Notes in 11 AntiHypertensive Drugs

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Published	07/30/2024	Renin release is stimulated by:{{c1:: ↓ ::↕}} renal arterial pressure{{c2::Sympathetic::para/sympathetic}} neural stimulation{{c3::↓::↕}} so…
Published	07/30/2024	Angiotensin II effects are primarily mediated by the {{c1::AT1}} receptor
Published	07/30/2024	Angiotensin II stimulates {{c1::aldosterone::hormone}} release
Published	07/30/2024	In the blood vessels, angiotensin II promotes vascular {{c1::constriction}} in the short term (physiologic)vascular {{c2::hypertrophy}} in the lo…
Published	07/30/2024	In the heart, angiotensin II promotes{{c1::positive inotropy }}in the short term (physiologic){{c2::myocardial hypertrophy}} …
Published	07/30/2024	Oral contraceptive pills can induce hypertension because it increases levels of {{c1::angiotensinogen}}
Published	07/30/2024	{{c1::Renin}} converts angiotensinogen into {{c2::angiotensiogen I}}
Published	07/30/2024	{{c1::ACE / angiotensin converting enzyme ::enzyme}} converts Angiotensin I into Angiotensin II
Published	07/30/2024	Angiotensin II promotes heart {{c1::remodeling}}, where the heart pathologically becomes oval/spherical instead of cylindrical
Published	07/30/2024	HypertensionProlonged Angiotensin II stimulates {{c1::NADPH oxidase::enzyme}} which creates ROS that damages organs
Published	07/30/2024	{{c1::Aliskiren}} is the only known renin antagonist
Published	07/30/2024	Uncomplicated HPN Monotherapy DOC: {{c1::ACEi::class}}
Published	07/30/2024	Between ACEIs and ARBs, which one completely blockades the effects of Angiotensin II?{{c1::ARBs}}
Published	07/30/2024	The compelling indications for using ACEIs in hypertension are:{{c1::CKD}}{{c1::High CHD risk}}{{c1::Heart Failure}}{{c1::After MI}}{{c1::Recurrent st…
Published	07/30/2024	An ideal ACEI drug would have high {{c1::lipo}}philicity to better penetrate tissues (L-RAAS)
Published	07/30/2024	The three first generation ACEIs are {{c1::Captopril}}, {{c1::Enalapril}}, and {{c1::Lisinopril}}
Published	07/30/2024	{{c1::Captopril}} is a sulfhydryl-containing ACEI
Published	07/30/2024	{{c1::Fosinopril}} is a phosphorus-containing ACEI
Published	07/30/2024	The most common side effect of ACEIs is {{c1::dry cough}}. This is an indication to switch to {{c2::ARBs}}
Published	07/30/2024	{{c1::1st dose hypotension}} is a notorious side effect of {{c2::1st::1st/2nd}} generation ACEIs
Published	07/30/2024	{{c1::Angioedema}} is a rare, potentially fatal side effect of ACEIs (mostly captopril)
Published	07/30/2024	Angiotensin receptors blockers (ARBs) block the {{c1::AT1}} receptor
Published	07/30/2024	the suffix for ARBs is {{c1::-sartan}}
Published	07/30/2024	ACEIs and ARBs can cause {{c1::hyperkalemia::electrolyte imbalance}} due to decrease in {{c2::aldosterone::hormone}}
Published	07/30/2024	The two mineralcorticoid receptor antagonists (MRAs) are {{c1::spironolactone}} and {{c1::epleronone}}
Published	07/30/2024	Which mineralocorticoid receptor antagonist (MRA) has partial affinity to glucocorticoid and androgen receptors?{{c1::Spironolactone}}
Published	07/30/2024	Which MRA is more specific to mineralocorticoid receptors?{{c1::Eplerenone}}
Published	07/30/2024	The compelling indication for MRAs is  {{c1::congestive heart failure}}
Published	07/30/2024	Adverse effects of potassium sparing diuretics used in hypertension:{{c1::Hyperkalemia}} - inhibits aldosterone{{c2::Gynecomastia, hirsutism}} - inhib…
Published	07/30/2024	Aldosterone promotes hypertension and increases CV risk because it promotes endothelial {{c1::dysfunction}} and stimulates {{c2::ROS}} produ…
Published	07/30/2024	In hypertension, the sodium intake should be no more than {{c1::2,400}} mg per day
Published	07/30/2024	In the RAAS system, {{c1::angiotensin II::hormone}} promotes vasoconstriction{{c1::aldosterone::hormone}} promotes Na and H2O retention
Published	07/30/2024	C-RAAS (circulating RAAS) refers to the traditional RAAS, where components are found in the {{c1::plasma}}
Published	07/30/2024	L-RAAS (tissue RAAS) refers to the RAAS systems localized in the {{c1::tissues}}
Published	07/30/2024	ACE inhibitors reduce peripheral resistance via1. ↓ ATII 2. {{c1::Inhibiting bradykinin breakdown → ↑ bradykinin → ↑ prostaglandin → vasodilation}}
Published	07/30/2024	The two active (non-prodrug) ACEIs are {{c1::captopril}} and {{c1::lisinopril}}
Published	07/30/2024	{{c1::Enalapril}} and {{c1::Lisinopril}} are a dicarboxyl-containing ACEIs
Published	07/30/2024	ARBs and ACEis are contraindicated in two situations: {{c1::bilateral renal artery stenosis}} and {{c1::pregnancy}}
Published	07/30/2024	The compelling indications for ARBs in hypertension are those with:{{c1::heart failure}}{{c1::diabetes mellitus}}{{c1::CKD}}
Published	07/30/2024	Aliskiren is given {{c1::orally::ROA}}, {{c1::once::frequency}} a day
Published	07/30/2024	VASODILATORSMechanisms of Vasodilation: Fall in intracellular calciumDrugs: {{c1::Hydralazine, Ca2+ Channel blockers}}
Published	07/30/2024	VASODILATORSMechanisms of Vasodilation: K+ ATP channel openersDrugs: {{c1::Minoxidil, Diazoxide}}
Published	07/30/2024	VASODILATORSMechanisms of Vasodilation: Release of nitric oxideDrugs: {{c1::Nitroprusside, Nitrates, Nitroglycerin}}
Published	07/30/2024	VASODILATORSMechanisms of Vasodilation: blocking the effect of angiotensin IIDrugs: {{c1::Angiotensin-converting enzyme inhibitors (ACEIs), Angio…
Published	07/30/2024	VASODILATORSMechanisms of Vasodilation: Blocking of alpha 1 receptorsDrugs: {{c1::Prazosin}}
Published	07/30/2024	VASODILATORSMechanisms of Vasodilation: alpha 2 agonism in CNSDrug: {{c1::Methyldopa}}Mechanisms of Vasodilation: alpha 2 agonism in BrainstemDrugs: {…
Published	07/30/2024	VASODILATORSCompensatory Responses of Drug ClassesCompensatory Responses: MinimalDrugs: {{c1::Diuretics (Thiazides, Loop agents), Beta blockers}}
Published	07/30/2024	VASODILATORSCompensatory Responses of Drug ClassesCompensatory Responses: Salt and water retentionDrugs: {{c1::Centrally-acting adrenergic blocke…
Published	07/30/2024	VASODILATORSCompensatory Responses of Drug ClassesCompensatory Responses: Salt and water retention, slight tachycardiaDrugs: {{c1::a-1 selective …
Published	07/30/2024	VASODILATORSCompensatory Responses of Drug ClassesCompensatory Responses: Salt and water retention, moderate tachycardiaDrugs: {{c1::Hydralazine}…
Published	07/30/2024	VASODILATORSCompensatory Responses of Drug ClassesCompensatory Responses: marked salt and water retention, marked tachycardiaDrugs: {{c1::Minoxid…
Published	07/30/2024	VASODILATORSCompensatory Responses of Drug ClassesCompensatory Responses: minor salt and water retentionDrugs: {{c1::Nifedipine, other CCBs}}
Published	07/30/2024	VASODILATORSCompensatory Responses of Drug ClassesCompensatory Responses: salt and water retention, tachycardiaDrugs: {{c1::Fenoldopam}}
Published	07/30/2024	VASODILATORSCompensatory Responses of Drug ClassesCompensatory Responses: very minimalDrugs: {{c1::ACEIs, ARBs, Aliskiren}}
Published	07/30/2024	Direct Acting Vasodilators{{c1::Hydralazine}}PD: pure arteriolar dilatorsIndications: hypertensive urgency, emergency in hypertensive pregnancy (non t…
Published	07/30/2024	K+ ATP CHANNEL OPENERS{{c1::Minoxidil}}PD: renal arteriolar dilatationIndications: severe HTN
Published	07/30/2024	K+ ATP CHANNEL OPENERS{{c1::Diazoxide}}Indications: HTN emergencies
Published	07/30/2024	RELEASERS OF NITRIC OXIDE{{c1::Na+ Nitroprusside}}PK: rapid onset, fast acting, short duration of action -> titratableIndications: HTN emergencies,…
Published	07/30/2024	CCBsRole of Ca2+ channel blockers{{c1::monotherapy/combination drugs for uncomplicated HTN}}HTN with compelling indications: {{c1::high CAD risk, Diab…
Published	07/30/2024	CCBsDihydropyridine (DHP){{c1::vasoselective (artery>cardiac)  }}inhibitory effect: {{c1::vascular smooth muscles > myocardial cells}}…
Published	07/30/2024	CCBs{{c1::Lercanidipine}}CCB with a long clinical half life but a short plasma half lifeDOA depends in how long they stay in tissue
Published	07/30/2024	CCBsNondihydropyridineBenzothiazepineDrug: {{c1::Diltiazem}}Selectivity: {{c1::artery = cardiac}}PhenylalklyamineDrug: {{c2::Verapamil}}Selectivity: {…
Published	07/30/2024	CCBs NDHPVerapamilPhenylalkylamineeffects: {{c1::AV node block, myocardial contractility}}most pronounced cardiac effect{{c1::most inotropic effect}}{…
Published	07/30/2024	CCBs NDHPDiltiazemBenzothiazepinenotable cardiac effect: {{c1::SA node block -> bradyarrhythmias}}selectivity: {{c1::artery = cardiac}}
Published	07/30/2024	CCBsmost common side effect: {{c1::BIPEDAL EDEMA}}
Published	07/30/2024	CCBs blocks {{c1::L-type Ca2+ channels}}
Published	07/30/2024	CCBs inhibition of Ca2+ influx leads to:{{c1::Vasodilation}}{{c1::negative inotropic and chronotropic effect}}{{c1::reduced cardiac output}}
Published	07/30/2024	Drugs that decreases both CO and TPR: {{c1::Diuretics, Nondihydropiridine CCB's}}
Published	07/30/2024	Drugs that acts on Vasomotor Center via alpha 2 agonism: {{c2::Methyldopa, Clonidine, Guanabenz, Guanfacine}}via imidazoline receptors: {{c1::Clo…
Published	07/30/2024	MOA of Diuresis in HTN:  DEC {{c1::renal sodium retention and fluid circulating blood volume}} -> DEC in {{c2::preload}} → DEC {{c3::blood pre…
Published	07/30/2024	Thiazide Diuretics Used as monotherapy drug for {{c2::uncomplicated hypertension}}Combination therapy with {{c1::other antihypertensives (e.g lercanid…
Published	07/30/2024	Adverse Effects of Hydrochlorothiazide {{c1::HyperGLUC (Glucose- Lipid- UA- Cholesterol}}{{c1::HypoMNK (Magnesemia-Natremia-Kalemia)}}   &nb…
Published	07/30/2024	CENTRALLY-ACTING ADRENERGIC BLOCKERS (ALPHA 2) {{c1::α-METHYLDOPA}} {{c1::CLONIDINE}}  PERIPHERAL ADRENERGIC INHIBITORS  {{c2::RESERPINE}} {…
Published	07/30/2024	Centrally-acting adrenergic blocker used in HPN during pregnancy {{c1::α-METHYLDOPA}}
Published	07/30/2024	Why is methyldope not given with B-blockers and CCBs? {{c1::Causes severe bradycardia due to increased parasymphatetic activity}}
Published	07/30/2024	Binds to the imidazoline receptor and synaptic α2 adrenergic receptor agonist (brainstem) {{c1::CLONIDINE}}
Published	07/30/2024	Xerostomia is an adverse effect of what drug? {{c1::CLONIDINE}}
Published	07/30/2024	MOXONIDINE and RILMENIDINE (SIRAs) - {{c2::Vasoselective}} because they act only on the imidazoline receptor that act on {{c1::RVLM (rostral ventrolat…
Published	07/30/2024	Reserpine is an alkaloid derived from {{c1::Rauwolfia serpentina}}
Published	07/30/2024	{{c1::GUANETHIDINE / GUANADREL}} MOA: Acting as false inactive neurotransmitter that is accumulated, stored and released like norepinephrine -> thu…
Published	07/30/2024	Suffix used for:adrenergic blockers β-adrenergic receptor blockers ({{c1::-olol}}) α-adrenergic receptor blockers ({{c2::-zosin}})
Published	07/30/2024	Why are alpha blockers usually given at bed time? Because they cause {{c1::postural hypotension}} (especially at the first dose) due to {{c2::venodila…
Published	07/30/2024	Pharmacologic effects of beta blockers in heart {{c1::DEC inotropy and chronotropy DEC CO; DEC BP INC contractility via cAMP}}
Published	07/30/2024	Other pharmacologic effects of beta 2 adrenergic stimulation {{c1::INC glucagonINC insulin secretion INC glycogenolysis}}
Published	07/30/2024	In ANTI-HYPERTENSIVE MANAGEMENT, we prefer the {{c1::β1-selective drugs}} because we do NOT want the effects of {{c1::β2 blockage}}.   &nbsp…
Published	07/30/2024	In decompensated patients, administration of beta blockers are deferred because of {{c1::severe bradycardia.}}
Published	07/30/2024	If fatigue is noted in patient taking beta blockers for 1 week, what will be your management be? {{c1::Resolution: Decrease the dose}}   &nb…
Published	07/30/2024	CNS effects of beta blockers are attributed to {{c1::lipid solubility}}
Published	07/30/2024	In patients with {{c1::peripheral arterial occlusive disease (PAOD)}}: Beta-blockers will let the alpha receptors predominate, causing vasoconstrictio…
Published	07/30/2024	What are the metabolic disturbances casued by intake of beta blockers? {{c1::↑ Triglycerides ↑ Weight gain ↓ HDL Glucose intolerance}}
Published	07/30/2024	Water-soluble Beta blockers {{c1::Labetalol, Atenolol, Nadolol, and Timolol (LANT)}}
Published	07/30/2024	CLASSIFICATION OF β-BLOCKERS ACCORDING TO RECEPTOR AFFINITY Beta-blockers that produce vasodilation by producing Nitric oxide: {{c1::Nebivolol and Car…
Published	07/30/2024	VERY Short-acting cardioselective drug {{c1::Esmolol}}
Published	07/30/2024	Have additional alpha-blocking properties that decreases total peripheral resistance by vasodilation {{c1::3rd generation vasodilatory Beta blockers}}…
Published	07/30/2024	HPN with compelling indication for BBs {{c1::Heart failure After myocardial infarction (cause of mortality is arrythmia)High coronary heart disease ri…
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