unit 3 pt 1

preload

volume of blood in ventricles at end of diastole

afterload

amount of resistance left ventricle must overcome to circulate blood

blood pressure

amount of force exerted on the arterial walls

stroke volume

amount of blood circulated with each beat

cardiac output

amount of blood ejected from the ventricle

what is the equation for blood pressure?

CO x SVR

what is the equation for cardiac output?

SV x HR

Hypertension

generally refers to a persistent elevation of blood pressure

what is the blood pressure level that is considered hypertension?

greater than or equal to 140/90

essential HTN (idiopathic or primary)

unknown direct cause

secondary HTN

liked to another problem

RAAS

renin angiotensin aldosterone system

why is the RAAS system important in someone with hypertension?

someone with HTN will cause ischemia, triggering the RAAS system

what is hypertension a risk factor for?

coronary artery disease, cardiovascular disease, stroke, heart failure, and peripheral vascular disease

what are some modifiable risk factors for HTN?

smoking, obesity, physical inactivity, and diet

what are some manageable, modifiable risk factors of HTN?

DM and dyslipidemia

what are some non-modifiable risk factors for HTN?

age, gender, and genetic predisposition

what are some target organs that are affected by HTN?

heart, brain, kidneys, eyes, and the circulatory system

what are the ABCDE’s of antihypertensive therapy?

ACE-I, ARBs, Beta blockers, Calcium Channel blockers, Diuretics, and Extras

What are the A's of antihypertensive therapy?

ACE-I (angiotensin converting enzyme inhibitors) and ARB’s (angiotensin II receptor blockers)

What is the B of antihypertensive therapy?

Beta blockers (beta-adrenergic blockers)

what is the C for antihypertensive therapy?

caclium channel blockers

what is the D for antihypertensive therapy?

Diuretics

what are the 5 extra classes of antihypertensive therapy?

alpha 1 antagonists, alpha/beta receptor blockers, alpha 2 adenergic agonists, direct vasodilators, and renin inhibitors

what are the 5 types of diuretics?

loop, potassium-paring/aldosterone inhibiting, thiazide/thiazide-like, osmotic, and carbonic anhydrase inhibitors,

ACE-I

angiotensin converting enzyme inhibitors

ARB

angiotensin II receptor blockers

CCB

calcium channel blocker

what is the suffix for ace inhibitors?

“-prils”

what is the suffix for ARB’s?

“-sartans”

what is the suffix for beta blockers?

“-olols”

What is the acronym for pneumonic prototype drugs

Very Nice Antihypertensive Drugs (Verapamil, Nifedipine, Amlodipine, Diltiazem)

what is the mechanism of action for ace inhibitors?

blocks the angiotensin converting enzyme

what is the mechanism of action for ARB’s?

Blocks the binding of angiotensin II to its receptors

what is the mechanism of action for beta blockers?

binds to, and blocks β₁ and β₂ receptors

Where are β₁ receptors?

the surface of the heart

Where are β₂ receptors?

on smooth muscle of the bronchioles

which antihypertensive therapies are used for renal protection?

ace inhibitors and ARBs

what is the mechanism of action of “cardioselective” beta blockers?

Bind to, and block β₁ receptors in the heart’s electrical conduction system

What is the pharmacokinetic effect of “cardioselective” beta blockers?

decreases HR

What is a chronotrope?

Anything that affects the heart rate through the electrical conduction system

what is a negative chronotrope?

a medication that decreases the HR by affecting the SA node

what is an inotrope?

anything that effects the force of contractility of the heart

what is a negative inotrope?

a medication that decreases the myocardial contractility of the heart

what is the mechanism of action of “nonselective” beta blockers?

Bind to, and block β₁ and β₂ receptors

What is the pharmacodynamic effect of “nonselective” beta blockers?

which antihypertensive therapies have a contraindication for hyperkalemia?

ace inhibitors, ARBs, and potassium-sparing/aldosterone inhibiting

What medication has has a high risk factor for angioedema in African Americans?

ACE-I

What is the most common side effect for ACE-I’s?

dry, non-productive cough

What is the most common side effect for ARB’s?

headache and upper respiratory infection