anti-hypertensives Flashcards
What are 3 ACE inhibitors?
Lisinopril
Captopril
Enalapril
All the -prils
What is the mechanism of action of ACE inhibitors?
Prevents the formation of angiotensin II from angiotensin I
What are the 2 main effects of angiotensin II?
- Activate adrenal glands to secrete aldosterone –> activates RAAS system
- Reduces production of NO –> vascular smooth muscle constriction –> increase in total peripheral resistance
What are the side effects of ACE inhibitors?
- Hypotension
- Acute renal failure
- Angioedema
- Dry cough
- Hyperkalemia
Why do ACE inhibitors cause angioedema & dry cough?
ACEI inhibit the inactivation of bradykinins –> causes an increase in NPO & prostaglandins –> dry cough + inflammation-like vasodilation
What are ACEI indicated in?
- Hypertension (duh)
- Cardiac failure
- following AMI
- Renal insufficiency
ARCH
What group of individuals are ACE inhibitors contraindicated in?
Pregnant women
What are 2 examples of ARBs?
Valsartan
Losartan
All the -sartans
What is the mechanism of action of ARBs?
Angiotensin II antagonists; prevent ang II from binding to the receptors
Why choose ARB > ACEI?
Less/no dry cough cuz they don’t inhibit the bradykinin inactivation pathway
What group of individuals are ARBs contraindicated in?
Pregnant women
Renal failure
Beta-blockers inhibit ________ (CICR), preventing the formation of the ________ and hence decreasing __________.
Beta-blockers inhibit calcium-induced calcium release (CICR), preventing the formation of the actin-myosin complex and hence decreasing heart contractility
What are the 3 non-selective beta blockers?
Propanolol
Pindolol
Carvedilol
What are the 3 beta-1 selective beta-blockers?
Atenolol
Bisoprolol
Metoprolol XL
When is Nebivolol non-selective?
In high doses & in slow metabolizers
What are beta-blockers indicated in?
- Hypertension
- Cardiac failure
- following AMI
- Abnormal heart rhythm
- Anxiety disorders
HCAAA
What are the adverse effects of beta-blockers?
- Hypotension
- Brachycardia
- AV nodal block
- Reduced exercise capaciy
- Bronchoconstriction
- Clinical depression (beta-blocker blues)
What group of individuals are beta-blockers contraindicated in?
Asthmatic & diabetic patients
What is the class of diuretics mainly used to treat HTN?
Thiazides
What are the 5 classes of first-line antihypertensives?
- ACEI
- ARBs
- Beta-blockers
- DHP calcium channel blockers
- Thiazides
Thiazides inhibit ________ reabsorption by blocking the ________ in the _______.
Tubular fluid in the collecting duct is hence more ________, reducing H2O ________ in the collecting duct.
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.
What are 2 thiazides?
Hydrochlorothiazide
Indapamide
What class of drugs interfere with action of thiazide diuretics?
NSAIDs reduce renal prostaglandin synthesis
What are thiazides indicated in?
- Hypertension
- Congestive heart failure
- Nephrolithiasis
