Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology (ikketenkpådetbror) > 10 Antihypertensive drugs > Flashcards

10 Antihypertensive drugs Flashcards

1
Q

Thiazide diuretics- Names

A

Hydrochlorothiazide
Indapamide
Chlorthalidone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Thiazide diuretics-MoA

A

They increase sodium and water excretion and thus lower BP by two mechanisms related to this:

  1. Decrease blood volume and thereby decrease cardiac output
  2. With continued administration over weeks/months, they also decrease PVR, due to reduction in the sodium content of arteriolar smooth muscle cells, which decreases muscle contraction in response to vasopressor agents such as norepinephrine and angiotensin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Thiazide diuretics- Clinical use

A

Treatment of mild to moderate hypertension

  • Hydrochlorothiazide->Initial treatment of mild to moderate HPT
  • Indapamide->Como with angiotensin inhibitors to control BP to reduce risk of stroke and MI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Thiazide diuretics-Adverse effects

A

Hypokalemia-> cardiac arrhythmias and muscle weakness.
Elevate plasma levels of: glucose, uric acid and lipids in some pat.
Hematologic toxicity
Aggravate hepatic disease and diabetes
Compensatory increase in renin secretion(Should use angiotensin inhibitor in combo with them)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Thiazide diuretics- Interactions

A
  • Increase serum levels of lithium->Lithium toxicity

- Hypotensive effect is decreased by NSAIDS and increased by ACE inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Thiazide diuretics- Specials

A
  • Reduces BP by 10-15 mm Hg
  • Protect against osteoporosis (decrease ca excretion)
  • Cheap drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Loop diuretics- Clinical use

A

Reserved for hypertensive pt who have poor renal function and serum creatinine more than 2,3mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Potassium-sparing diuretics- Names

A

Amiloride
Spironolactone
Eplerenone
Triameterene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Potassium-sparing diuretics- MoA

A

Mild natriuretic effect, and they reduce renal potassium excretion and thereby prevent hypokalemia caused by thiazide and loop-diuretics
-Spironolactone and eplerenone are mineralocorticoid receptor antagonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Potassium-sparing diuretics- Clinical use

A
  • Hypertension that cannot be controlled with combo of three or more drugs
  • Aldosteronism and heart failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Potassium-sparing diuretics- Adverse effects

A

Hyperkalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Potassium-sparing diuretics- Interactions

A

Hyperkalemic effect is increased by ACE inhibitors and potassium supplements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Alpha blockers-Clinical use

A

Not used in initial treatment of HPT, but can be added to other drugs when BP is not adequately controlled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Alpha blockers- Adverse effects

A
  • Reflex tachycardia and contractile force (may increase myocardial oxygen demand)
  • Fluid retention and orthostatic hypotension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Alpha blockers- interaction

A

Hypotensive effect is increased by beta blockers and diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Beta blockers- Clinical use

A

Hypertensive pt with cardiovascular diseases such as CAD, MI and heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Beta blockers- Adverse effects

A
  • Bronchospasm (avoid in COPD or use selective)
  • Hypoglycemia in excessive insulin administration and blockade of early signs of hypoglycemia (caution in pt with diabetes)
  • Decreased peripheral blood flow during exercise and risk of cold extremities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Beta blockers- Interactions

A

Hypotensive effect is decreased by NSAIDS

19
Q

Centrally acting drugs- Names

A

Clonidine
Guanfacine
Methyldopa

20
Q

Centrally acting drugs-MoA

A

Activates a2 receptors in brainstem and decrease sympathetic outflow, and vascular resistance

21
Q

Centrally acting drugs-Clinical use

A

Clonidine->Hypertensive urgencies and decrease withdrawal symptoms
Methyldopa-> Hypertension in pregnant women

22
Q

Centrally acting drugs-Adverse effects

A

Sedation, dry mouth, impaired mental acuity and rebound hypertension (if drug is discontinued abruptly)
-Methyldopa->Immunologic effects (Coombs positive hemolytic anemia and autoimmune hepatitis)

23
Q

Centrally acting drugs-Interactions

A

-Hypotensive effect decreased by TCA
-Sedative effect increased by CNS depressants
Methyldopa->Hypotensive effect increased by levodopa

24
Q

ACE inhibitors- names

A 
Benazepril
Enalapril
Quinepril
Ramipril
Fosinepril
Lisinopril
Captopril
25
Q

ACE inhibitors- MoA

A

They inhibit angiotensin-converting enzyme and thus the production of angiotensin II. This leads to several effects;

  1. Decreased vasoconstriction and thus decreased vascular resistance both in arteries (decreased afterload), and veins (decreased preload).
  2. Reduce aldosterone secretion, sodium and water resorption, norepinephrine release and leads to potassium retention.
  3. Inhibits inactivation of bradykinin by ACE and thus vasodilation
26
Q

ACE inhibitors- Clinical use

A

Hypertension in Heart failure, MI, CKD, and DM patients

27
Q

ACE inhibitors. Adverse effects

A

Fetal injury and death, renal failure in pt with bilateral renal artery stenosis, dry cough, angio edema, rash and abnormal taste

28
Q

ACE inhibitors- Contraindication

A

Pregnancy

29
Q

ACE inhibitors- Interactions

A
  • Antihypertensive effect is increased by diuretics and CCBs
  • Lithium toxicity
  • Hyperkalemic effect is increased by PS-diuretics and potassium supplements
  • Hypotensive effect is decreased by NSAIDs
30
Q

ACE inhibitors-Specials

A
  • All except captopril and lisinopril are prodrugs

- Enalaprilat is available IV, the rest is taken orally

31
Q

Angiotensin receptor blockers-Names

A 
Valsartan 
irbesartan
Losartan
Telmisartan
Candesartan
32
Q

Angiotensin receptor blockers-MoA

A

These drugs selectively block AT1 receptors in various tissues and thereby reduce vasoconstriction, aldosterone secretion, sodium reabsorption by the proximal tubule and norepinephrine release from sympathetic nerve terminals.

33
Q

Angiotensin receptor blockers-Clinical use

A

Hypertension (reduce cardiovascular consequences including, LVH and stroke)

34
Q

Angiotensin receptor blockers-Adverse effects

A

Hyperkalemia, neutropenia, elevated aminotransferases, and fetal injury

35
Q

Angiotensin receptor blockers-Contraindication

A

Pregnancy

36
Q

Direct renin inhibitor name and clinical use

A
  • Aliskiren

- Hypertension

37
Q

Calcium channel blockers-Name

A 
Diltiazem
verapamil
amlodipine
felodipine
isradipine
nicardipine 
nifedipine
38
Q

Calcium channel blockers-MoA

A

By blocking calcium ion channels in the plasma membranes of smooth muscle, the ccbs relax vascular smooth muscle and causes vasodilation. They have greater effect on arteriolar smooth muscle then venous, effect on BP is mainly because a reduction in PVR.

39
Q

Calcium channel blockers-Clinical use

A

Hypertension, angina pectoris, peripheral vascular disorders, cardiac arrhythmias

  • Hypertension pt with asthma
  • Protect against stroke, CAD and kidney disease
40
Q

Calcium channel blockers-Adverse effects

A

Dihydropyridine drugs may cause reflex tachycardia and gingival hyperplasia

41
Q

Hydralazine and minoxidil- MoA and clinical use

A
  • Vasodilator

- Hypertension and alopecia

42
Q

Hydralazine and minoxidil- Adverse effects

A

When used alone->Reflex tachycardia, fluid retention, and precipitation of angina in susceptible pt (Combine with diuretic + beta blocker or sympatholytic agent)

  • Hydralazine-> Lupus like syndrome
  • Minoxidil->Hypertrichosis
43
Q

Nitroprusside- Moa and clinical use

A
  • Vasodilator

- Management of hypertensive emergencies

44
Q

Fenoldopam- Moa, clinical use and adverse effects

A
  • Dopamine D1 agonist that leads to vasodilation in coronary, renal and mesenteric vessels
  • Hypertensive emergencies
  • Reduce potassium levels in blood

Pharmacology (ikketenkpådetbror) (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions