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Cardiology-Exam 2 > Anti-Hypertensives > Flashcards

Anti-Hypertensives Flashcards

1
Q

Loop Diuretic

A

Furosemide

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2
Q

Thiazide Diuretics (2)

A

Hydrochlorothiazide

Chlortalidone

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3
Q

K+ sparing diuretic classes

A

Aldosterone antagonist

ENaC inhibitor

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4
Q

Aldosterone antagonists (2 total)

A

Spironolactone

Eplerenone

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5
Q

ENaC inhibitor

A

Triamterene

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6
Q

Mechanism of action for diuretics

A

Inhibit the reuptake of Na and H2O (just differ on location and transporters affected)

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7
Q

Loop diuretics inhibit ___________ in the Loop of Henle

A

Na/K/Cl symporter

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8
Q

Loop diuretics act on what part of the nephron

A

Loop of Henle

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9
Q

Adverse effects of loop and thiazide diuretics

A

Hypokalemia

Alkalosis (inc. secretion of H+)

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10
Q

How do loop diuretics and thiazide diuretics cause alkalosis?

A

Inc. urine Na stimulates Na/H antiporters, favoring H+ loss in urine

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11
Q

Thiazide diuretics inhibit _____________ in the distal convoluted tubule

A

Na/Cl symporters

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12
Q

Thiazide diuretics act on what part of the nephron

A

Distal convoluted tubule

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13
Q

K+ sparing diuretics inhibit _______ in the collecting duct

A

Aldosterone or ENaC (Epithelial Na channel)

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14
Q

K+ sparing diuretics act on what part of the nephron

A

Collecting duct

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15
Q

enlargement of breast tissue in men

A

gynecomastia

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16
Q

Diuretic that runs the risk of gynecomastia

A

Spironolactone (Aldosterone antagonist)

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17
Q

How do NSAIDs oppose the effects of diuretics?

A 
nhibit prostaglandin (vasodilator)
Promote salt/water retention via breakdown inhibition of aldosterone
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18
Q

Increased Na from upstream (LoH, DCT) drives ______________ in collecting duct

A

the loss of K+

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19
Q

Hypokalemia results in…

A

Hyperpolarization

Delayed repolarization

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20
Q

Which diuretic is rarely used for HTN (Loop, Thiazide or K+ sparing)

A

Loop diuretics

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21
Q

Which diuretic is used in patients with arrhythmias or heart failure

A

K+ sparing

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22
Q

Furosemide has what drug risk classification

A

C

23
Q

Which diuretics have drug risk classification D (evidence of risk for human fetuses, but benefits may outweight risks)

A

Hydrochlorothiazide
Spironolactone (Aldosterone antagonist)
Triamterene (ENaC inhibitor)

24
Q

Vasodilator with an unknown mechanism; relaxes arterioles only; orally administered for long-term maintenance of severe HTN; issues with CHF (Na/H2O retention) and lupus-like syndrome

A

Hydralazine

25
Q

Why is hydralazine (vasodilator) often used in combination with other drugs

A

To avoid toxicities (reflex tachycardia, Na/H2O retention and Lupus-like syndrome)

26
Q

Vasodilator that opens K+ channels; hyperpolarizes smooth muscle cells; administered paraenteraly for HTN emergencies

A

Diazoxide

27
Q

Vasodilators that block Ca++ channels

A 
Amlodipine
Diltiazem
Nifedipine
Nimodipine
Verapamil
28
Q

Non-dihydropyridines (Ca channel blockers); affect cardiac tissue

A

Verapamil

Diltiazem

29
Q

Dihydropyridines (Ca channel blockers); affect vascular smooth muscle

A

Amlodipine

Nifedipine

30
Q

Adverse effect of Ca channel blockers

A

Drug-induced gingival enlargement (DIGE)

31
Q

Ca channel blocker of choice during pregnancy

A

Nifedipine

32
Q

ACE Inhibitors

A

Captopril

Lisinopril

33
Q

Angiotensin Receptor Blockers (ARBs)

A

Losartan

Valsartan

34
Q

Common toxicities for ACE inhibitors and ARBs

A

Dry cough
Angioedema
Arrhythmias (hyperkalemia)
Drug Risk Classification D

35
Q

African Americans are 3x as likely to have what reaction to ACE inhibitors/ARBs

A

Angioedema

36
Q

ACE Inhibitors and ARBs are _______ in the first trimester and ________ during the 2nd/3rd trimester

A

Teratogenic; fetal hypotension and renal failure

37
Q

a1 antagonist

A

Prazosin

38
Q

a2 agonist

A

Methyldopa

Clonidine

39
Q

b-blockers

A

Atenolol
Metoprolol
Carvedilol

40
Q

b1 specific blockers

A

Atenolol

Metoprolol

41
Q

Why are b-blockers less likely to induce reflex tachycardia than vasodilators

A

Doesn’t directly cause vasodilation (and thus doesn’t trigger baroreceptors as easily)

42
Q

Drug that is almost always given to those with congestive heart failure

A

B-blockers (decrease mortality)

43
Q

Toxicities of b-blockers

A

Blood sugar changes

Bronchospasms (non-selective)

44
Q

Toxicity of a1 antagonists

A

1st dose orthostatic hypotension (especially with Prazosin)

45
Q

b-blockers have what drug risk classification during the 2nd/3rd trimesters

A

D (risk to human fetus, but benefits may outweight risks)

46
Q

Drug of choice for HTN during pregnancy

A

Methyldopa

47
Q

Why don’t we typically give ACE inhibitors or ARBs to hypertensive African-Americans?

A

3x risk for angioedema

48
Q

Why is polypharmacy done when attempting to control HTN?

A

Physiological compensation when giving anti-hypertension drugs

49
Q

If you have a hypertensive patient with angina, you could give what classes of anti-hypertensives

A

B-blockers

Ca blockers

50
Q

If you have a hypertensive patient with diabetic nephropathy, you could give what classes of anti-hypertensives

A

ACE inhibitors

ARBs

51
Q

If you have a hypertensive patient with heart failure, you could give what classes of anti-hypertensives

A

Diuretics
ACE inhibitors
ARBs
B-blockers

52
Q

If you have a hypertensive patient with Benign Prostatic Hyperplasia, you could give what class of anti-hypertensives

A

a1 antagonists

53
Q

ventricular wall tension during contraction; the resistance that the ventricle must overcome to expel blood during systole (proportional to blood pressure and vascular stiffness)

A

afterload

54
Q

First line drug for HTN

A

Thiazide

Cardiology-Exam 2 (23 decks)

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