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Pharm 4 > Anti-HTN > Flashcards

Anti-HTN Flashcards

1
Q

First line DOC for HTN treatment

A

Diuretics**
CCBs
ACEIs
ARBs

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2
Q

Secondary drugs of choice for HTN treatment

A

Beta blockers
Centrally acting agents (sympatholytics)
Alpha adrenergic agonists
Vasodilators

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3
Q

DOC for uncomplicated HTN

A

Diuretics

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4
Q

MOA of thiazides

A

Inhibits Na/Cl cotransporter in distal duct
Later - decreases peripheral resistance (prostaglandin)
Mild Na+ excretory effect

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5
Q

Side effects of thiazides

A

Hypokalemia (higher Na+ is exchanged in collecting duct cell via ENaC; K+ then goes down gradient into lumen/urine)
Hyponatremia
Hyperglycemia
Increased LDL/HDL

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6
Q

Thiazide-drug interactions

A 
NSAIDs (prostaglandin disruption)
Beta blockers (hyperglycemia)
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7
Q

Side effects of furosemide

A 
Dehydration/hyponatremia
Hypokalemia
Impaired diabetes control
Increased LDL/HDL
Ototoxicity
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8
Q

Drug interactions of furosemide

A

NSAIDs

Aminoglycosides

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9
Q

K+ sparing diuretics that block on aldosterone receptors

A

SpironolactONE and eplerenONE are competitive aldosterONE antagonists

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10
Q

Side effects of K+ sparing diuretcs

A

Hyperkalemia

Gynecomastia (spironolactone)

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11
Q

K+ sparing diuretics that block Na+ channels (keeping K+ in blood)

A

Amiloride

Triamterene

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12
Q

Drug interactions with K+ sparing diuretics

A

NSAIDs

ACE inhibitors and ARBs = super hyperkalemia

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13
Q

Contraindications for K+ sparing diuretics

A

Renin angiotensinogen system inhibitors

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14
Q

MOA of Ca channel blockers

A

Reduction of vascular resistance by reducing calcium influx in VSM

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15
Q

Side effects of Ca channel blockers

A

Minimal

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16
Q

Site of action for non-dihydropyridines

A

Non-selective; both cardiac and smooth muscle

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17
Q

Site of action for dihydropyridines

A

Smooth muscle mostly

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18
Q

Example of dihydropyridine Ca channel blocker

A

Nifedipine

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19
Q

Example of nondihyrdopyridine Ca channel blockers

A

Verapamil

Diltiazem

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20
Q

Ca channel blocker(s) that may cause acute tachycardia

A

Nifedipine

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21
Q

Ca channel blocker(s) that may cause bradycardia

A

Diltiazem

Verapamil

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22
Q

Ca channel blocker that may cause constipation

A

Verapamil

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23
Q

Ca channel blocker that may cause peripheral edema

A

Nifedipine

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24
Q

Contraindication of nondihydropyridines

A

Nonhydropyridines act on the heart

Contraindicated in pts w/ conduction disturbances

25
Sympatholytic drugs MOA
Reduce sympathetic-mediated vasoconstriction, CO, renin release
26
Central acting sympatholytic agonist
Clonidine | Alpha 2 agonist, decreases sympathetic outflow
27
Adverse effects of clonidine
Sedation Dry mouth Dermatitis (from slow-release patch)
28
Rebound hypertension w/ clonidine?
Must withdraw clonidine administration slowly
29
Alpha 2 agonist that has a longer half-life than clonidine
Guanfacine | Less chance of rebound HTN
30
Most extensively used anti-HTN in pregnancy?
Methyldopa Alpha 2 agonist (same MOA as clonidine) Inhibits dopamine production
31
Reserpine MOA
Blocks VMAT vesicular transporter, preventing storage of NE centrally and peripherally
32
Side effects of reserpine
Depression (prevents storage of NE), nasal congestion
33
Phenoxybenzamine use
Pheochromocytoma. Blocks alpha adrenergic mediated vasoconstriction at receptor
34
Side effect of phenoxybenzamine
Tachycardia
35
Selective alpha 1 agonists
-osin Prazosin Terazosin (longer half-life) Doxazosin (longer half-life)
36
Side effects of prazosin
Orthostatic HTN after first dose
37
Better nonselective beta blocker than propanolol
Nadolol (longer half life, 1/day dosing)
38
Partial agonist, non-selective beta blocker, less bradycardia produced than others w/in class
Pindolol
39
Carvedilol characteristics
Non-selective beta blocker, alpha receptor blocker, vasodilator, somewhat lipophilic
40
Labetolol characteristics
Also has alpha blocker capacity. Lipophilic. Used for pheos
41
Atenolol
Beta 1 selective, hydrophilic
42
Metoprolol
Beta 1 selective, lipophilic
43
Side effects of ALL beta blockers
``` Bradycardia Increased TGs Decreased HDLs Hyperglycemia Impaired exercise tolerance ```
44
Drug interactions to consider with beta blockers
CCBs (reduced contractility and conduction)
45
Contraindications for beta blockers
``` Asthma Reduced cardiac function Cardiogenic shock Sinus bradycardia Severe HF ```
46
Beta blockers and hypoglycemia
Can mask and prolong insulin-induced hypoglycemia
47
Side effect of nitroprusside
Cyanide poisoning
48
Vasodilator used for drug-resistant HTN
Hydralazine (esp. in pregnancy) | Minoxidil
49
Side effect of minoxidil
Hypertrichosis (werewolf-like effect)
50
Side effects of hydralazine/minoxidil
Tachycardia, angina aggravation, fluid retention | NSAIDs can reduce effectiveness
51
ACE inhibitors
-pril Captopril Enalapril Lisinopril
52
Short half-life ACE inhibitor
Captopril
53
Longer half-life ACE inhibitor
Enalapril
54
Side effects of ACE inhibitors
``` CATCHH Cough Angioedema Teratogen Creatinine increase Hyperkalemia Hypotension ```
55
Should one use ACE inhibitors in pts with diabetic pts?
Yes! It preserves renal fxn
56
Use ACE inhibitors in pts post-MI?
Yes! Prolongs survival in post-MI pts with HF or LV dysfunction
57
Losartan - what is it?
ARB selective AT1 receptor antagonist Causes hyperkalemia
58
Contraindication of losartan?
Pregnancy
59
Good drug combos to combat HTN
Thaizide/loop with K+ sparing diuretic Thiazide w/ beta blocker CCBs w/ ACE inhibitor

Pharm 4 (4 decks)

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