(7.1) Drugs for Hypertension (Wolff) Flashcards
Why aren’t phentolamine and phenoxybenzamine frequently used for HTN?
LOTS OF ADVERSE EFFECTS
Hypotensive episodes, orthostatic hypotension, tachycardia, cardiac arrhythmias, miosis etc…
Why isn’t prazosin used much anymore to treat HTN?
Increases likelihood of stroke
PLUS!!!
Similar adverse reactions as phentolamine and phenoxybenzamine with the addition of retrograde ejaculation
Clonidine
Therapeutif effects?
Adverse effects?
Reduced sympathetic outflow due to alpha2 agonisim
Drowsiness, xerostomia, REBOUND HYPERTENSION IF DOSE IS MISSED
Alpha-methyldopa
Indications?
MOA?
Toxicities?
GESTATIONAL HTN
Selective alpha2 agonist
Positive coombs test, SLE like syndrome
Reserpine
MOA?
Adverse effects?
Blocks incorporation of NE and 5-HT into synaptic vesicles
SEVERE DEPRESSION/SUICIDAL IDEATION
Guanethidine
MOA?
Adverse effects?
Displaces NE from synaptic vesicles, also blocks receptors
Severe orthostatic hypotension, BP slowly increases during day
For a long time ___________ were used as first line therapy for HTN
Beta blockers
What happens if a daily alpha2 agonist or beta blocker is stopped abruptly??
REBOUND HYPERTENSION
DEATH
Why aren’t beta-blockers used as first line treatment for HTN?
Does NOT prevent MI, heart failure or death as well as other therapies
Is associated with significantly higher incidence of stroke than other therapies
What is the number one line of treatment for HTN?
ACE inhibitors
(captopril)
What are the major side effects associated with ACE inhibitors?
Cough
Angioedema
If your HTN pt gets angioedema, what’s a good medication to start them on?
Losartan
What is the MOA of losartan?
Competitive nonpeptide angiotensin II receptor antagonist
ACEI are contraindicated when?
Pregnancy
What is another class of drugs that is used for HTN?
Ca2+ channel blockers
