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Pharm 4 > Anti-HTN > Flashcards

Anti-HTN Flashcards

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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
Q

Sympatholytic drugs MOA

A

Reduce sympathetic-mediated vasoconstriction, CO, renin release

26
Q

Central acting sympatholytic agonist

A

Clonidine

Alpha 2 agonist, decreases sympathetic outflow

27
Q

Adverse effects of clonidine

A

Sedation
Dry mouth
Dermatitis (from slow-release patch)

28
Q

Rebound hypertension w/ clonidine?

A

Must withdraw clonidine administration slowly

29
Q

Alpha 2 agonist that has a longer half-life than clonidine

A

Guanfacine

Less chance of rebound HTN

30
Q

Most extensively used anti-HTN in pregnancy?

A

Methyldopa
Alpha 2 agonist (same MOA as clonidine)
Inhibits dopamine production

31
Q

Reserpine MOA

A

Blocks VMAT vesicular transporter, preventing storage of NE centrally and peripherally

32
Q

Side effects of reserpine

A

Depression (prevents storage of NE), nasal congestion

33
Q

Phenoxybenzamine use

A

Pheochromocytoma. Blocks alpha adrenergic mediated vasoconstriction at receptor

34
Q

Side effect of phenoxybenzamine

A

Tachycardia

35
Q

Selective alpha 1 agonists

A

-osin
Prazosin
Terazosin (longer half-life)
Doxazosin (longer half-life)

36
Q

Side effects of prazosin

A

Orthostatic HTN after first dose

37
Q

Better nonselective beta blocker than propanolol

A

Nadolol (longer half life, 1/day dosing)

38
Q

Partial agonist, non-selective beta blocker, less bradycardia produced than others w/in class

A

Pindolol

39
Q

Carvedilol characteristics

A

Non-selective beta blocker, alpha receptor blocker, vasodilator, somewhat lipophilic

40
Q

Labetolol characteristics

A

Also has alpha blocker capacity. Lipophilic. Used for pheos

41
Q

Atenolol

A

Beta 1 selective, hydrophilic

42
Q

Metoprolol

A

Beta 1 selective, lipophilic

43
Q

Side effects of ALL beta blockers

A 
Bradycardia
Increased TGs
Decreased HDLs
Hyperglycemia
Impaired exercise tolerance
44
Q

Drug interactions to consider with beta blockers

A

CCBs (reduced contractility and conduction)

45
Q

Contraindications for beta blockers

A 
Asthma
Reduced cardiac function
Cardiogenic shock
Sinus bradycardia
Severe HF
46
Q

Beta blockers and hypoglycemia

A

Can mask and prolong insulin-induced hypoglycemia

47
Q

Side effect of nitroprusside

A

Cyanide poisoning

48
Q

Vasodilator used for drug-resistant HTN

A

Hydralazine (esp. in pregnancy)

Minoxidil

49
Q

Side effect of minoxidil

A

Hypertrichosis (werewolf-like effect)

50
Q

Side effects of hydralazine/minoxidil

A

Tachycardia, angina aggravation, fluid retention

NSAIDs can reduce effectiveness

51
Q

ACE inhibitors

A

-pril
Captopril
Enalapril
Lisinopril

52
Q

Short half-life ACE inhibitor

A

Captopril

53
Q

Longer half-life ACE inhibitor

A

Enalapril

54
Q

Side effects of ACE inhibitors

A 
CATCHH
Cough
Angioedema
Teratogen
Creatinine increase
Hyperkalemia
Hypotension
55
Q

Should one use ACE inhibitors in pts with diabetic pts?

A

Yes! It preserves renal fxn

56
Q

Use ACE inhibitors in pts post-MI?

A

Yes! Prolongs survival in post-MI pts with HF or LV dysfunction

57
Q

Losartan - what is it?

A

ARB
selective AT1 receptor antagonist
Causes hyperkalemia

58
Q

Contraindication of losartan?

A

Pregnancy

59
Q

Good drug combos to combat HTN

A

Thaizide/loop with K+ sparing diuretic
Thiazide w/ beta blocker
CCBs w/ ACE inhibitor

Pharm 4 (4 decks)

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