Anti-Hypertensives Flashcards
1
Q
Furosemide (Lasix) Class
A
Loop diuretic (- charge)
2
Q
Hydrochlorothiazide (Microzide) Class
A
Thiazide diuretic (- charge)
3
Q
Chlorthalidone (Thalitone) Class
A
Thiazide-like diuretic
4
Q
Metolazone (Zaroxolyn) Class
A
Thiazide-like diuretic
5
Q
Amiloride (Midamor) Class
A
Renal ENaC inhibitor (+ charge)
6
Q
Captopril (Capoten) Class
A
ACE-I (vasodilators)
7
Q
Lisinopril (Prinivil); Benazepril (Lotensin); Quinapril (Accupril); Ramipril (Altace) Class
A
ACE-I (vasodilators)
8
Q
Enalapril (Vasotec) Class
A
ACE-I (vasodilators)
9
Q
Losartan (Cozaar); Valsartan (Diovan); Irbesartan (Avapro) Class
A
Angiotensin II Recepter Blockers
10
Q
Aliskiren (Tekturna) Class
A
Renin inhibitor
11
Q
Spironolactone (Aldactone) Class
A
Aldosterone receptor antagonist
12
Q
Eplerenone (Inspra) Class
A
Potassium-sparing diuretic
13
Q
Diltiazem (Cardizem); Verapamil (Calan) Class
A
Non-dihydropyridine Calcium channel blockers
14
Q
Amlodipine (Norvasc); Nifedipine (Procardia) Class
A
Dihydropyridine Calcium channel blockers
15
Q
Propranolol (Inderal) Class
A
Nonselective _-blocker
16
Q
Metoprolol (Lopressor) Class
A
_1-selective blocker
17
Q
Atenolol (Tenormin) Class
A
_1-selective blocker
18
Q
Nadolol (Corgard) Class
A
Nonselective _-blocker
19
Q
Bisoprolol (Zebeta) Class
A
_1-selective blocker
20
Q
Labetolol (Trandate) Class
A
Combined __ blocker
21
Q
Carvedilol (Coreg) Class
A
Combined __ blocker
22
Q
Esmolol (Brevibloc) Class
A
_1-selective blocker
23
Q
Terazosin (Hytrin) Class
A
_1-adrenergic receptor antagonist
24
Q
Doxazosin (Cardura) Class
A
_1-adrenergic receptor antagonist
25
Clonidine (Catapres) Class
Central _2-agonist
26
alpha-methyldopa (Aldomet) Class
Central _2-agonist
27
Hydralazine (Apresoline) Class
Direct (vasodilators)
28
Furosemide (Lasix) MOA
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
29
Hydrochlorothiazide (Microzide) MOA
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
30
Chlorthalidone (Thalitone) MOA
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
31
Metolazone (Zaroxolyn) MOA
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
32
Amiloride (Midamor) MOA
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
33
Captopril (Capoten) MOA
Blocks endothelial ACE from converting angiotensin I to angiotensin II (potent vasoconstrictor); as a side effect, also prevents breakdown of bradykinin (potent vasodilator)
34
Lisinopril (Prinivil); Benazepril (Lotensin); Quinapril (Accupril); Ramipril (Altace) MOA
Blocks endothelial ACE from converting angiotensin I to angiotensin II (potent vasoconstrictor); as a side effect, also prevents breakdown of bradykinin (potent vasodilator)
35
Enalapril (Vasotec) MOA
Blocks endothelial ACE from converting angiotensin I to angiotensin II (potent vasoconstrictor); as a side effect, also prevents breakdown of bradykinin (potent vasodilator)
36
Losartan (Cozaar); Valsartan (Diovan); Irbesartan (Avapro) MOA
Competitive inhibition of angiotensin II in vascular endothelium
37
Aliskiren (Tekturna) MOA
Renin inhibitor
38
Spironolactone (Aldactone) MOA
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
39
Eplerenone (Inspra) MOA
Block alodesterone; inhibits sodium reabsorption in distal tubule
40
Diltiazem (Cardizem); Verapamil (Calan) MOA
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
41
Amlodipine (Norvasc); Nifedipine (Procardia) MOA
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
42
Propranolol (Inderal) MOA
Nonselective _-blocker; primarily reduces cardiac output
43
Metoprolol (Lopressor) MOA
Moderately selective _1 blockade
44
Atenolol (Tenormin) MOA
Moderately selective _1 blockade
45
Nadolol (Corgard) MOA
Moderately selective _1 blockade
46
Bisoprolol (Zebeta) MOA
Moderately selective _1 blockade
47
Labetolol (Trandate) MOA
_1 blockade with vasodilatory effects
48
Carvedilol (Coreg) MOA
_1 blockade with vasodilatory effects
49
Esmolol (Brevibloc) MOA
---
50
Terazosin (Hytrin) MOA
Blocks post-synaptic _1-adrenergic receptor antagonist on vascular smooth muscle
51
Doxazosin (Cardura) MOA
Blocks post-synaptic _1-adrenergic receptor antagonist on vascular smooth muscle
52
Clonidine (Catapres) MOA
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
_-methyldopa (Aldomet) MOA
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
Hydralazine (Apresoline) MOA
Relax smooth muscle of peripheral arterioles
55
Furosemide (Lasix) Therapy
Crisis edema (pulmonary, CHF, cirrhosis), hypercalcemia, drug toxicity/OD; severe hypertension in setting of CHF or cirrhosis
56
Hydrochlorothiazide (Microzide) Therapy
HTN (intravascular contraction), chronic edema (cardiac insufficiency), idiopathic hypercalciuria (stones), nephrogenic diabetes insipidus
57
Chlorthalidone (Thalitone) Therapy
Reduce stroke risk, CHF events; HTN (intravascular contraction), chronic edema (cardiac insufficiency), idiopathic hypercalciuria (stones), nephrogenic diabetes insipidus
58
Metolazone (Zaroxolyn) Therapy
HTN (intravascular contraction), chronic edema (cardiac insufficiency), idiopathic hypercalciuria (stones), nephrogenic diabetes insipidus
59
Amiloride (Midamor) Therapy
Combination with other diuretics to prevent hypokalemia; edema, idiopathic hypercalciuria (stones); lithium-induced polyuria & toxicity, Liddle syndrome, mucocilliary clearance
60
Captopril (Capoten) Therapy
CHF, left ventricular hypertrophy, post-MI (prevents left ventricular remodeling)
61
Lisinopril (Prinivil); Benazepril (Lotensin); Quinapril (Accupril); Ramipril (Altace) Therapy
CHF, left ventricular hypertrophy, post-MI (prevents left ventricular remodeling)
62
Enalapril (Vasotec) Therapy
CHF, left ventricular hypertrophy, post-MI (prevents left ventricular remodeling)
63
Losartan (Cozaar); Valsartan (Diovan); Irbesartan (Avapro) Therapy
Fall in peripheral vascular resistance, w/little change in HR or CO; same uses as ACE-I
64
Aliskiren (Tekturna) Therapy
Not very effective
65
Spironolactone (Aldactone) Therapy
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
Eplerenone (Inspra) Therapy
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
Diltiazem (Cardizem); Verapamil (Calan) Therapy
Hypertension, anti-anginal (chronotropic effects --> decreased myocardial oxygen demand), SVT (class IV anti-arrhythymic)
68
Amlodipine (Norvasc); Nifedipine (Procardia) Therapy
Hypertension, Raynauds, angina (3rd choice drug)
69
Labetolol (Trandate) Therapy
Hypertensive urgency
70
Carvedilol (Coreg) Therapy
Acute coronary syndrome, CHF
71
Esmolol (Brevibloc) Therapy
AV nodal blockade in unstable patients
72
Terazosin (Hytrin) Therapy
BPH; second-tier meds (use when other condition around, not for isolated hypertension)
73
_-methyldopa (Aldomet) Therapy
Hypertension of pregnancy (only)
74
Hydralazine (Apresoline) Therapy
Hypertensive urgency; patients with BOTH advanced CHF and hypertension
75
Furosemide (Lasix) ISE
Hypokalemia/hypomagnesemia, hypercalcinuria, nephrocalcinosis, ototoxicity (esp. w/aminoglycoside)
76
Hydrochlorothiazide (Microzide) ISE
Hypokalemia/hypomagnesemia, contraction alkalosis, increased BUN & creatinine
77
Chlorthalidone (Thalitone) ISE
Hypokalemia/hypomagnesemia, contraction alkalosis, increased BUN & creatinine
78
Metolazone (Zaroxolyn) ISE
Hypokalemia/hypomagnesemia, contraction alkalosis, increased BUN & creatinine
79
Amiloride (Midamor) ISE
Hyperkalemia in patients with renal failure or on ACE inhibitors
80
Captopril (Capoten) ISE
Dry cough, angioedema, inhibits renal autoregulation, hypotension
81
Lisinopril (Prinivil); Benazepril (Lotensin); Quinapril (Accupril); Ramipril (Altace) ISE
Dry cough, angioedema, decreased renal function, hypotension
82
Enalapril (Vasotec) ISE
Dry cough, angioedema, decreased renal function, hypotension
83
Losartan (Cozaar); Valsartan (Diovan); Irbesartan (Avapro) ISE
Angioedema, decreased renal function, hypotension; dry cough less frequent than with ACE-I
84
Spironolactone (Aldactone) ISE
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
Eplerenone (Inspra) ISE
Hyperkalemia; much lower incidence of gynecomastia and mennorhagia
86
Diltiazem (Cardizem); Verapamil (Calan) ISE
Leg edema, bradycardia, AV nodal blockade, hypotension, worsening heart failure
87
Amlodipine (Norvasc); Nifedipine (Procardia) ISE
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
Propranolol (Inderal) ISE
Bronchospasm, bradycardia (negative chronotrope), CHF (negative ionotrope), masking of hypoglycemia symptoms
89
Metoprolol (Lopressor) ISE
Less likely to have bronchospasm, hypoglycemic awareness, and depression
90
Atenolol (Tenormin) ISE
Less likely to have bronchospasm, hypoglycemic awareness, and depression
91
Nadolol (Corgard) ISE
Less likely to have bronchospasm, hypoglycemic awareness, and depression
92
Bisoprolol (Zebeta) ISE
Less likely to have bronchospasm, hypoglycemic awareness, and depression
93
Terazosin (Hytrin) ISE
Orthostatic hypotension, fluid retention, worsening angina (secondary to reflex tachycardia)
94
Clonidine (Catapres) ISE
Rebound HTN if abruptly stopped; moderate orthostatic hypotension
95
_-methyldopa (Aldomet) ISE
Rebound HTN if abruptly stopped; moderate orthostatic hypotension
96
Hydralazine (Apresoline) ISE
Drug-induced lupus
97
Furosemide (Lasix) OSE
Hyper -glycemia, -lipidemia, -uricemia; hypo -magnesia, -natremia; gout, photosensitivity, drug interactions; erectile dysfunction
98
Hydrochlorothiazide (Microzide) OSE
Hyper -glycemia, -lipidemia, -uricemia, -calcemia; hypo -magnesia, -natremia; gout, photosensitivity, impotence, drug interactions
99
Chlorthalidone (Thalitone) OSE
Hyper -glycemia, -lipidemia, -uricemia, -calcemia; hypo -magnesia, -natremia; gout, photosensitivity, impotence, drug interactions
100
Metolazone (Zaroxolyn) OSE
Hyper -glycemia, -lipidemia, -uricemia, -calcemia; hypo -magnesia, -natremia; gout, photosensitivity, impotence, drug interactions
101
Diltiazem (Cardizem); Verapamil (Calan) OSE
Constipation (most common), headache, flushing
102
Amlodipine (Norvasc); Nifedipine (Procardia) OSE
Constipation (most common), headache, flushing
103
Propranolol (Inderal) OSE
Decreased exercise capacity, depression (crosses BBB), worsening symptoms of peripheral vascular disease
104
Clonidine (Catapres) OSE
Sedation, dry mouth, fatigue, depression
105
_-methyldopa (Aldomet) OSE
Sedation, dry mouth, fatigue, depression
106
Hydralazine (Apresoline) OSE
reflex tachycardia
107
Minoxidil (Loniten) OSE
reflex tachycardia
108
Furosemide (Lasix) Misc
avoid NSAIDs, take before salty meals, reduce salt intake; useful in patients with renal insufficiency (GFR < 30-40)
109
Hydrochlorothiazide (Microzide) Misc
avoid NSAIDs, bile sequestrants; ineffective if GFR <30
110
Chlorthalidone (Thalitone) Misc
avoid NSAIDs, bile sequestrants; ineffective if GFR <30
111
Metolazone (Zaroxolyn) Misc
avoid NSAIDs, bile sequestrants; ineffective if GFR <30
112
Amiloride (Midamor) Misc
Contraindicated in patients with renal failure (hyperkalemia), ACEi/ARB use; FeNa = 2%
113
Captopril (Capoten) Misc
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
Lisinopril (Prinivil); Benazepril (Lotensin); Quinapril (Accupril); Ramipril (Altace) Misc
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
Enalapril (Vasotec) Misc
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
Losartan (Cozaar); Valsartan (Diovan); Irbesartan (Avapro) Misc
Contraindicated in pregnancy, renal artery stenosis, hyperkalemia, and prior angioedema (no ARB allowed, either); caution in renal failure
117
Spironolactone (Aldactone) Misc
Contraindicated in patients with renal failure (hyperkalemia); FeNa = 2%; requires a salt-restricted diet; only drug not requiring tubular lumen access
118
Eplerenone (Inspra) Misc
Caution in renal failure, ACEi or ARB use, and in diabetics
119
Diltiazem (Cardizem); Verapamil (Calan) Misc
Contraindicated in overt decompensated heart failure, bradycardia, sinus node dysfunction, high-degree AV block
120
Amlodipine (Norvasc); Nifedipine (Procardia) Misc
Contraindicated in overt decompensated heart failure, bradycardia, sinus node dysfunction, high-degree AV block
121
Nadolol (Corgard) Misc
Longer-acting than other beta-blockers
122
Bisoprolol (Zebeta) Misc
Longer-acting than other beta-blockers
123
Esmolol (Brevibloc) Misc
Short half-life
124
_-methyldopa (Aldomet) Misc
Takes place of dopa, so less NE (also, methyl-NE activates _2)
125
Hydralazine (Apresoline) Misc
Serves as an antioxidant, preventing oxidation of NO
