Anti-hypertensive drugs

Question 1

4 thiazides?

Answer 1

hydrochlorothiazide
chlortalidone
metolazone
thiazides

Question 2

MOA: inhibits Na & Cl transporters in ascending and distal convoluted tubules, increasing Na & Cl excretion, reduces blood volume

Answer 2

thiazides diuretics

Question 3

distinguishing characteristics: Increases K and Mg excretion; decreases Ca and uric acid excretion; takes a couple days for maximum effect
predicted actions: decreases plasma volume, decreased CO, may cause electrolyte issues
uses: HTN; chronic edema; tx of hypocalcemia when due to excessive urinary loss of Ca
SEs: electrolyte abn, need to supplement with K+, pts w/ sulfa allergy need to avoid!

Answer 3

thiazide diuretics

Question 4

4 examples of loop diuretics?

Answer 4

furosemide
bumetanide
ethacrynic acid
torsemide

Question 5

MOA: inhibits Na-K-Cl tri-transporter in thick ascending loop of Henle

Answer 5

loop diuretics

Question 6

distinguishing characteristics: Competes with Cl for binding site; enhances passive Mg and Ca excretion; increases K and H excretion; onset in 20-30min with a half-life of 1-1.5hrs
uses: HTN; acute/chronic edema; renal disease patients; hypertensive emergencies (CHF, renal insufficiency, nephrotic syndrome); hypercalcemia
SEs: Electrolyte abnormalities! Patients with a sulfa allergy need to avoid; hypokalemia; C/I in patients taking Lithium (concentrates)

Answer 6

loop diuretics

Question 7

NSAIDs reduce organic cation transport thus reducing effectiveness

Answer 7

loop diuretics

Question 8

4 example of ACE Is?

Answer 8

lisinopril
enalapril
captopril
ramipril

Question 9

MOA: blocks a certain enzyme cascade, decreases peripheral vasoconstriction, inhibits bradykinin degradation

Answer 9

ACE Is

Question 10

distinguishing characteristics: Often used with a potassium-wasting diuretic since RAS inhibitors can increase K concentrations
predicted actions: reduction in BP
uses: HTN patients with diabetes or CHF; post-MI tx to reduce morbidity and and mortality
SEs: hypotension, dry cough, C/I in PG, angioedema, hyperkalemia, reduced KD fxn

Answer 10

ACE Is

Question 11

4 ARBs?

Answer 11

losartan
irbesartan
valsartan
candesartan

Question 12

MOA: blocks enzyme conversion resulting in significant decrease in peripheral vasoconstriction

Answer 12

ARBs

Question 13

distinguishing characteristics: Appears to not block the degradation of bradykinins; often used with a potassium-wasting diuretic
predicted actions: reduction in BP
uses: HTN pts w/DM or CHF
SEs: C/I in PG, hyperkalemia, reduced KD fxn, cough (rare), angioedema

Answer 13

ARBs

Question 14

3 categories of CCBs? 3 that we talk about a lot?

Answer 14

benzothiazepines (diltiazem)
diphenyl alkamines (verapamil)
dihydropyridines (amlodipine)

Question 15

MOA: blocks Ca2+ influx w/resultant improved myocardial tone & decreased CO output, targets cardiac cells

Answer 15

benzothiazepines (diltiazem) and diphenyl alkamines (verapamil)

Question 16

distinguishing characteristics: Slow onset of action; effects of peripheral vasodilation often useful in reducing both preload and afterload (good for CHF)
predicted actions: reduced CO & decreased BP
uses: HTN, angina, cardiac arrhythmias, prophylactic migraine HA and raynaud’s
SEs: Hypotension, dizziness, HA, flushed skin, negative inotropic effect (dec. cardiac output); gingival hyperplasia
use in caution in those w/bradycardia, severe CHF, elderly, or w/conduction issues

Answer 16

benzothiazepines (diltiazem) and diphenyl alkamines (verapamil)

Question 17

MOA: blocks Ca2+ influx w/resultant peripheral vasodilation, improved myocardial tone, targets peripheral SM cells

Answer 17

dihydropyridines (amlodipine)

Question 18

distinguishing characteristics: Slow onset of action; effects of peripheral vasodilation often useful in reducing both preload and afterload (good for CHF)
predicted actions: Reduced peripheral resistance with a decrease in BP
SEs: Ankle edema, HA and flushing (rare); gingival hyperplasia

Answer 18

dihydropyridines (amlodipine)