Pharm II (antihypertensives 1b)

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Pharm II (antihypertensives 1b)
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2011-01-17 17:27:08
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Pharm II antihypertensives 1b
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Pharm II (antihypertensives 1b)
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  1. Name the ANGIOTENSIN RECEPTOR BLOCKERS ARB (AT 1 BLOCKERS):
    Losartan, Erbesartan, Candesartan
  2. Name the RENIN INHIBITORS

    How does it work?
    What are the adverse effects?
    Aliskiren



    -Aliskiren inhibits the activity of renin and thus prevents the conversion of angiotensinogen to angiotensin-I

    -angioedema, hyperkalemia and hypotension

  3. Name the beta blockers.

    What are their effects?
    • Atenolol, Propranolol
    • -Decrease in cardiac output
    • -Inhibition of renin release
    • -Inhibition of NE release from presynaptic adrenergic terminals
    • -Reduction of central adrenergic tone
  4. What are the adverse effects of the Beta blockers?
    • Bradycardia, which sometimes presents as coolness
    • of hands and feet in winter.

    worsening of preexisting asthma and other forms of airway obstruction.
  5. Name the Alpha2 recepter blockers

    What do they do?
    What happens when they are Withdrawn abruptly?
    • Clonidine, Methyldopa
    • -REDUCING SYMPATHETIC OUTFLOW FROM CNS
    • -withdrawn abruptly leading to tachycardia, sweating, nausea, tremor,
  6. What is Nimodipine used for?
    subarachnoid hemorrhage
  7. Hydralazine
    What is it? How does it work?
    Is there a reflex?
    What are its adverse effects?
    • Arteriolar vasodilator
    • It releases NO
    • There is a reflex tachycardia

    • Its advese effects:
    • Throbbing headache, palpitations
    • SLE – in slow acetylators
    • Precipitation of angina and myocardial infarction.
  8. What are the uses for Hydralazine?
    • Hypertension
    • Used in hypertension of pregnancy
    • Hypertensive emergencies
  9. Minoxidil

    What is it?
    What happens if used chronically?
    a vasodilator (K channel activator)

    Chronic therapy –excess growth of hair on face, back and arms
  10. What is Sodium Nitroprusside (SNP)?

    How does it work?
    What is its toxicity?
    • -In has potent vasodilating effects in arterioles and venules
    • -Used in acute hypertensive emergency.
    • -sensative to light (becomes metabolized)
    • -Breaks down in circulation and releases NO
    • -When it is metabolized it releases CN-. Which inhibits the Electron transport chain.--> can lead to Lactic acid production.
  11. What do you give in CN posining?
    Concomitant administration of sodium thiosulfate or hydroxocobalamin

    These prevent CN accumulation in patients on Nitroprusside.
  12. Diazoxide
    What is it?
    How does it work?
    What is its toxicity?
    • -it is a long acting arterial dilator.
    • -Used in Hypertensive emergencies.
    • -It acts by opening K channels--> leading to relaxation of the bloodvessels.

    -Toxicity: Excessive Hypotension and hyperglycemia (because it inhibits Insulin release)
  13. What is Fenoldopam?
    How does it work?
    What are the major Toxicities?
    -A drug that is via IV to treat hypertensive crisis.

    -It acts as a selective peripheral dopamine D1 receptor weak partial agonist.

    major toxicities: reflex tachycardia, headache, and flushing.
  14. In diabetes what are C.I and what are IN?

    In Dyslipidemia ?
    In Pregnancy?
    • -Diuretics are CI and Ace inhibitors are IN
    • -Diuretics are CI
    • -Diurectis and Ace Inhibitors are CI
  15. Name the Endothelin receptor antagonists

    What are they?
    Bosentan, Sitaxentan

    (vasoconstrictors)
  16. Name the Phosphodiesterase type 5 inhibitors

    When is it used?
    Sildenafil

    Used in Pulmonary hypertension
  17. Name the Prostacyclin derivatives
    • Epoprostenol (PGI2),
    • Iloprost (PGI2)
  18. What are the DOC fort:
    -uncomplicated HTN?
    -patients with hypertension and diabetes mellitus
    -hypertensive patient with history of CAD.
    -HTN patient with history of bronchial asthma.
    -treatment of HTN in pregnancy.
    • -Diuretics
    • -Ace inhibitors
    • -Beta Blockers
    • -Calcium channel blockers
    • -Methyldopa

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