Anti Hypertensive Flashcards
Decrease SANS
Decrease HR, TPR, CO
A2 Agonists - Clonidine & Methyldopa
Tx: opiate, smoking & ethanol withdrawal
Mild & moderate HTN
Clonidine
Tx: mild & moderate HTN; HTN in pregnancy
Methyldope
SE: Depression, dry mouth
Sudden withdrawal = hypertensive crisis
Clonidine
SE: + Coombs test hemolytic anemia
Methyldopa
Inhibits VMAT - Deceasing NE release
Decreases SANS, HR, BP
Crosses BBB
Reserpine
SE: Depression, diarrhea, Increase gastric acid secretion
Contraindications: peptic ulcer & depression
Reserpine
Inhibits re uptake of NE by blocking NET
Decreases SANS, HR, BP
Doesn’t cross BBB
Guanethidine
SE: Orthostatic HTN, diarrhea, edema, sexual dysfucntion
Contraindications: can be inhibited by NET blockers - cocaine & TCAs
Guanethidine
Decrease TPR & vasodilate
Alpha Blockers
Blocks irreversibly A1 & A2
Tx: Secondary HTN
phenooxybenzamine - nonselective
Blocks reversibly A1 & A2
phentolamine - nonselective
Blocks A1 reversibly
selective - prazosin, terazosin, tamsulosin, doxazosin
Tx: HTN emergency by IV
Non selective - phenooxybenzamine & phentolamine
Tx: Essential HTN
Prazosin & Terazosin
Tx: BPH
Tamsulosin
ADR: 1st dose effect Nasal Blockade Reflex tachycardia retroejaculation
Alpha Blockers
Drug of choice to tx - HTN emergency
Labetolol - Alpha & Beta Blocker
Tx: HTN & reduces mortality in patients w/ heart failure
Carvedilol - Alpha & Beta Blocker
Decrease s - CO, TPR, contractility, HR, relaxation rate, conduction velocity
Inhibits renin release
Beta Blockers
Non Selective Beta Blockers
Carteolol Carvedilol Labetolol Nadolol Penbutolol Pindolol Propanolol Timolol
Selective Beta Blockers
Bisoprolol Betaxolol esmolol Acebutolol Metaprolol Atenolol Nebivolol
Tx: HTN, Angina, MI, Arrhythmias, Heart Failure
Beta Blockers
ADR: Impaired exercise tolerance Hyperlipidemia Diabetes (alter hyperglycemia & mask hypoglycemia) asthma heart block/heart failure sexual dysfunction
Beta Blockers
nervousness, tachycardia, angina, HTN & heart infection
Sudden withdrawal from Beta Blockers
Antidote for over dose of Beta blockers causing heart block/ heart failure
glucagon
BP >/= 180/110 without end organ damage severe headache SOB nosebleeds sever anxiety
Hypertensive urgency
BP >/= 180/120 with damage to at least one organ (brain, heart, kidney) stroke heart attack loss of kidney fucntion loss of consciousness & memory loss damage to eye aortic dissection angina pulmonary edema eclampsia
Hypertensive emergency
Hypertensive tx for blacks
Thiazide & CCB
stage 1 HTN tx
mono therapy
stage 2 HTN tx
combo therapy - 2 agents with different MOA
patient has diabetes or kidney disease with HTN what id the treatment
ACE-I, ARBs
blood pressure goal
less than 130/80 mmHg
used to tx HTN in pregnancy
Labetolol
Nifedipine
methyldopa
