Anti-Hypertension Drug Therapy Deck 3 Flashcards
Minoxidil more
selecive dialation of arterioles
Minoxidil more intense
More intense dilation than hydralazine, but causes more severe adverse reactions
Minoxidil used for severe
Used for severe hypertension unresponsive to safer drugs
Minoxidil ADR
Reflex tachycardia Sodium and water retention Hypertrichosis Pericardial effusion Other
Sodium Nitroprusside [Nitropress] is the
fastest acting antihypertensive agent
Sodium Nitroprusside [Nitropress] causes
venous and arteriolar dialation
Sodium Nitroprusside [Nitropress] administration
IV
Sodium Nitroprusside [Nitropress] onset
Onset: Immediate (BP returns to pretreatment level in minutes when stopped)
Sodium Nitroprusside [Nitropress] used for
Used for hypertensive emergencies
Sodium Nitroprusside [Nitropress] adverse
Excessive hypotension
Cyanide poisoning
Thiocyanate toxicity
Alpha 1 blocker MOA
Dilate both resistance and capacitance vessels
Alpha 1 blocker dialate
Dilate both resistance and capacitance vessels
Alpha 1 net effect
Net effect: BP reduce, may cause retention of Na and water when given without a diuretic
slective alpha 1 receptor blockers do not
Selective alpha 1 receptor blockers do not cause reflex tachycardia
alpha one decrease what and increase what
Decreases TG, increase HDL
alpha one blocker not recomended
for initial monotherapy
Consider patients with HTN and BPH
Consider giving with a diuretic
Alpha 1 blocker SE
First-dose phenomenon: dizziness or syncope
Hypotension
CNS: depression, lassitude, vivid dreams
Priapism
Administer initially at HS and titrate slowly
Precautions: liver disease, prostate cancer, cataract surgery
Contraindications: sensitivity
common combination
Thiazide and ACE/ARB
ACCOMPLISH trial
long-acting dihydropyridine calcium channel blocker plus a long-acting angiotensin-converting enzyme (ACE)inhibitor/ARB
other combination
BB + thiazide or dihydropyridine CB
ACE-I or ARB – likely to be less
ACE-I or ARB – likely to be less
Beta blocker use in caution in
Beta blocker use in caution in
Consider BP >20/10 mmHg
above goal
Follow-up
Start one drug, titrate to maximum, then add a second dose
Follow-up monthly until BP goal is met.
BP at goal, follow-up every 3 to 6 months
Monitor serum potassium, creatinine and urine microalbumin 1 to 2 times per year
monotehrapy
thiazide-type diuretic
chlorthaladone prerred
monitor what with thiazide type
hypokalemia
chlorthalidone and indapamide are
signifcantly more potent antihypersetnive agents that hydrochlorothizide, at simlar dose levels
loop diuretics moa
acts on acending loop of henle to block reabsorption
loop pharmacokinetics
rapid onset PO 60 min IV 5 min
loop use
pulmonary edema, edematous states, hypertension
loop ADR
hyponatremia, hypochloremia, dehydration, hyoptnesion, hyopkalemia, ototoxicity, hyperglycemia, hyperuricemia
