pharm II exam #6

peripheral vascular resistance __ as sodium is depleted from the body when taking diuretics

declines

indapamide MOA

diuretic and vasodilating properties, acts directly on smooth muscles of blood vessels

hydrochlorothiazide adverse effects

- hypokalemia

- hyperglycemia

- hyperuricemia

- hyperlipidemia

metolazone indication

most commonly used to supplement a loop diuretic two or three times per week

methyldopa class

central acting on vasomotor center in the brain

methyldopa contraindication

liver disease

clonidine class

alpha 2 receptor agonist

clonidine adverse effects

- rebound hypertension

- dry mouth

- sedation

- depression

metoprolol class

cardioselective beta blocker

metoprolol indications

- BP

- angina

- improve survival after a heart attack

carvedilol class

blocks beta 1, beta 2, and alpha 1 receptors

propranolol MOA

reduces BP primarily as a result of decreased cardiac output

propranolol indication

- HTN

- performance anxiety

propranolol adverse effects

- bronchospasm

- bradycardia

- depression

- nightmares

- peripheral vasoconstriction

- withdrawal syndrome

pindolol MOA

intrinsic sympathomimetic activity, partial beta-agonist activity

pindolol interactions

antagonized by NSAIDs

DOC for BP control and preeclampsia during pregnancy

labetalol

nebivolol class

B1 selective blocker with vasodilating properties that are not mediated by alpha blockade

prazosin indications

- HTN

- BPH

prazosin adverse effect

first dose syncope

prazosin can also be used to treat

nightmares

minoxidil adverse effects

- reflex tachycardia

- fluid retention

what can minoxidil be used for topically

baldness, hair growth is a side effect for PO use as well

nitroprusside indication

short term rapid reduction of BP

sodium nitroprusside is a powerful ____ vasodilator used for the treatment of ___

parenterally administered, hypertensive emergencies

nitroprusside side effects

accumulation of cyanide with prolonged use

what develops rapidly when hydralazine is used as a monotherapy

tachyphylaxis

hydralazine doses of 400 mg/day or more causes a 10 to 20% incidence of

a syndrome that resembles SLE

lisinopril MOA

inhibits ACE enzyme, decreases angiotensin II

lisinopril contraindications

- ACEi induced angioedema

- pregnancy

lisinopril adverse effects

- cough due to increase in bradykinin

- renal impairment

- angioedema

lisinopril drug interactions

hyperkalemia with K sparing diuretics or K supplements

losartan adverse effects

- hyperkalemia

- cough

- angioedema

aliskiren class

direct renin inhibitor

high BP lifestyle modifications

- used before pharmacotherapy

- healthy body weight

- healthy diet

- exercise

- reduce alcohol intake

- reduce stress

beta blockers should not be used for patients ___ years of age

>60

thiazide diuretics can also be good for

osteoporosis

the most common cause of angina

atherosclerosis of the large coronary vessels

coronary blood flow is directly related to the ____ and the duration of ___

perfusion pressure (aortic diastolic pressure), disatole

coronary blood flow ___ during systole

ceases

the duration of ___ becomes a limiting factor for ____ during tachycardia

diastole, myocardial perfusion

myocardial oxygen demand is determined by

- ventricular wall stress (pressure, radius, thickness)

- heart rate

- contractility

beta blockers have their effect by reducing ____ through reduction of heart rate

myocardial oxygen demand

prototype of nitrate group

nitroglycerin

NTG is volatile and must be stored in

a tightly sealed glass bottle

oral bioavailability of nitroglycerin is only ___ due to ___

10 to 20%, first pass metabolism

nitric oxide causes activation of ___ and an increase in ___

guanylyl cyclase, cyclic GMP

a nitrate free period of ___ should be observed between doses

8 hours

the primary direct result of NTG

- marked relaxation of veins

- increased venous capacitance

- decreased ventricular preload

nitroglycerin adverse effects

- orthostatic hypotension

- tachycardia

- throbbing headache

drug of choice for the prophylaxis of variant (prinzmetal's angina)

calcium channel blockers

the beneficial effect of beta blockers is related primarily to

their hemodynamic effects (decreased HF, BP, and contractility)

what is the principal mechanism in patients with unstable angina with recurrent ischemic episodes at rest

recurrent platelet-rich nonocclusive thrombus formation

pentoxifylline

a xanthine derivative thought to act by reducing the viscosity of blood, allowing it to flow more easily through partially obstructed areas

cilostazol

a PDE3 inhibitors that is poorly understood, but may have selective antiplatelet and vasodilating effects

nondihydropyradine CCB

- don't end in the -ine

- more cardiac depression

- decreased contractility and heart rate