5 - Hypertension (part 2) Flashcards
Cardio-selective beta blockers block ____ more than ____ receptors.
Cardio-selective beta blockers block beta1 more than beta2 receptors.
Adverse effects of this type of medication include persistent dry hacking cough (smoker’s cough), hyperkalemia, angioedema, leukopenia, and fetal toxicity.
Ace Inhibitors
Stimulates alpha 2 receptors in CNS, causing the arterioles and veins to dilate, and a decrease in blood pressure. Major adverse effect is drowsiness (CNS depression and sexual dysfunction).
Centrally Acting Alpha 2 Agonists
Which two types of medications decrease potassium loss and cause a moderate increase in urine output?
Potassium-Sparing Diuretics & Aldosterone Antagonists
Blocks sodium potassium chloride transport in the thick ascending loop of Henle, which causes volume depletion and blocks sodium reabsorption.
Loop Diuretics
Competitive inhibition of Aldosterone binding, which causes a decrease in the loss of potassium, a moderate increase in urine output, and prevents heart failure from worsening. Adverse effects include hyperkalemia and cardiac dysrhythmias.
Aldosterone Antagonists
Blocks the conversion of angiotensin I to angiotensin II, and lowers total peripheral resistance. Adverse effects include persistent dry hacking cough (smoker’s cough), hyperkalemia, angioedema, leukopenia, and fetal toxicity.
Ace Inhibitors
Directly inhibits renin, suppressing RAAS cascade as it starts. Also eliminates the production of angiotensin II.
Direct Renin Inhibitors
Adverse effects of this type of medication include masking early signs of hypoglycemia, rebound cardiac excitation, bradycardia, a decrease in cardiac output, heart failure, and bronchoconstriction.
Beta Adrenergic Blockers
Blocks the interaction of norepinephrine on vascular alpha adrenergic receptors, and dilates urethral smooth muscles. Works by dilating arterioles and veins, decreasing peripheral resistance, decreasing venous return, and decreasing cardiac output. Major adverse effect is orthostatic hypotension.
Alpha 1 Adrenergic Blockers
For this type of medication you want to avoid using with potassium sparing diuretics and ACE-inhibitors.
ARBs
Acts directly on vascular smooth muscle, causing selective dilation of arterioles. Has little to no effect on veins. Adverse effects include hypertrichosis (lots of hair growth), severe fluid retention, exacerbation of angina, and an increase in myocardial contractions.
Direct Acting Vasodilators
Which two types of medication do you want to avoid potassium supplements to avoid hyperkalemia?
Potassium Sparing Diuretics & Aldosterone Antagonists
Adverse effects of this type of medication include sexual dysfunction, rebound HTN with abrupt withdrawal of Clonidine, CNS depression, drowsiness, and hepatotoxicity.
Centrally Acting Alpha 2 Agonists
Blocks sodium chloride co-transporter in the distal convoluted tubule, which decreases blood volume, renal blood flow, and cardiac output.
Thiazide Diuretics
Blocks calcium entry into vascular smooth muscle cells and prevents contractions. Acts selectively on arterial system (not veins), causing decreased arterial pressure. Does not affect serum calcium level. Second choice med for African Americans. Adverse effects include dizziness, headache, facial flushing, peripheral edema, and reflex tachycardia.
Calcium Channel Blockers
Block Angiotensin II receptors, causing vasodilation and suppression of aldosterone. Given if dry cough from ACE inhibitors become problematic. Adverse effects include hyperkalemia.
ARBs
Blocks the interaction of norepinephrine on vascular alpha adrenergic receptors, and dilates urethral smooth muscles. Works by dilating arterioles and veins, decreasing peripheral resistance, decreasing venous return, and decreasing cardiac output. Major adverse effect is orthostatic hypotension.
Alpha 1 Adrenergic Blockers
Blocks sodium reabsorption and acts on the distal tubule independent of Aldosterone, which causes a decrease in potassium loss and a moderate increase in urine output. Adverse effects include hyperkalemia and cardiac dysrhythmias.
Potassium-Sparing Diuretics
Adverse effects for these two types of medications are hypokalemia, hyperglycemia, hyperuricemia, an increase in LDL and triglyceride levels, occasional hyponatremia, hypovolemia, and dehydration.
Thiazide Diuretics & Loop Diuretics
Preferred type of BP medication.
Thiazide Diuretics
