+
Related Flashcards
Related Topics
Cards In This Set
| Front | Back |
|
Hypertension
|
Common, asymptomatic disorder wherein bp exceeds 140/90 mm Hg- Major risk factor for coronary artery dis, cardiovascular dis, renal failure & peripheral vascular disease- Impt risk factor for stroke & heart failure
|
|
If BP goes UP
|
The kidney will expel excess Na fr the body (if kidney is not wrkg well, Na will be retained & BP will rise up)
|
|
If BP goes DOWN,
|
The kidney releases RENIN w/c triggers release of ANGIOTENSIN w/c will constrict blood vessels & will stimulate adrnl crtex to release ALDOSTERONE to retain Na & H2O in the body and increase BP
|
|
DIURETICS (Water Pills)
|
-1st line hypertension treatment in JNC7 guidelines- Helps kidney remove salt & H2o from the body. So less volume circulating in the vessels leads to lower BP- Decreases plasma & extracellular fluid volume ~ decreased preload, decreased cardiac output & total peripheral resistance, decreased heart workload.
|
|
Thiazide Diuretics (Hydro-chloro-thiazide)
|
The most commonly used diuretics for hypertension.
|
|
BETA BLOCKERS (peripheral adrenergic drugs ending in 'lol')
|
- Make heartbeat slow down by blocking adrenaline (bioname for epi)- Reduces secretion of RENIN (therefore, no AII for vasoconstrctn & no aldos for urine retentn/vol expnsion)
- Reduces Peri vasc resistance- Keep heart from pumping hard- Make the blood go thru the vessel w/ less force... so pressure inside the vessel goes down. |
|
ALPHA 1 BLOCKERS (peripheral acting adrenergic drug ending in "sin")
[***note: alpha1 receptors stimulate release of norepinephrine w/c produces high BP] |
- Make blood vessels relaxed by reducing the tightening of the nerve impulse..... Making BP lower.- Dilates arteries & veins- Reduces peripheral vascular resistance, so BP goes down- Decreases SVR & PVP (pulmo venous pressure) & increases cardiac output- Increases urinary flow rates by preventing smooth muscle contraction in the bladder & urethra.
|
|
Examples of Alpha1 Blocker Drugs (peripheral adrenergic) "SIN"
|
- Cardura (DoxazoSIN) - most used- Hytrin (TerazoSIN)- Minipress (PrazoSIN)*Tamsulosin (Flomax) - only for BPH [benign prostatic hyperplasia], not BP
|
|
DUAL ACTION ALPHA1 Blockers & BETA Blockers (peripheral adrenergic)
|
- Alpha 1 blckr for vasodilation- Beta blckr for reduction of heart rate
|
|
Examples of Beta Blocker drugs (peripheral) "LOL"
|
PropanololAtenololNebivolol (Bystolic) [O: 20-120mins / P: 1-4 h / HL: 6-8h / D: 8-24h)
|
|
Examples of Dual Alpha1 lckr & Beta Blckr drugs (peripheral adrenergic drugs - also ending in "lol")
|
LabetalolCarvedilol (Coreg) - also adjunct with diuretics, digoxin (for heart failure)
|
|
ALPHA2 AGONIST (centrally acting adrenergic drug) - not 1st hand drug
|
- Reduces sympathetic outflow by reducing norepinephrine production resulting to reduced BP- affects kidney by reducing RENIN ACTIVITY (vasoconstriction)
|
|
Ex of Alpha2 agonist (centrally acting adrenergic drug)
|
- Clonitidine - most used; also for mgmt of opioid w/drawal- Methyldopa
|
|
ADRENERGIC DRUG CATEGORIES
|
Centrally acting - Alpha2 agonistPeripheral acting - Alpha1 Blocker / AntGonist - Beta Blocker - Dual acting Alpha1 & Beta Blocker
|
|
Contraindications for Adrenergic Drugs - Alpha1 Blokr - Beta Blokr - Alpha2 Agonist - Alpha1 & Beta Blokrs
|
- drug allergy- acute heart failure- concurrent use of MAOI- severe mental depression- peptic ulcer- colitis- severe liver/kidney disease- asthma (pt tkng non-cardio beta blkr, Carvedilol)- heart failure 2ndary to diastolic dysfnctn
|
