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34 Cards in this Set
- Front
- Back
what drugs work at each site?
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plug in the peripheral adrenergic drugs
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plug in the chemical and enzyme
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plug in site of action
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plug in drugs
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what diuretics work here?
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what is normal, pre, stage 1, and stage 2 hypertension BP's?
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normal-<120/<80
pre-120-139/80-89 stage1-140-159/80-89 stage2->160/>100 |
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what is first line treatment for hypertension?
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thiazide diuretics
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what is the rate limiting step in catecholamine synthesis?
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tyrosine conversion to dopa by tyrosine hydroxylases
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what 2 substances breakdown catecholamines?
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MAO and COMT
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what is the site of action of centrally acting sympatholytics?
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a2 receptors of the vasomotor center
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3 drugs acting on a2 receptors
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clonidine, guanabenz, guanfacine
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prodrug that acts on a2 receptor
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a-methyldopa
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active form of a-methyldopa
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a-methylnorepinephrine
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intracerebroventricular injection of a2 agonists cause BP to go higher or lower?
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lower
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sedation, vertigo, and lactation in men are side effects of what class of drugs?
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centrally acting sympatholytics
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what type of drug would block the effect of clonidine and guanethadine?
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tricyclic antidepressants
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what is the MOA of reserpine?
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blocks repackaging of NE, dopamine, seratonin taken up into cell causing eventual depletion of NE, dopamine, seratonin stores
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what is the MOA of guanethadine?
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displaces NE from vesicle, prevents release by anesthetic-like effect, causes eventual depletion of NE stores
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what does vesicular depletion of transmitter stores do to post synaptic receptors?
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causes upregulation, supersensitivity of receptors
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caution should be taken when using OTC cold medicines while taking guanethadine because...
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sympathomimmetics in cold medicines can cause hypertensive crisis
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guanethadine is used in pheocromocytoma pts but can cause what?
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hypertensive crisis by release of lg stores of NE in tumor
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what were the problems with the first a blockers?
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blocked both a1 and a2 and caused tachycardia and tolerance to antihypertensive effects
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what is the major difference between phentolamine and phenoxybenzamine?
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phenoxybenzamine is irreversible
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which 2 a1 blockers have significant first pass effect?
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prazosin and terazosin
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which 4 B blockers have ISA?
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acebutolol, carteolol, pindolol, penbutolol
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what is the most selective B1 antagonist also thought to have B2 agonist properties?
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nebivolol
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Longest acting B antagonist, doesn't pass BBB
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nadolol
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what effect does B1 blockade have on the kidney?
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blocks renin release thus blocking RAAS response to drop in BP
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What is nebivolol's effect in the kidney?
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blocks renin release and decreases peripheral resistance, B2 agonist action causes renal vasodilation via NO formation
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what is missing in ESRD pts that normally breaks down NE and E in the synapse?
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renalase
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What are the 2 benefits of using a B blocker with ISA?
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less resting bradycardia but still blocks exercise induced increase in HR, less receptor upregulation after long term use/less supersensitivity
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what conditions are contraindicated for use of B blockers?
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AVB, CHF, asthma, SB
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How does B blockers contribute to atherogenesis?
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increasing triglycerides and LDL, decreasing HDL
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