Anti-hypertensive drugs - Overview Flashcards
Which pharmacologic agents are used to treat essential hypertension?
- Diuretics
- Calcium channel blockers
- Angiotensin-converting enzyme inhibitors
- Angiotensin II receptor blocks
First-line drug for essential hypertension
Hydrochlorothiazide
α-blockers used as antihypertensives
- Doxazosin
- Prazosin
- Terazosin
- Summary:*
- All ‘ozins’ except Tamsulosin
MOA of beta-blockers as antihypertensive
- ↓ CO
- ↓ renin secretion (due to β1-receptor blockade on JGA cells)
Which pharmacologic agents are used to treat hypertension in patients with congestive heart failure?
- Diuretics
- Angiotensin-converting enzyme inhibitors
- Angiotensin II receptor blocks
- β-blockers (in compensated congested heart failure only)
- Potassium-sparing diuretics
Must be used cautiously in decompensated HF and are contraindicated in cardiogenic shock
β-blockers
Which pharmacologic agents are used to treat hypertension in patients with diabetes mellitus?
- Angiotensin-converting enzyme inhibitors/angiotensin II receptor blocks
- Calcium-channel blockers
- Diuretics
- β-blockers
Drugs protective against diabetic nephropathy
ACE inhibitors/ARBs
Why are angiotensin-converting enzyme inhibitors especially important in patients with diabetes mellitus?
They have been shown to delay progression to diabetic nephropathy
Drugs used in hypertension in pregnancy
Hydralazine, labetalol, methyldopa, nifedipine
Drugs contraindicated in bilateral renal artery stenosis
ACE Inhibitor (Captopril)
Drug used in hypertension with co-morbid BPH
Prazosin/Tamsulosin
Side effect of this drug is (+) Coomb’s hemolytic anemia
Methyldopa
Side effect of this drug is reflex tachycardia, drug-induced lupus
Hydralazine
Side effect of this drug is hypertrichosis
Minoxidil
Side effect of this drug is cyanide poisoning
Nitroprusside
Side effect of this drugs is flushing, edema, gingival hyperplasia
Calcium channel blockers such as nifedipine
Memory aid:
-
Chewing gum!
- C - Calcium channel blockers such as Nifedipine
- C - Calcineurin inhibitors such as Cyclosporin
- C - antiConvulsants such as Phenytoin
- G - Gingival hyperplasia
Why do patients taking nitrates usually experience throbbing headaches?
Meningeal artery vasodilation
In which case of HTN are beta-blockers used with caution?
- used cautiously in decompensated HF
- contraindicated in cardiogenic shock
What two agents are first-line therapies for hypertension in pregnancy?
Hydralazine with methyldopa
What is the mechanism of action of minoxidil?
Minoxidil opens potassium channels on the cell membrane, which causes hyperpolarization and subsequent relaxation of vascular smooth muscle
What are the toxicities of minoxidil?
- Hypertrichosis
- Reflex tachycardia
- Angina
- Salt retention
- Pericardial effusion
A 60-year-old man with severe hypertension presents with complaints of increased hair growth and new chest pain. Toxicity of which antihypertensive drug is most likely causing these symptoms?
Minoxidil
A patient is started on antihypertensive therapy. One week later he returns complaining of swollen ankles and flushed skin. Which class of medication was he likely prescribed?
Calcium channel blockers
