PHRD6085 Pharmacotherapy Lecture 3 - Antihypertensive Agents

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daynuhmay
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281259
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PHRD6085 Pharmacotherapy Lecture 3 - Antihypertensive Agents
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2014-08-25 04:54:37
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Antihypertensive Agents
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Antihypertensive Agents
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  1. receptors on vascular smooth muscle that promote contraction (3)
    • 1) 1
    • 2) AT1
    • 3) ETA
  2. receptors on vascular SM that promote relaxation (2)
    • 1) 2
    • 2) NP
  3. nerve cell receptor that prevents NE release (leads to dilation of SM)
    1) 2
  4. 2 nerve cell receptors that facilitate NE release (leads to contraction of SM)
    • 1) AT1
    • 2) 2
  5. MOA of vasopeptidase inhibitors
    inhibit angiotensin II formation (or receptor actions)
  6. 3 examples of centrally-active sympatholytic drugs (2 R agonists)
    • 1) clonidine
    • 2) methyldopa
    • 3) monoxidine
  7. advantage of monoxidine over clonidine
    no rebound HTN
  8. MOAs of adrenergic neuron-blocking drugs (2)
    • 1) decrease NE release from sympathetic neurons
    • 2) elicit partial depletion of CCAs
  9. example of adrenergic neuron blocking drug
    reserpine
  10. activation of 1 R in the JGA leads to...
    inc renin secretion -> inc AngII -> aldosterone
  11. -azosin's
    • 1-adrenoceptor antagonists
    • block vasoconstrictor effects of CCAs to dec PVR in aterioles & dec VR in veins
  12. most prevalent initial SE in -azosin's
    orthostatic HTN
  13. -olol's
    • -adrenoceptor antagonists
    • block cardiac effects of CCAs to dec PVR
  14. 2 major SEs of methyldopa
    • 1) hemolytic anemia
    • 2) hepatoxicity
  15. notable SE of reserpine
    mental depression (by depletion of 5HT)
  16. advantage of dihydropyridines over diltiazem/verapamil
    calcium channel antagonist that is selective for arterioles => won't depress the heart
  17. -ipine's
    • calcium-channel antagonists
    • arteriole-selective dihydropyridines
  18. MOA of hydralazine
    relaxes arteriolar SM by NO release & hyperpolarization of vascular SM
  19. notable SEs for hydralazine (2)
    • SLE syndrome
    • secondary tachyphylaxis
  20. MOA of minoxidil
    activates ATP-sensitive K+ channels to hyperpolarize vasc SM, inhibit VOCCs, relax arteriolar SM
  21. notable SEs of minoxidil (2)
    • 1) fluid retention
    • 2) hypertrichosis
  22. -pril's
    • ACE inhibitors
    • inhibit both AngII formation & bradykinin degradation
  23. notable SEs of -pril's (5)
    • 1) dry cough
    • 2) angioedema
    • 3) teratogenic
    • 4) acute renal failure
    • 5) hyperkalemia
  24. -artan's
    AngII receptor antagonists
  25. HTN drug class removed from market due to severity of angioedema
    vasopeptidase inhibitors (-atrilat)
  26. -kiren's
    • renin inhibitors
    • block formation of AngI & AngII
  27. -sentan's
    • endothelin R antagonists
    • block ETreceptor
  28. notable SEs of -sentan's (5)
    • 1) peripheral edema
    • 2) nasal congestion
    • 3) flushing
    • 4) liver injury
    • 5) pregnancy category X
  29. anti-hypertensive drug class in which compensatory fluid-retention does NOT occur
    calcium channel antagonists
  30. common long-term effects of all anti-hypertensive agents
    dec afterload (PVR/SVR)

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