antihypertensives and renal agents

  1. Arteries
    • Vessels which transport oxygenated blood to arterioles:
    • thick walled, elastic
    • mostly smooth muscle
    • sympathetic stimulation causes vasoconstriction
  2. Veins
    • Return unoxygenated blood to heart
    • Thin walled, stretch
    • Relies on skeletal muscle contraction and pressure changes
    • Low pressure
    • One way valves peripherally
  3. Capillaries
    • Join arterioles and veins
    • Carbon dioxide and oxygen exchange
    • nutrition and waste eschange
  4. Blood Pressue Maintenance
    • Pressure exerted on artery wall
    • determined by:
    • Blood volume
    • Cardiac output
    • Arterial distensibility
    • Peripheral vascular resistance
  5. Blood Pressure
    • Maintained by:
    • Renin-angiotensin system
    • Andreneric recptors in the vessel wall
    • Baroreceptors in the vessel wall
    • Baroreceptors in the carotid sinus, aorta, and medulla
  6. Renin (kidney) + angiotensinogen (liver) =
    Angiotensin I
  7. Angiotensin I + Angiotensin Converting Enzyme (ACE) =
    Angiotensin II
  8. What are Baroreceptors
    • Pressure sensitive nerve endings which decrease Bp in response to stretching
    • Aorta
    • Carotid Sinus
    • Medulla
  9. Adrenergic receptors do what to Bp?
    • Alpha1-raise Bp
    • Alpha2-lower Bp
    • Beta1-raise Bp
    • Beta2-lower Bp
  10. Cause of elevated Bp
  11. Hypertension:
    Most common, no identifiable cause, no cure.
  12. Hypertension:
    Due to another condition (chronic renal disease, adrenal tumor, oral contraception, conditions causeng fluid retention (edema) Can be cured with removal of problem
  13. Untreated HTN
    Causes damage to vessels
  14. Complications of hypertension
    • Arteriole constriction increases peripheral vascular resistance wich increaces workload of left ventricle then left ventricular hypertrophy which leads to heart failure
    • Sclerosis of vessels which narrows lumen which lowers blood flow that lowers tissue perfusion and possibly thrombosis.
    • Usually occurs without symptoms
  15. Blood pressure maintenance
    • Diet low in fats and carbohydrates
    • Limit alcohol
    • Weight loss if obese
    • African-Americane have higher risk for HTN
  16. What is Edema
    • Accumulation of fluid in body tissues
    • Fluid retention- accumulation of fluids due to heart and or kidney failure of liver disease
    • Hypertension- increased Bp may be due to accumulation of fluids in the vascular system
    • i.e. Increased fluid volume
  17. 7 Medications for HTN
    • Beta blockers
    • Adrenergic blockers
    • Direct acting vasodilators
    • Angiotensin II Converting Enzyme inhibitors (ACE inhibitors)
    • Angiotensin II Receptor Antagonists
    • Calcium channel blockers
    • Diuretics
  18. Use of beta blockers
    • Angina
    • dysrhythmias
    • HTN
  19. Action of beta blockers
    To block beta 1 which lowers sympathetic response which lowers CO, vascular resistance, and renin
  20. Common beta blocker drugs
    • atenolol (Tenormin)
    • metoprolol(LoPressor)
    • propranolol(Inderol)
  21. Adrenergic blockers are used for ?
    To treat HTN
  22. Action of Adrenergic blockers
    to block alpha receptors in the sympathetic NS causing vasodilation and lower Bp
  23. Common Adrenergic blocker drugs
    • prazosin(Minipress)
    • methydopa(Aldomet)
    • clonidine(Catapres)
    • labetalol(Trandate)
  24. Use of direct acting vasodilators
    To treat moderate to severe HTN
  25. Action of direct acting vasodilators
    Relax smooth muscle of blood vessels leading to vasodilation
  26. Common of direct acting vasodilators drugs
    • hydralazine(Apresoline)
    • minoxidil(Rogain)
    • nitroprusside(Nipride)
  27. Angiotensin converting enzyme (ACE) inhibitors are used for ?
    Treatment of HTN and CHF
  28. Action of ACE inhibitors
    Inhibit formation of angiotensin II and block release of aldosterone causing Na and water excretion and lower peripheral resistance
  29. Common ACE inhibitor drugs
    • benazepril (Lotension)
    • lisinopril (Zestril)
    • catopril (Capoten)
Card Set
antihypertensives and renal agents