is the DOC for HTN in diabetics

A

ACE/ARB- prevents nephropathy

37
Q

What is the drug of choice for CKD even when they don’t have HTN?

A

ACE/ARB

38
Q

If your patient is showing even the slightest sign of diabetic nephropathy, what drug do you need to give them

A

ACE/ARB

39
Q

What drug class is not ok for patients with bilateral renal artery stenosis?

A

ACE/ARBs

Their GFR is already too low, they need Angiotensin and aldosterone to keep it up.

40
Q

Which drugs can cause hemolytic anemia if the pt has a positve Coombs test

A

Methyldopa

41
Q

What do sympatholytics (other than clonidine and methyldopa) do to Na+ and H2O retention

A

They increase it! Due to activating the baroreflex.

These drugs are best combined with a diuretic

Pharmacology II Exam 2 (Lauren) (9 decks)

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