Anti-Hypertensives

Question 1

DIURETICS
Thiazides
Loop Diuretics (Lasix)=More effective.
Potassium sparing=Used if hypokalimia is an issue.

Answer 1

MECHANISM
Inhibit tubular reabsorption of sodium and chloride in the kidney which in turn inhibits water reabsorption and increases urine volume.
INDICATION
Hypertension
SIDE EFFECTS
Hyperglycemia especially with diabetics
Hypokalemia
Hyperuricemia: gout
Increase in LDL
Hypercalcemia/Hypocalcemia (loops only)
ADVERSE EFFECTS

Question 2

BETA-ADRENERGIC BLOCKERS
Propanolol, Nadolol, penbutolol
Beta 1 selectives: Lopressor, atenolol

Answer 2

MECHANISM
Non-selectively block beta 1 and 2 receptors in heart and lungs respectively. Blocks sympathetic activity and lowers cardiac output by slowing HR.

INDICATION
Hypertension

SIDE EFFECTS
Sleep Disturbances
Mental status changes including depression
Cold extremities.
ADVERSE EFFECTS

Question 3

CALCIUM CHANNEL BLOCKERS

Procardia, Norvasc, Cardizem, verpamil.

Answer 3

MECHANISM
Inhibit influx of calcium ions to myocardial cells and vascular cells. Decreased HR, decreased force of contraction and decreased vasoconstriction.

INDICATION
Hypertension

SIDE EFFECTS
Significant bradycardia
Peripheral vasodilation can cause flushing, headache and ankle swelling.

ADVERSE EFFECTS
Reflex tachycardia. BP drops so much that body starts reflexively speeding up HR.

Question 4

ALPHA-ADRENERGIC BLOCKERS
A1: prazosin (minipress)
A2: clonidine (catapres) methyldopa (aldomet)

Answer 4

MECHANISM
Alpha 1: Blocks A1 receptors in smooth muscle allowing A&V vasodilation.
Alpha 2: Stimulate A2 receptors to decrease sympathetic signals. Decreases HR, decrease peripheral resistance.

INDICATION
Hypertension

SIDE EFFECTS
A1: Syncope, headache and palpitations
A2: Dry mouth, sedation, depression.

ADVERSE EFFECTS
Rebound hypertension with sudden withdrawl.