Anti-hypertensive Drugs Flashcards
How is hypertension defined in adults older than 60?
Persistent SBP greater 150 and/or DBP greater than 90
How is hypertension defined in adults younger than 60?
SBP greater than 140 and/or DBP greater than 90
How is blood pressured measured?
Cardiac output x systemic vascular resistance
What is normal cardiac output?
4-8L/min
What is SVR?
Systemic Vascular Resistance; determined by vascular diameter and masculature
What is essential or primary hypertension?
When the cause is unknown
What is secondary hypertension?
Everything that’s not primary
What are the 7 main categories of hypertension drugs?
VICARDD
1) Vasodilators
2) Inhibitors (ACE & ARBs)
3) CCBs
4) Adrenergic
5) Renin Inhibitors
6) Diuretics
Describe what part of the body these drug subcategories work on:
1) Adrenergic neuron blockers
2) a2 receptor agonists
3) a1receptors blockers
4) b receptor blockers
5) combo a&b blockers
1) central and peripheral
2) central
3) peripheral
4) peripheral
5) peripheral
Name two a2 Receptor Agonist drugs
Clonidine
Methyldopa
How do a2 receptor agonist drugs work?
- They stimulate the a2 receptors in the brain
- This causes lower outflow of CNS
- Results in lack of norepinephrine which reduces blood pressure
- Also stimulates the kidneys which reduces activity of renin
Name 4 a1 receptor blocker drugs
Doxazosin
Prazosin
Terazosin
Tamsulosin
How do a1 Receptor Blocker drugs work?
- They block the a1 receptors from being stimulated by epinephrine which normally would cause blood pressure to rise
Name 2 combo receptor drugs
Labetalol
Carvedilol
What else are a1 Receptor Blockers useful for especially in men?
Relieve symptoms of BPH
What are contraindications of adrenergic drugs?
- Acute heart failure
- Current use of Monoamine Oxidase Inhibitors
- Peptic Ulcers
- Severe liver/kidney disease
What are the most common adverse affects of adrenergic drugs?
BEDS DDDC
- Bradycardia
- Edema
- Depression
- Sexual Dysfunction
- Dry mouth
- Dizziness
- Drowsiness
- Constipation
What suffix indicates an ACE Inhibitor drug?
-Pril
What is a prodrug?
A drug that is administered in its inactive form and must be metabolized by the body to its active form
What 2 ACE Inhibitors are not prodrugs?
Captopril
Lisinopril
(best in a patient with liver dysfunction)
Can pregnant women take ACE Inhibitors?
Fuck no
How do ACE Inhibitors work?
Prevent ACE (Angiotensin Converting Enzyme) from converting Angiotensin I into Angiotensin II
Which drugs are the drug of choice for patients with hypertension and heart failure and patients with diabetes? Why?
ACE Inhibitors; They prevent ventricular remodeling and hypertrophy after an MI and have protective effects on the kidneys
What are contraindications of ACE inhibitors?
- 5mEq/L or more of potassium
- Pregnancy
Name the adverse effects of ACE Inhibitors
CHAMBRED
Cough
Hyperkalemia
Angioedema
Mood changes
Bitterness (loss of taste)
Renal Impairment
Exhaustion
Dizziness
Can you take NSAIDs with ACE Inhibitors?
No; they can reduce the antihypertensive effects and cause acute renal failure
How do you identify an ARB drug?
Ends with -tan
How do ARBs work?
They prevent Angiotensin II from binding onto tissues
Can you take ARBs while pregnant or breastfeeding?
Fuck no
What are the most common adverse effects of ARBs?
FLATHEAD
-Fatigue
-Loss of taste
-Angioedema
-Taste Loss
-Headaches
-Electrolyte Imbalance
-Angioedema
-Dizziness
How do CCBs work?
They prevent calcium from binding to receptors preventing contraction
Name top 5 CCBs
Diltiazem
Amlodipine
Nifedipine
Verapamil
Felodipine
How do diuretics work?
They decrease plasma and extracellular fluids
This decreases preloads
Which decreases cardiac output, peripheral resistance, and workload of the heart
How do you identify a diuretic?
Thiazide
Name 4 vasodilator drugs
1) Minoxidil
2) Hydralazine
3) Diazoxide
4) Nitroprusside
What are contraindications of vasodilator drugs?
Hypotension
Cerebral Edema
Head injury
Acute MI
Coronary Artery Disease
What is the only Direct Renin Inhibitor drug?
Aliskiren
What are contraindications of Aliskiren?
Pregnancy
What electrolyte imbalance can hydrochlorothiazide cause?
Hypokalemia