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Pharmacology > Anti-HPN Drugs > Flashcards

Anti-HPN Drugs Flashcards

1
Q

Sympatholytic: Alpha-adrenoceptor Antagonist

A

A. Alpha-adrenoceptor Antagonist - not recommended for initial treatment of hypertension
* Doxazosin
* Prazosin
* Terazosin

S/E: Reflex Tachycardia, Fluid Retention, Orthostatic HPN (first dose syncope)

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2
Q

Sympatholytic: Beta-adrenoceptor Antagonist

A

MOA: Blocks B1-receptors

Selective: Metoprolol, Atenolol
Non-Selective: Propranolol, Nadolol, Labetalol, Carvedilol

Use: Reduce HR, Contractility, renin secretion

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3
Q

Sympatholytic: Centrally-Acting Drugs

A

(+) Alpha-2 Agonists

  • Clonidine (Catapres)
  • Guanfacine
  • Guanabenz
  • Methyldopa (Aldomet®, Dopamet®) - converted first to ⍺-methyldopamine & ⍺-methylNE
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4
Q

Calcium Channel Blockers

A

i. Dihydropyridines (DHPs) - Vasoselective
* Nifedipine (Adalat®)
* Nimodipine (Nicardia®)
* Amlodipine (Norvasc®)
* Felodipine

ii. Non-DHPs - Antiangina, Antiarrhythmia
* Verapamil
* Diltiazem

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5
Q

MOA of Dihydropiridine CCBs

A

Block the L-type Ca channel in arteriolar smooth muscles

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6
Q

MOA of Non-DHP CCBs

A

Block the L-type Ca channel in arteriolar smooth muscles and myocardium

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7
Q

DOC for Subarachnoid hemorrhage

A

Nimodipine

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8
Q

A/Es of Dihydropiridines

A

Flushing
Gingival Hyperplasia
Reflex tachycardia
Peripheral edema

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9
Q

Cardioselective; greatest depressant effect in the heart amongst all CCBs

A

Verapamil

S/E: Constipation

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10
Q

DOC for Prinzmetal Angina

A

Verapamil + Trandolapril

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11
Q

Vasodilators

A

a. Arteriolar Vasodilators
* Hydralazine
* Minoxidil
* Diazoxide

b. Mixed Arteriolar/Venous dilators
* Na Nitroprusside
* Fenoldepam

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12
Q

Hydralazine MOA

A

Increases levels of Nitric
Oxide (endogenous vasodilator)

↑ NO ↑ cGMP. NO interacts with guanylate cyclase. GTP is thus converted

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13
Q

Hydralazine

A

Uses:
* Management of HTN specifically in pregnant wpmen with HTN crisis
* Adjunct in the management of CHF (with ISDN)

SE: Systemic Lupus Erythematous

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14
Q

Minoxidil

A

MOA: induce opening of K+ channel in the vascular/arteriol smooth muscles

Use: most efficacious but alternative only for HTN crisis

SE: Hirsutism, hypertrichosis

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15
Q

Diazoxide

A

MOA: same with minoxidil
Use: alternative for hypertensive crisis, Treatment of Insulinoma
SE: HyperGLU (metabolic related)

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16
Q

Common A/Es of Vasodilators

A
  1. All arteriolar vasodilators cause reflex
    tachycardia
  2. Peripheral edema
17
Q

Na Nitroprusside

A

MOA: increase CGMP levels (Releases NO from drug molecule)

18
Q

First line in hypertensive emergency

A

Na Nitroprusside

19
Q

Special precautions: Na nitroprusside

A

Na nitroprusside must be freshly prepared, used within 24 hrs; prone to photodegradation

20
Q

Adverse Effects of Na Nitroprusside

A

Cyanide Toxicity
Accumulation of cyanide (inhibits cytochrome oxidase =
cellular respiration is inhibited)

21
Q

Management of Cyanide Toxicity

A

Cyanide Antidote Kit
* amyl nitrate!
* Na nitrite (NaNO2)
* Na thiosulfate (Na2S2O4)

Hydroxo / Hydroxycobalamin
Methylene blue (high dose)

22
Q

Fenoldepam

A

Activates Dopamine 1 → Vasodilation

23
Q

Base treatment in px with CHF, HPN + Diabetic nephropathy

A

ACE Inhibitors (-pril)

24
Q

1st line in the management of HTN in px with CKD or
DM; 1st line in the management of Albuminuria

A

ACEIs & ARBs

25
Q

MOA of Angiotensin Converting Enzyme
Inhibitors (ACEIs)

A

Prevent formation of Angiotensin II
Dec. vasoconstriction, Inc. bradykinin, increase prostaglandin
Decrease AII, BV, SVR
Inc. bradykinin, decreasing SVR

26
Q

Angiotensin Converting Enzyme
Inhibitors (ACEIs)

A

Captopril
Fosinopril
Ramipril
Enalapril

26
Q

Angiotensin Converting Enzyme
Inhibitors (ACEIs)

A

Captopril - sulfhydryl group
Fosinopril
Ramipril
Enalapril

27
Q

all -prils are prodrugs except: Acute ACEi where their parent molecules are already activates

A
  • Capropril
  • Lisinopril
  • Enalaprilat (IV)
28
Q

Adverse Effects of ACEIs

A

Hyperkalemia
Fetal Injury
Dry cough (Inc. bradykinin)
* NSAIDS - reduce the efficacy of ACEi in the mx HTN

29
Q

Angiotensin Receptor Blockers (ARBs: -sartan)

A

Losartan
Candesartan
Valsartan
Saralasin

30
Q

MOA of Angiotensin Receptor Blockers
(ARBs)

A

Prevents the action of AT1
Blocks the binding of AT1 to its receptor

31
Q

A/Es of Angiotensin Receptor Blockers
(ARBs)

A

Hyperkalemia
Fetal Injury
NO Dry cough

32
Q

Renin Inhibitor

A

Aliskerin

33
Q

Aliskerin

A

MOA: Renin inhibitor; reduces angiotensin I synthesis /(binds to rennin preventing interaction of rennin to angiotensin

CLINICAL USE/S: add-on to ACE-inhibitors or ARBs for HTN

SE: Angioedema, renal impairment, dry cough, rashes

Pharmacology (26 decks)

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