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dpt 542 exam 02 study guide

dpt 542 exam 02 study guide - DPT 542 Pharmacology Exam 2...

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DPT 542 – Pharmacology Exam 2 Part 8A – Antihypertensve Medications What do diuretics (“water pills”) do? A diuretic acts on the kidneys by increasing excretion of sodium and water, thus decreasing the total amount of fluid in the vascular system. Decreases pressure on arterial system; this may lower blood pressure and consequently decrease the work load on the heart Indications : hypertension and congestive heart failure Examples : thiazides, loop diuretics, and potassium sparing agents (keep potassium in the body system so that it is not lost with the sodium and the water) What are the adverse effects of diuretics? Adverse effects of diuretics include: o Excretes too much sodium and other electrolytes (fluid depletion and loss of fluid) o Orthostatic hypotension o Weakness o Fatigue o Confusion o (general symptoms of dehydration) What does a beta blocker do, and when is it indicated? A beta blocker binds to the heart and blocks the effects of endogenous catecholamines (epinephrine and norepinephrine AKA adrenaline and noradrenaline) o Because it is very difficult to control the release of these chemicals into the body, we instead prevent them from over stimulating the heart once they are released o This decreases heart rate, contraction force, and overall cardiac output. o Can also decrease blood pressure Indications : high blood pressure, arrythmeas, angina, heart failure, recovery from myocardial infarction (MI) What is the difference between cardioselective and nonselective drugs? Cardioselective – more preferential for beta I subtype (predominantly on heart) than beta II (predominantly on lungs) o Will preferentially bind to the heart o Examples: Atenolol and Metoprolol Nonselective – bind equally to beta I and beta II subtypes o Examples: pindolol and proprandolol o Nonselective drugs are still very effective at what they do as long as lungs are still healthy What are the adverse effects of Beta Blockers? Bronchoconstriction (especially if the patient already has asthma, emphysema, or bronchitis) Decreased maximal exercise capacity o Since the heart is slowed down by the medicine, we don’t want to overexert it
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o Lowers maximal heart rate about 20-30 bpm from what the person would have achieved without the beta blocker o People can still get a cardiac training effect while on a beta blocker Orthostatic hypotension (dizzy if they stand up suddenly) Psychotropic effects, especially in older men (depression, lethargy) What do vasodilators do, and what are some of the adverse effects? Directly inhibit smooth muscle contraction in the vascular smooth muscle Indications : high blood pressure, heart failure Examples : minoxidil (Loniten) – also causes hair growth Adverse effects: o Reflex tachycardia – an increase in heart rate to try to bring blood pressure back up o Postural or orthostatic hypotension o Dizziness o Headaches o Edema and fluid retention How does the renin-angiotensin system work?
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