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What is the equation for arterial pressure?
Arterial pressure = cardiac output x peripheral resistance
What is peripheral resistance?
How constricted the areteriols are (afterload)
What is the normal amount for stroke volume?
What three things determine stroke volume? How is that related to hypertension?
- Preload - Contractility - Blood Volume
- Reducing the stroke volume will help reduce BP/hypertension. So to do that we can target one of these three areas.
What are the three general ways to reduce hypertension?
Reduce heart rate, reduce stroke volume, or reduce peripheral resistance.
What is the range for prehypertension?
What is the BP range for hypertension?
List 4 general side effects of anti-hypertensive drugs.
- Orthostatic hypotension
- Reflex tachycardia
- Compensatory Na/H2O retention
- Rebound hypertension/hypertensive crisis
Describe reflex tachycardia as a side effect of anti-hypertensive drugs; who would not get it?
The BP has gone down so the body says WTF and pumps harder. People taking sympatholytic drugs, such as metoprolol.
Describe compensatory Na/H2O retention as a side effect of anti-hypertensive drugs.What is a sign of this side effect? Who will not get it?
The BP has gone down so the body says WTF and holds onto Na and H2O. People taking diuretics won't get this.
Describe Rebound hypertension/hypertension crisis as a side effect of anti-hypertensive drugs. Who is most at risk?
If you stop taking the anti-hypertensive drugs abruptly your BP will skyrocket past original levels. Most severe with people taking Metoprolol.
What is a common BP goal for pts with and w/o diabetes or chronic kidney disease?
- With DM or Chronic disease: <140/90
- W/O: <130/80
What is a common BP where you would NOT administer a HTN drug? What about heart rate?
What is the MOA of metoprolol?
b-blocker and supresses the renin-angiotension-aldosterone system?
What conditions are HCTZ associated with?
- 1 Hypo and Tri(3) Hypers
- Hypokalemia b/c it washes away K+
- Hyperglycemia, cholesterolemia, and uricemia
What are two side effects metoprolol?
bradycardia and hypotension
ACE inhibitor prototype?
Lisenopril (lisen to ACE)
ARB prototype? How do you remember what ARBs end in?
Valsartan (Angie R. Barton)
What is the MOA of ACE inhibitors?
- Reduce angiotension II
- reduce aldosterone
- increase bradykinin (vasodilator, opposite of renin/aldosterone)
What are side effects of ACE inhibitors?
Hypotension, Hyperkalemia, fetal injury, angioedema, cough and increase in bradykinin.
How do the side effects of ARB differ fom ACE.
ARBs do not have the hyperkalemia and cough
Prototype Calcium Channel Blocker (CCB), how do you remember it?
- CCBs cause a dip in(e) areteriole calcium
What is the MOA of CCBs?
block calcium in vascular smooth muscle so the areterioles and coronary arteries stay open and the heart can pump against open channels. This increases supply and decreases demand.
What are indications for Nifedipine?
- Angina (makes sense b/c angina is caused by a lack of O2 to the heart muscle, if the coronary arteries are dilated more blood can get to the myocardium) and hypertension.
- Also used for preterm labor to slow down contractions