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Pharm Ch 47
exam 5
| Term | Definition |
|---|---|
| Primary Hypertension/essential hypertension | - most common form of hypertensive disease - Has no identifiable cause - diagnosis made by ruling out probable causes - patients will experience rise in bP throughout their lives |
| Secondary Hypertension | - an elevation in BP brought on by an identifiable primary cause, - curable if actual cause is treated |
| Diagnosis of HTN | - diagnosis should be made on several BP readings - If BP is high on one visit (but not dangerous) BP should be taken again on two subsequent office visits - 2 readings should be taken 5 minutes apart with high reading noted in contralateral arm |
| Diagnostic tests | - electrocardiogram, complete urinalysis, hemoglobin, hematocrit, - blood levels of sodium, K+, Ca+, creatinine, uric acids, triglycerides, and cholesterol |
| ultimate Treatment goals | - to reduce cardiovascular and renal morbidity and mortality |
| Sodium Restriction | - All people with hypertension should consume below 2300 mg of sodium daily |
| Dash Diet | - diet rich in fruits, vegetables, and low-fat dairy products & low in total fat, saturated fat, and cholesterol -Also encourages whole-grain products, nuts, poultry, & recommends minimal intake of red meat & sweets |
| Alcohol restriction | - men 1/ounce/day - women 0.5 ounce/day |
| Aerobic exercise | - Activity of walking 30-45 minutes a day most days of the week |
| Maintenance of Ca & K+ | - both associate with reduced chance of hypertension |
| Principal determinants of BP | - Cardiac output: influenced by HR, myocardial contractility, blood volume, & venous return of blood to the heart (Arterial pressure = CO x PERIPHERAL RESISTANCE) - |
| What increases vascular resistance? | - arteriolar constriction |
| Systems that help regulate BP | - Sympathetic baroreceptor reflex: Beta Blocker used to prevent reflex tachycardia - RAAS: elevated BP with the release of renin from the juxtaglomerular cells of the kidney - Renal regulation of BP: When BP falls, glomerular filtration rate (gfr) falls |
| Brainstem | - hypertensive drugs act in brainstem to supress sympathetic outflow to the heart and blood vessels resulting in decreased HR, decreased myocardial contraction, and vasodilation |
| Sympathetic ganglia | - reduces sympathetic stimulation of the heart and blood vessels - sympathetic ganglia blockers only used in hypertensive emergencies |
| Terminals of adrenergic nerves | - decrease the release of NE resulting in decreased sympathetic stimulation of the heart and blood vessels |
| Beta 1 Adrenergic receptors on the heart | - prevents sympathetic stimulation of the heart |
| Alpha 1 adrenergic receptors on blood vessels | - promotes dilation of aterioles and veins |
| Vascular smooth muscle | - Sodium Nitroprusside is used only in hypertensive emergencies and others used for chronic hypertension |
| renal tubules | - promote salt and water excretion |
| beta 1 receptors on Juxtaglomerular cells | - suppresses release of renin |
| Block of Renin | - decreases conversion of angiotensinogen to angio 1 |
| Angiotension converting enzyme | - suppresses formation of angio II |
Created by:
KristinL
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