1. for homeostasis , serum pH just be

    • Use CO2 to remove Acid fro the Lungs
    • Kidney excrete hydrogen in urine to remove acid
  2. Hypertension
    elevation of systemic arterial blood pressure
  3. Stages of BP
    • Normal 119/79 or less
    • Prehypertension 120-139/80-89
    • Stage I 140-159/90-99
    • Stage II 160 or higher/100 or higher
  4. factors that affect BP
    • Blood Volume
    • Peripheral Vascular Resistance
    • Cardiac Output
  5. how does blood volume affect the blood pressure
    total amount of blood in the vascular system

    More blood exerts additional pressure on arteries
  6. how does peripheral vascular resistance affect BP
    friction reduces velocity of blood as it flows through the vascular system

    Arteries have smooth muscles that constrict causing the inner lumen to become smaller, creating resistance and higher pressure
  7. how does Cardiac output affect BP
    • amount of blood pumped per min
    • amount of blood pumped out in a single min (determined by stroke volume and heart rate
  8. what are consequences of HTN
    heart must pump harder to distribute the blood to the organs (which makes the heart muscle get bigger and the heart is less affective)

    • Can cause heart to fail and fluid to back up into the lungs
    • TIA and strokes
    • Decreased blood flow to the kidneys
    • Rupture or occluded vessels in the eyes
  9. how are hypertensives selected?
    based on risk factors, comorbid conditions, degree of blood pressure elevation

    • usually start wih diuretic
    • with stage II or resistant HTN, start combing (this can result in using lower doses of 2 meds and less side effects)
  10. Drugs to treat HTN
    • Diuretics
    • Angiotension-Converting Enzyme Inhibitors
    • Angiotension II Receptor Blockers
    • Calcium Channel Blockers
    • Beta-Adrenergic Antagonists
  11. how do diuretics lower blood pressure
    reduce blood volume by excretion of water and electrolytes
  12. Renin-Angiotension-Aldosterone System
    • renin is secreted when BP drops
    • Renin converts angiotension (produced by liver) to angiotension I
    • angiotension I is converted to angiotension II (very powerful vasoconstrictor) as it passes through the lungs
    • Angiotension II stimulates the secretion of aldosterone which enhances Na+ reabsorption causing the body to retain water and increase blood volume
  13. ACE Inhibitors

    • Benazepril
    • Captopril
    • Enalopril
    • Fosinopril
    • Lisinopril
    • Quinapril
  14. Ace Inhibitor
    Mec of action
    blocks the effects of angiotensin IIL which lowers peripheral vascular resistance and blood volume
  15. ACE Inhibitors

    route of Admin
    • PO
    • IV
  16. Kinetics
    ACE Inhibitors
    Half Lives, onset and duration depend on which drug
  17. Adverse Effects

    ACE Inhibitors
    • Cough
    • Postural Hypotension
    • Hyperkalemia
    • Angioedema
  18. contraindications for ACE Inhibitors
    Pregnancy Category D
  19. Drug Interactions

    ACE Inhibitors
    • antihypertensives
    • K+ sparing diuretic
    • Lithium
    • NSAIDS
  20. overdose
    ACE Inhibitors
    • Hypotension
    • typically responds well to IV fluid
  21. Angiotensin II Receptor Blockers

    • Losartan / Cpzaar
    • Valsartin / Diovan
    • Azilsartin / Edarbi
    • Irbesartan / Avapro
    • Telmisartan / Micardis
    • Olmesartan / Benicar
  22. Mec of Action

    Angiotensin II Receptor Blockers
    blocks receptors in the arteriolar smooth muscle and in the adrenal glands causing blood pressure to fall
  23. Routes of admin

    Angiotensin II Receptor Blockers
  24. Kinetics

    Angiotensin II Receptor Blockers
    depends on the drug
  25. ARB
    Adverse Effects
    • Headache
    • Dizziness
    • Orthostatic hypotension
    • Angioedema

    contraindicated for pregnancy
  26. Tekturna
    prevents formation of angiotensin I&II

    most common adverse effects are diarrhea and flu-like symptoms

    Can be combined with HCTZ, amploipine or valsartan
  27. Calcium channel blocker
    • Amlodipine/Norvasc
    • Felodipine/Plendil
    • Isradipine
    • Nicardipine
    • Nifedipine
    • Diltiazem
    • Verapamil
  28. mec of action for calcium channel blockers
    inhibit Ca from entering the cell and limits muscular contraction (muscle contraction is regulated by amount of Ca+ in cell)

    at low doses, relaxes smooth muscle, some are selective and only relax arterioles, some are nonselective and relax arterioles and cardiac muscle
  29. route of admin
    calcium channel clocker
    • PO
    • IV
  30. calcium channel blocker that only has 1/2 life of 1 minute is
    Clevidipine (cleviprex)
  31. adverse effects
    calcium channel blockers
    • dizziness
    • reflex tachycardia
    • flushing
    • headache
  32. calcium channel blockers

    • Digoxin
    • Antihypertensives
    • Alcohol
    • Grapefruit Juice
  33. beta blockers
    • acebutolol
    • atenolol
    • metoprolol
    • nadolol
    • nebivolol
    • propranolol
  34. beta blockers
    mec of action
    block beta adrenergic receptors to decrease heart rate, contractility and stroke volume

    also used to treat BP, HF, MI, migraines, Dysrythmias
  35. route od admin
    beta blockers
    • PO
    • IV
  36. beta adrenergic blockers
    adverse effects
    • based on inhibition of fight or flight
    • bradycardia
    • fatigue
    • activity intolerance
    • impotence
    • steven johns sybdrome
    • agranulocytosis
  37. Beta Adrenergic Blockers
    • Asthma (can cause bronchospasm)
    • Sinus Brady
    • Heart blocks greater than 1st degree

    interaction with digoxin and Insulin & Hyperglycemics
  38. Overdose of Beta Blockers
    • Seizures, conduction delays, hypotension, bradycardia
    • Glucagon
    • Vasopressors
  39. examples of Beta Adrenergic Blockers
    • Doxazosin
    • Prazaosin
    • Terazosin
  40. vasodilators
    • drdralazine
    • minoxidil

    relaxes vascular smooth muscle

    PO & IV
Card Set
pharm test