Anti-hypertensives Flashcards
What are the 4 classes of anti-hypertensive drugs?
ACE inhibitors
Angiotensin II Receptor Blockers (ARB)
Calcium Channel Blockers (CCB)
Beta blockers (BB)
What are the prototypes of the 4 classes of anti-hypertensive drugs?
ACE inhibitors =
Angiotensin II Receptor Blockers (ARB) =
Calcium Channel Blockers (CCB) =
Beta blockers (BB) =
ACE inhibitors = captopril
Angiotensin II Receptor Blockers (ARB) = losartan
Calcium Channel Blockers (CCB) = diltiazem
Beta blockers (BB) = propanolol
What is the action of captopril?
ACE inhibitor
- Inhibits converting angiotensin I → II
- Reduces total peripheral resistance
- Aldosterone blocked ⇒ ↓blood volume (Na+ not reabsorbed)
What is the uses of captopril?
- Treat HTN, CH, MI
- Diabetic nephropathy (complication of diabetes that dmgs kidneys)
What are the precautions of captopril?
- Renal failure
- Pregnancy category C (1st trimester) + D (2nd-3rd tri.)
What are the adverse effects of captopril?
- First-dose or orthostatic hypotension
- Angioedema
- non-productive cough
What is the action of losartan?
ARB
- block action of angiotensin II (can’t increase BP)
What are the uses of losartan?
HTN
CHF
Diabetic nephropathy
What are the precautions of losartan?
- Renal failure
- Pregnancy category D
What are the adverse effects of losartan?
First-dose or orthostatic hypotension
What is the action of diltiazem?
Calcium Channel Blocker
- Cardioselective blocker
- Enhances vasodilation and coronary perfusion
- Lowers arterial pressure
- Slows SA and AV node conduction
What is the use of diltiazem?
- HTN
- angina pectoris/ chest pain
- Dysrhythmia
What are the precautions of diltiazem?
- Significant first-pass metabolism
- Would req increased dosing.
What are the adverse effects of diltiazem?
- Constipation
- Edema of ankles and feet
Antidote: Calcium gluconate (IV)
What is the action of propanolol?
Beta Blocker
- non-selective beta blocker
- reduced heart rate and contraction strength
- slows AV conduction.
nonselective = heart + lungs
selective = cardioselective (heart)
What are the uses of propanolol?
- HTN
- Dysrhythmias
- Angina pectoris
- MI
What are the precautions of propanolol?
- Block beta2 receptors in lungs ⇒ bronchoconstriction
- Block beta2 receptors in liver ⇒ inhibits glycogenolysis.
What are the adverse effects of propanolol?
- Bradycardia
- Rebound cardiac excitation with withdrawal
- Lipid-soluble cross BBB ⇒ insomnia + depression
