Anti HTN Flashcards
Contraindications for thiazides diuretics
Hyperuricemia, gout, sulfa allergy
ADRs for thiazides diuretics
Hypo Na, Mg, K
Hyperglycemia
Inc cholesterol
Sexual dysfunction
DDIs for thiazides
Dec by NSAIDs
Increases lithium levels
Examples of thiazides
Hydrochlorothiazide Chlorothalidone Chlorothiazide Indapamide Metolazone
Loop diuretics MOA
Block Na reabsorption in ascending loop of Henle, powerful natriuresis
Loop diuretics precautions
Profound diuresis
Monitor fluids, renal function, electrolyte status
Contraindications for loop diuretics
Sulfa allergy
ADRs for loop diuretics
Hypo Ca and K Renal affects Hyperglycemia hyperuricemia Pancreatitis, hepatic damage Sexual dysfunction ototoxicity
DDIs for loops
Dec by NSAIDs
Inc lithium levels
Loop diuretics examples
Furosemide
Toresemide
Bumetanide
Ethacrynic acid
K sparing diuretics MOA
Block reabsorption of Na in collecting duct but reduce K secretion into urine
Precautions of K sparing diuretics
Can cause hyperkalemia
ADRs of K sparing diuretics
HypoNa Inc BUN/Cr Jaundice H/a N/v/d
DDIs K sparing diuretics
ACE inhibitors-hyperkalemia
NSAIDs
Lithium
Examples of K sparing diuretics
Spironolactone
Amiloride
Triamterene
ACE inhibitor MOA
Blocks conversion of angiotensin I to angiotensin II (vasoconstrictor) and blocks degradation of bradykinin (a vasodilator) to reduce peripheral vascular resistance
Precautions of ACE inhibitors
Can cause renal failure if b/l renal artery stenosis
CI for ACE inhibitors
Angioedema
B/l renal stenosis
PREGNANCY
ADRs for ACE inhibitors
Nonproductive cough Rash Angioedema Hyperkalemia Dec renal function
DDIs for ACE inhibitors
Effects inc with diuretics
Hyperkalemia w/ K sparing drugs
Inc lithium levels
Dec by NSAIDs
Examples of ACE inhibitors
Enalapril
Quinacrine
Benazapril
ARB MOA
Blocks binding of angiotensin II to its receptors in vascular smooth muscle to cause vasodilation
ADRs for ARBs
Similar to ACE: Rash Angioedema Hyperkalemia URI
Examples of ARBs
Losartan
Valsartan
CCB MOA
Blocks Ca ion channels in plasma membrane of smooth muscle to vasodilate
CI for Verapamil and diltiazem
Hypotension
Cardiogenic shock
Sick sinus syndrome
2nd or 3rd degree heart block
ADRs for CCBs
Constipation Bradycardia Flushing CHF, heart block, hypotension Reflex tachycardia Syncope and heart block and sinus arrest for nifedipine
DDIs for verapamil and diltiazem
Digoxin
Amiodarone
Azoles
Others
Examples of DHP CCBs
Amlodipine
Delodipine
Israpidine
Nicardipine
Examples of non-DHP CCBs
Diltiazem
Verapamil
Precautions for beta blockers
Reflex tachycardia
Need cardio selective in DM and bronchospastic dz
CI for beta blockers
Sinus bradycardia 2nd or 3rd degree heart block Heart failure Cardiogenic shock Sick sinus syndrome Peripheral artery dz
ADRs for beta blockers
Bradycardia CHF Hypotension Broncho constriction Sexual dysfunction Will mask sxs of hypoglycemia
DDIs for beta blockers
Digoxin
CCBs
Examples of non selective beta blockers
Propranolol
Nadolol
Timolol
Examples of cardioselective beta blockers
Atenolol Metoprolol Betaxolol Bisoprolol Nebivulol
Beta blockers with ISA activity- less bradycardia
Acebutolol
Penbutolol
Pindolol
Alpha and beta blocker examples
Carvedilol
Labetalol
Alpha 1 blocker MOA
Blocks vasoconstriction of peripheral vascular smooth muscle
Can increase heart rate and contractility and fluid retention
Precautions for alpha blockers
Orthostatic hypotension and syncope so give at night
ADRs of alpha blockers
Orthostatic hypotension
Sexual dysfunction
Reflex tachycardia
Dry mouth
Examples of alpha blockers
All end in azosin
Doxazosin
Terazosin
Prazosin
Centrally acting agents used for
Refractory HTN after other agents fail
Precautions for centrally acting agents
Avoid rapid withdrawal to avoid rebound HTN a
Caution in elderly
Avoid TCA use
CNS depression
Centrally acting agents
Clonidine
Methyl dopa
Guanethidine and reserpine
Centrally acting agent that can cause Coombs positive hemolytic anemia
Methyl dopa
ADRs of direct vasodilators
Reflex tachycardia
Angina
Myocardial ischemia
Examples of direct vasodilators
Hydralazine
Minoxidil
Sodium nitroprusside
Diazoxide
Unique ADRS for hydralazine
Lupus like syndrome
Cyanide toxicity is concern is which drug
Sodium nitroprusside
Direct renin inhibitor
Aliskiren
Combo products
Benazapril and amlodipine
Benazapril and HCTZ
Bisopril and HCTZ
IV options for hypertensive emergency
Beta blockers Nitros Hydralazine Dopamine receptor agonists good for renal dysfunction CCBs ACE inhibitor
Thiazides diuretics MOA
Block NaCl reabsorption at distal convoluted tubules; cell membrane alteration
