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Systemic Pharmacology > 1 - Anti-Hypertensives > Flashcards

1 - Anti-Hypertensives Flashcards

1
Q

what are the 4 ACE inhibitor drugs?

A

lisinopril, benazepril, captopril, and enalapril

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2
Q

What is the mechanism of action for ACE Inhibitors?

A

Renin Angiotensin Aldosterone (RAA) system inhibitor - blocks the conversion of angiotension1 to angiotension2
results in elevated levels of bradykinin

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3
Q

What is the main distinguishing two side effects of an ACE Inhibitors/Lisinopril?

A

Cough with no phlegm (non productive) and Taste disturbance

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4
Q

what hypersensitivity side effect is seen with ACE inhibitors/Lisinopril?

A

angioedema (looks like preceptal cellulitis) and eyelid edema

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5
Q

What are the most common side effects of an ACE Inhibitors/Lisinopril?

A

photosensitivity, reduced vision, headache, hypotension and conjunctivitis (also retinal hemorrhages and diplopia)

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6
Q

What 2 drugs will inhibit renal prostaglandins and antagonize therapy with Lisinopril?

A

Acetaminophen and ASA

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7
Q

What major drug is known to cause renal toxicity and exacerbate hyperkalemia when combined with Lisinopril?

A

Cyclosporine

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8
Q

What major disease should you watch out for when using Lisinopril?

A

Sjogren’s Syndrome

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9
Q

What are the 2 Angiotensin 2 Receptor Blockers?

A

ValSARTAN and CandeSARTAN

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10
Q

What type of drugs are used for someone post MI?

A

Angiotensin 2 Receptor Blockers and Beta Blocker

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11
Q

what are the hypersensitivity reactions seen with valsartan?

A

Angioedema and Vasculitis

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12
Q

What are the 2 major contraindications for Valsartan?

A

NSAID’s (antagonism) and Cyclosporine (hyperkalemia)

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13
Q

What type of Anti-Hypertensive drug group works directly on the walls of the heart? What is the mechanism of action?

A

Calcium Channel Blockers (Amlodipine,Diltiazem and Veraprimil)
Mechanism - Inhibits trans membrane Ca++ current into VSM&raquo_space; cardiac muscle

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14
Q

Name 3 ocular issues when using Amlodipine?

A

Conjunctivitis, Diplopia and Pain

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15
Q

what are the common side effects for amlodipine?

A

Headache, Dizziness

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16
Q

What is the most common contraindication of Anti-Hypertensives?

A

Cyclosporine - It can induce renal toxicity, suppress metabolism

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17
Q

What will occur if a pt. is taking a amlodipine and Dexamethosone?

A

Enhancement of metabolism will occur and diminish the results of amlodipine

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18
Q

What two types of Glaucoma drugs are contraindicated with Amlodipine?

A

Alpha 2 agonists and Beta Blockers

both are additive

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19
Q

what are the indications for amlodipine?

A

hypertension and coronary artery disease (CAD)

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20
Q

what is the alpha blocker anti-hypertensive?

A

Terazosin

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21
Q

What are two common indications of Terazosin?

A

HTN and BPH (Benign Prostatic Hypertrophy)

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22
Q

What is the mechanism of action for Terazosin?

A

Antagonizes peripheral alpha 1 adrenergic receptors

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23
Q

what are the common side effects for terazosin?

A

headache, dizziness, pain and paresthesia

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24
Q

What is the distinguishing side effect for Terazosin?

A

Intraoperative floppy iris syndrome

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25
Q

When a pt. takes Terazosin, what will happen if they take a sympathomimetic?

A

reduced effect of BP lowering

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26
Q

What are the 3 types of beta blockers?

A

Metoprolol, Propranolol and Atenolol

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27
Q

what are the indications for metoprolol?

A

hypertension, angina pectoris and post MI

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28
Q

What is the mechanism of action for metoprolol?

A

selective competitive antagonism of beta1 receptors = reduces systolic BP and CO via negative inotropic and chronotropic effects
central acting inhibition of sympathetic outflow and suppression of renin activity

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29
Q

What Anti-hypertensive drug has a side effect of depression and short term memory loss?

A

Metoprolol

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30
Q

What are the number 1 health threats in men and women?

A

Heart problems

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31
Q

what are the common ocular side effects for metoprolol?

A

increased migranious scotomata, reduced IOP, glaucoma progression and exacerbation of myasthenia gravis

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32
Q

What is the mechanism of action for Furosemide?

A

inhibits re-absorption of NaCl at proximal/distal convoluted tubule and loop of Henle

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33
Q

what are the common side effects for furosemide?

A

Blurred vision, hypotension, pruritus (allergy based)

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34
Q

What is a contraindication/caution when using furosemide or hydrocholorthiazide?

A

Sulfonamide allergies

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35
Q

What major ocular adverse effect can occur when using hydrocholorthiazide?

A

Angle Closure Glaucoma

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36
Q

what happens if you take CAIs with hydrochlorothiazide?

A

synergy or additive = used to treat an acute angle closure in clinic *monitor BP - patient may faint

37
Q

what are the indications for spirolactone?

A

hypertension, CHF, hyperaldosteronism, and hypokalemia

38
Q

What is the mechanism of action for Spironolactone?

A

Antagonize aldosterone receotors in distal tubule. This will cause loss of water, sodium and have high amounts of potassium retension

39
Q

What diuretic will could cause, as adverse affect, gynecomastia and menstrual irregularities?

A

Spironolactone (steroid side effects are seen)

40
Q

What will occur when NSAID’s and Spironolactone are interacted?

A

reduced BP lowering

41
Q

what is the mechanism of action for clonidine?

A

Stimulation of central and spinal alpha 2 adrenergic receptors (presynaptic and post junctional)
Note: It is a Central Acting Alpha Agonist

42
Q

what is a serious side effect seen with clonidine?

A

Angioedema

43
Q

what happens if you take ophthalmic beta-blockers and decongestants with clonidine?

A

antagonistic effect

**beta blockers should be BP lowering but they enhance sympathomimetic activity at alpha1 receptors

44
Q

What is the mechanism of action for hydralazine?

A

Directly dilates peripheral vessels via hyperpolarization of vascular smooth muscle which thus inhibits Ca++ influx (depolarization)

45
Q

what are the side effects for hydralazine?

A

headaches and Lupus erythematosus

46
Q

What is a important drug interaction with hydralazine?

A

NSAID’s (antagonistic = these raise BP)

47
Q

What is the mechanism of action for Hydrocholorthiazide?

A

Inhibits reabsorption of NaCl at distal convoluted tubule

48
Q

What is the mechanism of action for beta blockers?

A

Antagonism of B1 receptor reducing systolic BP and CO. Suppression of Renin activity

49
Q

What Anti-hypertensive drug has a side effect of depression and short term memory loss?

A

Beta-Blockers (Meopholol, Propranolol and Atenolol)

50
Q

What is the mechanism of action for Furosemide?

A

Specifically, Cl- binding is inhibited

Inhibition reabsorption of NaCl at the both proximal/distal tubules and loop of henle of the kidneys

51
Q

What is the most common ocular adverse effect of furosemide?

A

Blurred vision

52
Q

What durietic drug is contraindication when NSAID’s are given?

A

ALL HAVE Contraindication

53
Q

What is the mechanism of action for Hydrocholorthiazide?

A

Inhibits reabsorption of NaCl at distal convoluted tubule

54
Q

What major ocular adverse effect can occur when using hydrocholorthiazide?

A

Angle Closure Glaucoma

55
Q

What are the 3 types of drug contraindications when using hydrocholorthiazide?

A

CAI’s, NSAID’s and Erythromycins

56
Q

Which of the diuretics does potassium sparing?

a. hydrocholorthiazide
b. spironolactone
c. furosemide

A

b. Spironolactone

57
Q

What is the mechanism of action for Spironolactone?

A

Antagonize aldosterone receotors in distal tubule. This will cause loss of water, sodium and have high amounts of potassium

58
Q

What will occur when NSAID’s and Spironolactone are interacted?

A

reduced BP lowering

59
Q

Clonidine is used for severe cancer related pain and as a hypertensive drug. What is the mechanism of action?

A

Stimulation of central and spinal alpha 2 adrenergic receptors (presynaptic and post junctional)

Note: It is a Central Acting Alpha Agonist

60
Q

What is a serious adverse of Clonidine?

A

Angioedema

61
Q

What is the mechanism of action for hydralazine?

A

Directly dilates peripheral vessels via hyperpolarization of vascular smooth muscle which thus inhibits Ca++ influx (depolarization)

62
Q

What is a major adverse effect of hydralazine?

A

Lupus erythematosus

63
Q

What is a important drug interaction with hydralazine?

A

NSAID’s

64
Q

what happens if you take terazosin with a systemic beta-blocker?

A

it is additive - enhances BP lowering

65
Q

what is the caution for terazosin?

A

cataract surgery - due to intraoperative floppy iris syndrome

66
Q

what are the common side effects for metoprolol?

A

visual disturbances, decreased tear production (dry eye syndrome) and headaches

67
Q

what happens if you take metoprolol with ophthalmic alpha2 agonists or beta blockers?

A

there is an additive effect

68
Q

what happens if you take metoprolol with pilocarpine?

A

there is an additive effect - cholinergic agents produce additive effects on cardiac conduction

69
Q

what happens if you take metoprolol with NSAIDs or ophthalmic decongestants?

A

antagonistic effect

70
Q

what are the 3 diuretics used to treat hypertension?

A

furosemide, hydrochlorothiazide, and spironolactone

71
Q

what is the indication for furosemide?

A

hypertension, acute pulmonary edema and hypercalcemia

72
Q

what is the pharmacology for furosemide?

A

high ceiling/loop diuretic = Ca2+ and K+ depleting

73
Q

what are the hypersensitivity reactions are seen with furosemide?

A

stevens johnson syndrome and erythema multiforme

74
Q

what is the cardiovascular side effect seen with furosemide?

A

decreased potassium and vasculitis

75
Q

what is the hematology side effect seen with furosemide?

A

anemia

76
Q

what happens if you take furosemide with aminoglycosides?

A

additive - nephrotoxicity

77
Q

what happens if you take CAIs or erythromycins with furosemide?

A

prolong QT interval = life threatening

78
Q

what are the indications for hydrochlorothiazide?

A

hypertension, peripheral edema, CHF, and osteoporosis

79
Q

what are the hypersensitivity reactions seen with hydrochlorothiazide?

A

erythemia multiforme and stevens johnson syndrome

80
Q

what are the hematology side effects seen with hydrochlorothiazide?

A

anemia, leukopenia, and thrombocytopenia

81
Q

what happens if you take NSAIDs with hydrochlorothiazide?

A

antagonistic effect (NSAIDs raise BP)

82
Q

what happens if you take erythromycins with hydrochlorothiazide?

A

prolonged QT interval

83
Q

what happens if you take spironolactone with cyclosporine?

A

hyperkalemia may result

84
Q

what are the indications for clonidine?

A

hypertension and severe cancer related pain

85
Q

what is the pharmacology for clonidine?

A

antihypertensive = central acting alpha agonist

analgesic

86
Q

what happens if you take clonidine and antihistamines or opioids?

A

enhanced CNS depression

87
Q

what happens if you take clonidine with ophthalmic alpha 2 agonists?

A

additive effect

88
Q

what are the indications for hydralazine?

A

hypertension, CHF, and hypertensive crisis

89
Q

what is the pharmacology for hydralazine?

A

antihypertensive = vasodilator

Systemic Pharmacology (6 decks)

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