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Definition
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Definition
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Definition
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essential or primary hypertension |
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Definition
90 to 95% of cases where cause is unknown |
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Ethnicity with highest rates of hypertension |
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Definition
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Term
Chronic hypertension can lead to damage of.... |
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Definition
The cardiovascular system
CNS
Renal system
Retinal damage |
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Term
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Definition
-Obesity
-Stress
-Lack of exercise
-Diet (excess salt)
-Alcohol Intake
-Cigarette Smoking |
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Term
percentage of adults with hypertension |
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Definition
50% of people over the age of 60 |
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Term
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Definition
-reduce weight to normal BMI
-DASH eating plan
-Dietary Sodium reduction
-Increase Physical activity
-Reduce alcohol consumption |
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Term
most common drug choice for stage 1 hypertention |
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Definition
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Most common drug choice for Stage 2 hypertension |
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Definition
2 drug combination
-usually Thiazide-type diuretic and either an Ace inhibitor, Angiotensin receptor blocker, Ca channel blocker or a Beta blocker |
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Term
are used to reduce blood volume, which reduces venous return, which reduces stroke volume, which reduces CO, which decreases MAP |
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Definition
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Term
drugs that block myocardial contractility, which decreases SV, then CO, then MAP |
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Definition
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Term
Adverse effect of Diuretics |
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Definition
Due to volume and sodium depletion, renin is secreted which will elevate the BP |
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Term
First choice diuretic for noncomplicated cases |
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Definition
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Term
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Definition
chlorothiazide & hydrochorothiazide |
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Term
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Definition
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Term
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Definition
-loop diuretic
-Has high ceiling
-used to get rid of edema fast |
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Term
potassium sparing diuretics |
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Definition
1. Spironolactone
2.Triamterene
3. Amiloride |
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Term
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Definition
1. Selective Alpha-1 recep blockers (prazosin)
2.Beta-Adrenergic blockers(Propranolol)
3. Agents that act on CNS (methyldopa, clonidine) |
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Term
how do Selective Alpha-1 Antagonists decrease BP? |
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Definition
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Term
Adverse effect of using alpha-1 antagonist |
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Definition
1st dose phenomenon (orthostatic hypotension), fluid retention, dizziness, headache |
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Term
When and how are selective Alpha-1 antagonist used to treat hypertension? |
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Definition
-used in refractory HT
-used in stage 1 and 2 in combination with a diuretic and a beta blocker |
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Term
Selective alpha-1 antagonist |
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Definition
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Term
non-selective beta blocker (1st generation) |
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Definition
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Term
Selective B1 blocker (2nd generation) |
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Definition
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Term
B-blocker with intrinsic sympathomimetric activity (ISA)
3rd generation |
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Definition
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Term
ways that beta blockers lower BP |
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Definition
1. block cardiac beta-1 receptors & lower CO
2. Block renal Beta-1 recepors & lower renin which lowers PVR |
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Term
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Definition
used to treat diabetes and asthma |
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Term
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Definition
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Term
mechanism by which Propanolol works |
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Definition
blocks cardiac B1 to lower co
&
blocks renal B1 to lower renin & PVR |
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Term
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Definition
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Term
Adverse effecct Propranolol |
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Definition
bradycardia, blocks B2 receptors in airways |
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Term
Pharmacokinetics of Propranolol |
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Definition
heavily metabolized by first pass
30 to 50%
t1/2- 3-5 hrs |
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Term
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Definition
Used for stage 1 and stage 2 alone or with a diuretic and/or vasodilator |
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Term
propranolol drug interactions |
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Definition
cant be used with verapamil, diltiazem (Ca channel blockers) or Digitalis b/c they slow A/V node conduction |
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Term
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Definition
A1, B1 and B2 blocker
Beta blocking is more prominent.
some ISA property |
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Term
When and how is Labetalol used? |
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Definition
Used in hypertensive emergencies and can be given both orally or by IV |
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Definition
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Term
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Definition
an A2 agonist that suppresses SNS output from the CNS |
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Term
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Definition
a2 agonist that decreases SNS activity |
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Term
Methyldopa & Clonidine main effects |
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Definition
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Term
Methyldopa & Clonidine Adverse effects |
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Definition
sedation, bradycardia, rebound hypertension, postural hypotension |
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Term
types of vasodilator drugs |
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Definition
1. CA entry blockers
2. Potassium channel openers
3. direct acting vasodilators |
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Term
Names of Ca entry blockers |
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Definition
Verapamil
Diltiazem
Nifedipine |
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Term
Mechanism of action for Ca blockers |
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Definition
inhibit Ca entry through L-type voltage gated channels |
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Term
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Definition
Only blocks vascular Ca channel, no effect on the heart |
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Term
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Definition
vasodilation, which lower PVR, which lower BP |
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Term
Nifedipine (Procardia) adverse effects |
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Definition
ankle edema, reflex tachycardia with short acting version (now have aProcardia SR) |
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Term
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Definition
Hypertension (most effective in african americans)
Not useful as Antiarrhythmic drug |
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Term
Verapamil & Diltiazem Mechanism for action |
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Definition
Block Ca channels in the vascuature and in the heart and A/V node |
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Term
Verapamil & Diltiazem Main effects |
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Definition
Vasodialate which leads to lower BP |
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Term
Verapamil & Diltiazem Adverse effects |
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Definition
ankle edema & others similar to nifedipine, but no reflex tachycardia |
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Term
Verapamil & Diltiazem Drug interactions |
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Definition
caution for AV block when used with beta blockers or digitalis |
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Term
Verapamil & Diltiazem Use |
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Definition
to treat hypertension, angina and arrhythmias |
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Term
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Definition
K channel opener
opens Ca channels on smooth muscle, K leaves cell, cell hyperpolarizes, leads to vasodialation, which lowers PVR, which lower BP |
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Term
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Definition
relex tachycardia, Na and fluid retention |
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Term
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Definition
Vasodilator
-metabolite is NO, which activate cGMP, which vasodialates arteries and veins, which lower PVR, which lowers BP
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Term
Na-Nitroprusside Adverse Effects |
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Definition
Reflex tachycardia, can lead to severe hypotension |
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Term
When is Na-Nitroprusside used? |
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Definition
In hypertensive emergencies
Its very fast acting and has a short half life |
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Term
Drugs that effect RAS (renin Angiotensis system) |
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Definition
ACE inhibitors (captopril)
Angiotensin II receptor blockers (Losartan) |
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Term
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Definition
ACE inhibitor
-inhibits ACE, which decreaces Ang II, which decreaces PVR, which decreaces BP |
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Term
Captopril adverse effects |
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Definition
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Term
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Definition
used in stage 1 and 2 hypertension, Congestive heart failure |
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Term
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Definition
Angiotensin II receptor blocker
-selectively blocks Ang II AT-1 receptor, which decreases PVR, which decreases BP |
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Term
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Definition
some Hyperkalemia as in ACE inhibitors, but no cough |
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