Anti-hypertensives Flashcards by Chris Anderson

Antihypertensive drugs

Diuretics
Sympatholytics
Vasodilators
RAAS agents

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Thiazides

First-line treatment for uncomplicated HTN:
Chlorothiazide
Hydrochlorothiazide

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Loops

Furosemide
Bumetanide
Ethacrynic acid
Torsemide

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K-sparing

Spironolactone
Triamterene
Amiloride

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Diuretics - MoA

Thiazides- block Na/Cl cotransporter @ distal conv
Loops- block NaK2Cl cotransporter @ loop
K-sparing- block aldosterone/block eNAC @ collecting duct

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Diuretics - adverse effects

elevated renin, angiotensin II, aldosterone

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Sympatholytics

Non-selective B antagonists
Selective B1 antagonists
Neuronal blockers
Alpha 2 agonists
Alpha 1 antagonists

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Non-selective B antagonists

Propranolol

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Selective B1-antagonists

Atenolol

Metoprolol

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Neuronal blockers

Reserpine (prevents NE vesicle loading)

Guanethedine (prevents NE vesicle docking at cleft)

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CNS alpha-2 agonist

clonidine

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alpha-1 antagonist

Prazosin

Terazosin

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CNS alpha-2 contraindication

Elderly pts do not take clonidine due to sedation/confusion and orthostatic hypotension

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Vasodilators

Calcium channel blockers

Direct vasodilators

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Calcium channel blockers

Nifedipine (dihyrdopyridine)
Diltiazem
Verapamil

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Calcium channel blocker - MoA

Block L-type calcium channels and prevent vascular smooth muscle contraction (dihyropyridines)
Block calcium entry into cell (non-dihyropyridines)

Calcium channel blockers - adverse effects

Nifedipine - reflex tachy, ankle edema

Diltiazem/Verapamil - ankle edema. do not use with Beta blockers - can cause AV block

Direct acting vasodilators

Hydralazine
Minoxidil
Sodium Nitroprusside

Hydralazine/Minoxidil- MoA

Dilates arterioles

Hydralazine/Minoxidil - adverse effects

Reflex Tachy

Minoxidil - hirsutism, ankle edema

Sodium Nitroprusside - MoA

Dilate venules

Sodium Nitroprusside - adverse effects

cyanide toxicity

RAAS agents

ACE Inhibitors

Angiotensin receptor blockers

ACE inhibitors

-pril drugs

ACE inhibitor- adverse effects

Using two classes at the same time can lead to hyperkalemia (ACEI, ARB, renin inhib, K-sparing) ACE Inhibitor induced angioedema* and bradykinin cough*

ARBs

-sartans

ACE, ARB major contraindication

pregnancy (fetal kidney defects)

Renin inhibitor

Aliskiren