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Pharm Unit 4 > Anti-Hypertensives > Flashcards

Anti-Hypertensives Flashcards

1
Q

Furosemide (Lasix) Class

A

Loop diuretic (- charge)

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2
Q

Hydrochlorothiazide (Microzide) Class

A

Thiazide diuretic (- charge)

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3
Q

Chlorthalidone (Thalitone) Class

A

Thiazide-like diuretic

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4
Q

Metolazone (Zaroxolyn) Class

A

Thiazide-like diuretic

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5
Q

Amiloride (Midamor) Class

A

Renal ENaC inhibitor (+ charge)

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6
Q

Captopril (Capoten) Class

A

ACE-I (vasodilators)

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7
Q

Lisinopril (Prinivil); Benazepril (Lotensin); Quinapril (Accupril); Ramipril (Altace) Class

A

ACE-I (vasodilators)

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8
Q

Enalapril (Vasotec) Class

A

ACE-I (vasodilators)

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9
Q

Losartan (Cozaar); Valsartan (Diovan); Irbesartan (Avapro) Class

A

Angiotensin II Recepter Blockers

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10
Q

Aliskiren (Tekturna) Class

A

Renin inhibitor

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11
Q

Spironolactone (Aldactone) Class

A

Aldosterone receptor antagonist

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12
Q

Eplerenone (Inspra) Class

A

Potassium-sparing diuretic

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13
Q

Diltiazem (Cardizem); Verapamil (Calan) Class

A

Non-dihydropyridine Calcium channel blockers

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14
Q

Amlodipine (Norvasc); Nifedipine (Procardia) Class

A

Dihydropyridine Calcium channel blockers

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15
Q

Propranolol (Inderal) Class

A

Nonselective _-blocker

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16
Q

Metoprolol (Lopressor) Class

A

_1-selective blocker

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17
Q

Atenolol (Tenormin) Class

A

_1-selective blocker

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18
Q

Nadolol (Corgard) Class

A

Nonselective _-blocker

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19
Q

Bisoprolol (Zebeta) Class

A

_1-selective blocker

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20
Q

Labetolol (Trandate) Class

A

Combined __ blocker

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21
Q

Carvedilol (Coreg) Class

A

Combined __ blocker

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22
Q

Esmolol (Brevibloc) Class

A

_1-selective blocker

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23
Q

Terazosin (Hytrin) Class

A

_1-adrenergic receptor antagonist

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24
Q

Doxazosin (Cardura) Class

A

_1-adrenergic receptor antagonist

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25
Q

Clonidine (Catapres) Class

A

Central _2-agonist

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26
Q

alpha-methyldopa (Aldomet) Class

A

Central _2-agonist

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27
Q

Hydralazine (Apresoline) Class

A

Direct (vasodilators)

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28
Q

Furosemide (Lasix) MOA

A

Inhibits Cl portion of Na-K-2Cl cotransporter in luminal membrane at medullary and cortical (proximal) talH –> decreased Ca++ and Na+ (and water) reabsorption, resultant K+ loss

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29
Q

Hydrochlorothiazide (Microzide) MOA

A

Inhibits the Cl portion of the Na-Cl cotransporter in the luminal membrane at the early distal tubule –> decreased Na+ (and water) reabsorption, increased Ca++ reabsorption, resultant K+ loss

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30
Q

Chlorthalidone (Thalitone) MOA

A

Inhibits the Cl portion of the Na-Cl cotransporter in the luminal membrane at the early distal tubule –> decreased Na+ (and water) reabsorption, increased Ca++ reabsorption, resultant K+ loss

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31
Q

Metolazone (Zaroxolyn) MOA

A

Inhibits the Cl portion of the Na-Cl cotransporter in the luminal membrane at the early distal tubule –> decreased Na+ (and water) reabsorption, increased Ca++ reabsorption, resultant K+ loss

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32
Q

Amiloride (Midamor) MOA

A

Blocks Na channel and Na/H antiporter in lumenal membrane at the late distal tubule and collecting duct –> decreased K+ secretion and distal tubule acid secretion, increased Ca++ absorption

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33
Q

Captopril (Capoten) MOA

A

Blocks endothelial ACE from converting angiotensin I to angiotensin II (potent vasoconstrictor); as a side effect, also prevents breakdown of bradykinin (potent vasodilator)

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34
Q

Lisinopril (Prinivil); Benazepril (Lotensin); Quinapril (Accupril); Ramipril (Altace) MOA

A

Blocks endothelial ACE from converting angiotensin I to angiotensin II (potent vasoconstrictor); as a side effect, also prevents breakdown of bradykinin (potent vasodilator)

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35
Q

Enalapril (Vasotec) MOA

A

Blocks endothelial ACE from converting angiotensin I to angiotensin II (potent vasoconstrictor); as a side effect, also prevents breakdown of bradykinin (potent vasodilator)

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36
Q

Losartan (Cozaar); Valsartan (Diovan); Irbesartan (Avapro) MOA

A

Competitive inhibition of angiotensin II in vascular endothelium

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37
Q

Aliskiren (Tekturna) MOA

A

Renin inhibitor

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38
Q

Spironolactone (Aldactone) MOA

A

Competes for aldosterone receptor, inhibiting mRNA transcription and translation –> decreased Na and K channels, decreased number and activity of Na-K-ATPase pumps in the late distal tubule and collecting duct –> decreased K+ secretion, distal tubule acid secretion

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39
Q

Eplerenone (Inspra) MOA

A

Block alodesterone; inhibits sodium reabsorption in distal tubule

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40
Q

Diltiazem (Cardizem); Verapamil (Calan) MOA

A

Interact with L-type voltage gated plasma membrane Ca channel –> decreased calcium entry into vascular smooth muscle cell, preventing contraction; causes decreased contractility, firing rate of aberrant pacemaker sites, and conduction velocity; prolongs repolarization in SA node and AV node (–> decreases HR); less vasodilation

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41
Q

Amlodipine (Norvasc); Nifedipine (Procardia) MOA

A

Interact with L-type voltage gated plasma membrane Ca channel –> decreased calcium entry into vascular smooth muscle cell, preventing contraction; causes dilation of epicardial coronary arteries, arteriolar resistance arteries; less heart-specific activity

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42
Q

Propranolol (Inderal) MOA

A

Nonselective _-blocker; primarily reduces cardiac output

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43
Q

Metoprolol (Lopressor) MOA

A

Moderately selective _1 blockade

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44
Q

Atenolol (Tenormin) MOA

A

Moderately selective _1 blockade

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45
Q

Nadolol (Corgard) MOA

A

Moderately selective _1 blockade

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46
Q

Bisoprolol (Zebeta) MOA

A

Moderately selective _1 blockade

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47
Q

Labetolol (Trandate) MOA

A

_1 blockade with vasodilatory effects

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48
Q

Carvedilol (Coreg) MOA

A

_1 blockade with vasodilatory effects

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49
Q

Esmolol (Brevibloc) MOA

A
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50
Q

Terazosin (Hytrin) MOA

A

Blocks post-synaptic _1-adrenergic receptor antagonist on vascular smooth muscle

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51
Q

Doxazosin (Cardura) MOA

A

Blocks post-synaptic _1-adrenergic receptor antagonist on vascular smooth muscle

52
Q

Clonidine (Catapres) MOA

A

Stimulation of central _2a adrenergic receptors –> reduction in sympathetic outflow from vasomotor systems in brainstem; inhibition of renin release (secondary to decreased sympathetic tone)

53
Q

_-methyldopa (Aldomet) MOA

A

Stimulation of central _2a adrenergic receptors –> reduction in sympathetic outflow from vasomotor systems in brainstem; inhibition of renin release (secondary to decreased sympathetic tone)

54
Q

Hydralazine (Apresoline) MOA

A

Relax smooth muscle of peripheral arterioles

55
Q

Furosemide (Lasix) Therapy

A

Crisis edema (pulmonary, CHF, cirrhosis), hypercalcemia, drug toxicity/OD; severe hypertension in setting of CHF or cirrhosis

56
Q

Hydrochlorothiazide (Microzide) Therapy

A

HTN (intravascular contraction), chronic edema (cardiac insufficiency), idiopathic hypercalciuria (stones), nephrogenic diabetes insipidus

57
Q

Chlorthalidone (Thalitone) Therapy

A

Reduce stroke risk, CHF events; HTN (intravascular contraction), chronic edema (cardiac insufficiency), idiopathic hypercalciuria (stones), nephrogenic diabetes insipidus

58
Q

Metolazone (Zaroxolyn) Therapy

A

HTN (intravascular contraction), chronic edema (cardiac insufficiency), idiopathic hypercalciuria (stones), nephrogenic diabetes insipidus

59
Q

Amiloride (Midamor) Therapy

A

Combination with other diuretics to prevent hypokalemia; edema, idiopathic hypercalciuria (stones); lithium-induced polyuria & toxicity, Liddle syndrome, mucocilliary clearance

60
Q

Captopril (Capoten) Therapy

A

CHF, left ventricular hypertrophy, post-MI (prevents left ventricular remodeling)

61
Q

Lisinopril (Prinivil); Benazepril (Lotensin); Quinapril (Accupril); Ramipril (Altace) Therapy

A

CHF, left ventricular hypertrophy, post-MI (prevents left ventricular remodeling)

62
Q

Enalapril (Vasotec) Therapy

A

CHF, left ventricular hypertrophy, post-MI (prevents left ventricular remodeling)

63
Q

Losartan (Cozaar); Valsartan (Diovan); Irbesartan (Avapro) Therapy

A

Fall in peripheral vascular resistance, w/little change in HR or CO; same uses as ACE-I

64
Q

Aliskiren (Tekturna) Therapy

A

Not very effective

65
Q

Spironolactone (Aldactone) Therapy

A

Reduction in CHF mortality (30% in NYHA class III and IV); combination with other diuretics to prevent hypokalemia; edema; primary and secondary aldosteronism; hypertension; anti-testosterone agent

66
Q

Eplerenone (Inspra) Therapy

A

Reduction in CHF mortality (30% in NYHA class III and IV); combination with other diuretics to prevent hypokalemia; edema; primary and secondary aldosteronism; hypertension; anti-testosterone agent

67
Q

Diltiazem (Cardizem); Verapamil (Calan) Therapy

A

Hypertension, anti-anginal (chronotropic effects –> decreased myocardial oxygen demand), SVT (class IV anti-arrhythymic)

68
Q

Amlodipine (Norvasc); Nifedipine (Procardia) Therapy

A

Hypertension, Raynauds, angina (3rd choice drug)

69
Q

Labetolol (Trandate) Therapy

A

Hypertensive urgency

70
Q

Carvedilol (Coreg) Therapy

A

Acute coronary syndrome, CHF

71
Q

Esmolol (Brevibloc) Therapy

A

AV nodal blockade in unstable patients

72
Q

Terazosin (Hytrin) Therapy

A

BPH; second-tier meds (use when other condition around, not for isolated hypertension)

73
Q

_-methyldopa (Aldomet) Therapy

A

Hypertension of pregnancy (only)

74
Q

Hydralazine (Apresoline) Therapy

A

Hypertensive urgency; patients with BOTH advanced CHF and hypertension

75
Q

Furosemide (Lasix) ISE

A

Hypokalemia/hypomagnesemia, hypercalcinuria, nephrocalcinosis, ototoxicity (esp. w/aminoglycoside)

76
Q

Hydrochlorothiazide (Microzide) ISE

A

Hypokalemia/hypomagnesemia, contraction alkalosis, increased BUN & creatinine

77
Q

Chlorthalidone (Thalitone) ISE

A

Hypokalemia/hypomagnesemia, contraction alkalosis, increased BUN & creatinine

78
Q

Metolazone (Zaroxolyn) ISE

A

Hypokalemia/hypomagnesemia, contraction alkalosis, increased BUN & creatinine

79
Q

Amiloride (Midamor) ISE

A

Hyperkalemia in patients with renal failure or on ACE inhibitors

80
Q

Captopril (Capoten) ISE

A

Dry cough, angioedema, inhibits renal autoregulation, hypotension

81
Q

Lisinopril (Prinivil); Benazepril (Lotensin); Quinapril (Accupril); Ramipril (Altace) ISE

A

Dry cough, angioedema, decreased renal function, hypotension

82
Q

Enalapril (Vasotec) ISE

A

Dry cough, angioedema, decreased renal function, hypotension

83
Q

Losartan (Cozaar); Valsartan (Diovan); Irbesartan (Avapro) ISE

A

Angioedema, decreased renal function, hypotension; dry cough less frequent than with ACE-I

84
Q

Spironolactone (Aldactone) ISE

A

Hyperkalemia in patients with renal failure or on ACE inhibitors; male patients may have gynecomastia, erectile dysfunction, and loss of libido; female patients may have amenorrhea, breast soreness, and oligomenorrhea

85
Q

Eplerenone (Inspra) ISE

A

Hyperkalemia; much lower incidence of gynecomastia and mennorhagia

86
Q

Diltiazem (Cardizem); Verapamil (Calan) ISE

A

Leg edema, bradycardia, AV nodal blockade, hypotension, worsening heart failure

87
Q

Amlodipine (Norvasc); Nifedipine (Procardia) ISE

A

Leg edema (less than 1st generation), heart failure, AV nodal blockade, reflex tachycardia (lipophilic agents gain entry to brain and depress vasomotor center, rapidly dropping BP; this causes more reflex sympathetic activation (leading to adverse CV effects); long-acting agents are less lipophilic, and will cause less sympathetic activation and initial fall in BP)

88
Q

Propranolol (Inderal) ISE

A

Bronchospasm, bradycardia (negative chronotrope), CHF (negative ionotrope), masking of hypoglycemia symptoms

89
Q

Metoprolol (Lopressor) ISE

A

Less likely to have bronchospasm, hypoglycemic awareness, and depression

90
Q

Atenolol (Tenormin) ISE

A

Less likely to have bronchospasm, hypoglycemic awareness, and depression

91
Q

Nadolol (Corgard) ISE

A

Less likely to have bronchospasm, hypoglycemic awareness, and depression

92
Q

Bisoprolol (Zebeta) ISE

A

Less likely to have bronchospasm, hypoglycemic awareness, and depression

93
Q

Terazosin (Hytrin) ISE

A

Orthostatic hypotension, fluid retention, worsening angina (secondary to reflex tachycardia)

94
Q

Clonidine (Catapres) ISE

A

Rebound HTN if abruptly stopped; moderate orthostatic hypotension

95
Q

_-methyldopa (Aldomet) ISE

A

Rebound HTN if abruptly stopped; moderate orthostatic hypotension

96
Q

Hydralazine (Apresoline) ISE

A

Drug-induced lupus

97
Q

Furosemide (Lasix) OSE

A

Hyper -glycemia, -lipidemia, -uricemia; hypo -magnesia, -natremia; gout, photosensitivity, drug interactions; erectile dysfunction

98
Q

Hydrochlorothiazide (Microzide) OSE

A

Hyper -glycemia, -lipidemia, -uricemia, -calcemia; hypo -magnesia, -natremia; gout, photosensitivity, impotence, drug interactions

99
Q

Chlorthalidone (Thalitone) OSE

A

Hyper -glycemia, -lipidemia, -uricemia, -calcemia; hypo -magnesia, -natremia; gout, photosensitivity, impotence, drug interactions

100
Q

Metolazone (Zaroxolyn) OSE

A

Hyper -glycemia, -lipidemia, -uricemia, -calcemia; hypo -magnesia, -natremia; gout, photosensitivity, impotence, drug interactions

101
Q

Diltiazem (Cardizem); Verapamil (Calan) OSE

A

Constipation (most common), headache, flushing

102
Q

Amlodipine (Norvasc); Nifedipine (Procardia) OSE

A

Constipation (most common), headache, flushing

103
Q

Propranolol (Inderal) OSE

A

Decreased exercise capacity, depression (crosses BBB), worsening symptoms of peripheral vascular disease

104
Q

Clonidine (Catapres) OSE

A

Sedation, dry mouth, fatigue, depression

105
Q

_-methyldopa (Aldomet) OSE

A

Sedation, dry mouth, fatigue, depression

106
Q

Hydralazine (Apresoline) OSE

A

reflex tachycardia

107
Q

Minoxidil (Loniten) OSE

A

reflex tachycardia

108
Q

Furosemide (Lasix) Misc

A

avoid NSAIDs, take before salty meals, reduce salt intake; useful in patients with renal insufficiency (GFR < 30-40)

109
Q

Hydrochlorothiazide (Microzide) Misc

A

avoid NSAIDs, bile sequestrants; ineffective if GFR <30

110
Q

Chlorthalidone (Thalitone) Misc

A

avoid NSAIDs, bile sequestrants; ineffective if GFR <30

111
Q

Metolazone (Zaroxolyn) Misc

A

avoid NSAIDs, bile sequestrants; ineffective if GFR <30

112
Q

Amiloride (Midamor) Misc

A

Contraindicated in patients with renal failure (hyperkalemia), ACEi/ARB use; FeNa = 2%

113
Q

Captopril (Capoten) Misc

A

Short-acting; contraindicated in pregnancy, renal artery stenosis, hyperkalemia, and prior angioedema (no ARB allowed, either); caution in renal failure; reduces incidence of future CAD events, may reduce risk of diabetes

114
Q

Lisinopril (Prinivil); Benazepril (Lotensin); Quinapril (Accupril); Ramipril (Altace) Misc

A

Long-acting; contraindicated in pregnancy, renal artery stenosis, hyperkalemia, and prior angioedema (no ARB allowed, either); caution in renal failure; reduces incidence of future CAD events; may reduce risk of diabetes

115
Q

Enalapril (Vasotec) Misc

A

Metabolized to enalaprilat, a more active metabolite;contraindicated in pregnancy, renal artery stenosis, hyperkalemia, and prior angioedema (no ARB allowed, either); caution in renal failure; reduces incidence of future CAD events; may reduce risk of diabetes

116
Q

Losartan (Cozaar); Valsartan (Diovan); Irbesartan (Avapro) Misc

A

Contraindicated in pregnancy, renal artery stenosis, hyperkalemia, and prior angioedema (no ARB allowed, either); caution in renal failure

117
Q

Spironolactone (Aldactone) Misc

A

Contraindicated in patients with renal failure (hyperkalemia); FeNa = 2%; requires a salt-restricted diet; only drug not requiring tubular lumen access

118
Q

Eplerenone (Inspra) Misc

A

Caution in renal failure, ACEi or ARB use, and in diabetics

119
Q

Diltiazem (Cardizem); Verapamil (Calan) Misc

A

Contraindicated in overt decompensated heart failure, bradycardia, sinus node dysfunction, high-degree AV block

120
Q

Amlodipine (Norvasc); Nifedipine (Procardia) Misc

A

Contraindicated in overt decompensated heart failure, bradycardia, sinus node dysfunction, high-degree AV block

121
Q

Nadolol (Corgard) Misc

A

Longer-acting than other beta-blockers

122
Q

Bisoprolol (Zebeta) Misc

A

Longer-acting than other beta-blockers

123
Q

Esmolol (Brevibloc) Misc

A

Short half-life

124
Q

_-methyldopa (Aldomet) Misc

A

Takes place of dopa, so less NE (also, methyl-NE activates _2)

125
Q

Hydralazine (Apresoline) Misc

A

Serves as an antioxidant, preventing oxidation of NO

Pharm Unit 4 (7 decks)

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