1. Peters - Urgency And Emergency HTN Meds Flashcards
Captopril
Class: ACE Inhibitor
AE: rash, pruritis, proteinuria, loss of taste, hyperkalemia
Misc: contraindicated in pregnancy, caution for use in severe renal insufficiency and acute MI
Lobetalol
Class: combined alpha and beta antagonist
AE: dizziness, lightheadedness, nausea
Misc: used in urgency (PO) and emergency (IV), contraindicated in 2nd and 3rd degree heart block, heart failure and asthma/COPD
Nicardipine
Class: CCB (dihydropyridine) –> arteriole and venule dilation
AE: reflex tachycardia
Misc: contraindicated in pts w/ advanced aortic stenosis
Clevidipine
Class: CCB (3rd gen dihydropyridine) –> decrease after load
AE: Afib, fever - no reflex tachycardia (difference btwn nicardipine)
Misc: available in a lipid emulsion, max of 1000mL over 24 hrs. Contraindicated if allergic to soybeans, soy products, eggs or egg products.
Nitroprusside
Class: Nitric Oxide Vasodilator –> decrease preload and after load
AE: reflex tachycardia, chromaturia (red urine), erytheme (red skin)
Misc: toxic metabolites (cyanide and thiocyanate toxicity), avoid prolonged used in pts w/ renal or hepatic impairment, needs intra-arterial BP monitoring, rule of 2: used for >2 days, if dose is >2mcg/kg/min or sCr>2 –> increased chances of toxicity
Nitroglycerin
Class: Nitric Oxide Venodilator –> works on veins to reduce preload
AE: headache, methemoglobinemia
Misc: must be stored in glass, contraindicated w/ cerebrovascular accident (head trauma, intracerebral hemorrhage), low dose use w/ MI and acute coronary syndromes, NEVER USE W/ STOKE
Hyrdralazine
Class: Direct Arterial Vasodilator –> reduce after load
AE: tachycardia, nausea, headache
Misc: unpredictable responses, long duration, use lowest dose to determine pt effect
Phentolamine
Class: Alpha Antagonist
AE: tachycardia, flushing, headache
Misc: used for catecholamines excess, increased BP related to drug use or pheochromocytoma
Esmolol
Class: Cardioselective Beta(1) Blocker –> decrease HR
AE: bradycardia
Misc: metabolized by rapid hydrolysis in RBC (safe for pts w/ renal or hepatic issues), avoid in cocaine-induced HTN
Lobetalol
Class: Combined Alpha and Beta Antagonist –> decrease rate and force of contraction
AE: dizziness, lightheadedness, nausea
Misc: used in urgency (PO) and emergency (IV), contraindicated in 2nd and 3rd degree heart block, heart failure and asthma/COPD
FenOLDopam
Class: Peripheral Dopamine-1 Agonist
AE: headache, flushing, tachycardia, dizziness, dose related increase in intra-ocular pressure
Misc: avoid in pts w/ glaucoma, increase cranial pressure (stroke) and pts w/ sulfite allergy, safely used in the elderly, can be used w/ renal issues
Enalaprilat
Class: ACE Inhibitor
AE: rash, pruritis, proteinuria, loss of taste
Misc: contraindicated in pregnancy, caution in pts w/ severe renal insufficiency and acute MI, the only IV ACE inhibitor, has a longer duration than majority of the other IV agents
Clonidine
Class: Alpha-2 agonist
AE: sedation
Misc: contraindicated in altered mental status and carotid artery stenosis
