Anti-hypertensive Meds Flashcards
General MOAs for antiHTN meds
affect variables in CO and MAP to alter BP
AntiHTN meds effect on variables of CO and MAP
1) . reduce HR –> decrease CO and AP
2) . decrease contractility –> decrease SV –> decrease BP
3) . increase vasodilation –> lower peripheral vascular resistance –> decrease BP
4) . reduce plasma volume –> decrease SV –> decrease bP
Classes of AntiHTN meds
1) . diuretics
2) . direct vasodilators
3) . calcium-channel blocking vasodilators
4) . beta-blockers
5) . α1-Adrenoceptor Blockers
6) . Dual α- & β- blockers
7) . alpha agonists
8) . RAAS inhibitors
what is the recommended initial therapy for all HTN patients?
Diuretics
Types of Diuretics
1) . Loop
2) . Thiazide
3) . K+ sparring
which diuretic is the most frequently used?
Thiazide
MOA of loop diuretics
inhibits reabsorption of Na+, K+, chlorine – prevents reabsorption of water
AE of Loop Diuretics
dehydration, hypokalemia, hyponatremia, hypocalcemia, ototoxicity, hyperglycemia, increased LDLs
PK/PD considerations for Loop Diuretics
may be taken along with supplemental K+ or K+ sparing diuretics to reduce risk of hypokalemia and metabolic alkalosis
Loop diuretics suffix
-ide
MOA for Thiazide diuretics
inhibits mechanism that favors Na+ reabsorption –> result in Na+ and K+ excretion and reabsorption of Ca2+
AE of Thiazide diuretics
similar to loop diuretics, may cause hypercalcemia and significant loss of K+
PK/PD considerations for Thiazide Diuretics
1) . may be given along w/loop diuretics in cases of CHF, severe edema
2) . favored for older adults to reduce Ca+ loss and maintain bone loss
which Diuretic is better choice for individuals prone to renal calculi?
Thiazide Diuretics
Thiazide Diuretic suffix
-azide
MOA for K+ sparring diuretics
inhibits the Na+/K+ exchange mechanism and limits the reabsorption of Na+ and excretion of K+. Limits osmotic gradient which drives reabsorption of water from tubule
AE of K+ sparring diuretics
hyperkalemia, nausea, lethargy, mental confusion
PK/PD considerations for K+ sparring diuretics
1) . less effective at producing diuresis but are K+ sparring
2) . Prevents hypokalemia (good for arrythmias)
Therapeutic Concerns with Diuretics
1) . look for signs of hypokalemia or hyperkalemia
2) . hyperglycemia and abnormal lipid levels
3) . dehydration
4) . DDIs with NSAIDs
T/F: there is a fall risk with diuretics
True: mental status can change due to hypo/hyperkalemia, dehydration
T/F: risk of orthostatic hypotension with diuretics
True, increased TPR
effect of NSAIDs in DDIs with diuretics
NSAIDs cause Na+ retention and decreases in renal perfusion –> cause diuretics to be less effective
MOA of direct vasodilators
inhibit smooth muscle contraction in arterioles to directly vasodilate the peripheral vasculature
AE of direct vasodilators
dizziness, orthostatic hypotension (reflex tachycardia - to compensate for fall in BP)
