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CVS pharm > anti-hypertensives > Flashcards

anti-hypertensives Flashcards

1
Q

What are 3 ACE inhibitors?

A

Lisinopril
Captopril
Enalapril

All the -prils

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2
Q

What is the mechanism of action of ACE inhibitors?

A

Prevents the formation of angiotensin II from angiotensin I

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3
Q

What are the 2 main effects of angiotensin II?

A
  1. Activate adrenal glands to secrete aldosterone –> activates RAAS system
  2. Reduces production of NO –> vascular smooth muscle constriction –> increase in total peripheral resistance
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4
Q

What are the side effects of ACE inhibitors?

A
  1. Hypotension
  2. Acute renal failure
  3. Angioedema
  4. Dry cough
  5. Hyperkalemia
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5
Q

Why do ACE inhibitors cause angioedema & dry cough?

A

ACEI inhibit the inactivation of bradykinins –> causes an increase in NPO & prostaglandins –> dry cough + inflammation-like vasodilation

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6
Q

What are ACEI indicated in?

A
  1. Hypertension (duh)
  2. Cardiac failure
  3. following AMI
  4. Renal insufficiency

ARCH

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7
Q

What group of individuals are ACE inhibitors contraindicated in?

A

Pregnant women

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8
Q

What are 2 examples of ARBs?

A

Valsartan
Losartan

All the -sartans

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9
Q

What is the mechanism of action of ARBs?

A

Angiotensin II antagonists; prevent ang II from binding to the receptors

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10
Q

Why choose ARB > ACEI?

A

Less/no dry cough cuz they don’t inhibit the bradykinin inactivation pathway

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11
Q

What group of individuals are ARBs contraindicated in?

A

Pregnant women
Renal failure

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12
Q

Beta-blockers inhibit ________ (CICR), preventing the formation of the ________ and hence decreasing __________.

A

Beta-blockers inhibit calcium-induced calcium release (CICR), preventing the formation of the actin-myosin complex and hence decreasing heart contractility

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13
Q

What are the 3 non-selective beta blockers?

A

Propanolol
Pindolol
Carvedilol

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14
Q

What are the 3 beta-1 selective beta-blockers?

A

Atenolol
Bisoprolol
Metoprolol XL

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15
Q

When is Nebivolol non-selective?

A

In high doses & in slow metabolizers

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16
Q

What are beta-blockers indicated in?

A
  1. Hypertension
  2. Cardiac failure
  3. following AMI
  4. Abnormal heart rhythm
  5. Anxiety disorders

HCAAA

17
Q

What are the adverse effects of beta-blockers?

A
  1. Hypotension
  2. Brachycardia
  3. AV nodal block
  4. Reduced exercise capaciy
  5. Bronchoconstriction
  6. Clinical depression (beta-blocker blues)
18
Q

What group of individuals are beta-blockers contraindicated in?

A

Asthmatic & diabetic patients

19
Q

What is the class of diuretics mainly used to treat HTN?

A

Thiazides

20
Q

What are the 5 classes of first-line antihypertensives?

A
  1. ACEI
  2. ARBs
  3. Beta-blockers
  4. DHP calcium channel blockers
  5. Thiazides
21
Q

Thiazides inhibit ________ reabsorption by blocking the ________ in the _______.

Tubular fluid in the collecting duct is hence more ________, reducing H2O ________ in the collecting duct.

A

Thiazides nhibits NaCl reabsorption by blocking the Na/Cl transporter in the DCT.

Tubular fluid in the collecting duct is hence more hypertonic, reducing H2O reabsorption in the collecting duct.

22
Q

What are 2 thiazides?

A

Hydrochlorothiazide
Indapamide

23
Q

What class of drugs interfere with action of thiazide diuretics?

A

NSAIDs reduce renal prostaglandin synthesis

24
Q

What are thiazides indicated in?

A
  1. Hypertension
  2. Congestive heart failure
  3. Nephrolithiasis
25
Q

Which salt experiences enhanced reabsorption in the DCT due to the action of thiazide diuretics?

A

Calcium

26
Q

What are the adverse effects of thiazide diuretics?

2 hypos + 3 hypers

A
  1. Hypokalaemic metabolic alkalosis
  2. Hyponatraemia
  3. Hyperuricaemia
  4. Hyperglycaemia
  5. Hypercalcaemia

Only sodium & potassium hypo, urea + glucose + calcium all hyper

27
Q

What are the second-line antihypertensives?

A
  1. Hydralazine
  2. Alpha-adrenergic antagonists
  3. Mineralocorticoid receptor antagonists
28
Q

Alpha-1 antagonists inhibit alpha-1 adrenergic receptors on ________, causing vasodilation and hence reducing _____________.

A

Alpha-1 antagonists inhibit alpha-1 adrenergic receptors on vascular smooth muscles, causing vasodilation and hence reducing total peripheral resistance.

29
Q

What are examples of alpha-adrenergic antagonists?

A

Prazosin
Alfuzosin
Terazosin

All the -osin

CVS pharm (6 decks)

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