antihtn Flashcards
What are 3 ACE inhibitors?
LisinoprilCaptoprilEnalapril## FootnoteAll the -prils
What is the mechanism of action of ACE inhibitors?
Prevents the formation of angiotensin II from angiotensin I
What are the 2 main effects of angiotensin II?
- Activate adrenal glands to secrete aldosterone –> activates RAAS system2. Reduces production of NO –> vascular smooth muscle constriction –> increase in total peripheral resistance
What are the side effects of ACE inhibitors?
- Hypotension2. Acute renal failure3. Angioedema4. Dry cough5. Hyperkalemia
Why do ACE inhibitors cause angioedema & dry cough?
ACEI inhibit the inactivation of bradykinins –> causes an increase in NPO & prostaglandins –> dry cough + inflammation-like vasodilation
What are ACEI indicated in?
- Hypertension (duh)2. Cardiac failure3. following AMI4. Renal insufficiency## FootnoteHARC
What group of individuals are ACE inhibitors contraindicated in?
Pregnant women
What are 2 examples of ARBs?
ValsartanLosartan## FootnoteAll the -sartans
What is the mechanism of action of AT1 blockers?
Angiotensin II antagonists; prevent ang II from binding to the receptors
Why choose ARB > ACEI?
Less/no dry cough cuz they don’t inhibit the bradykinin inactivation pathway
What group of individuals are ARBs contraindicated in?
Pregnant women
Beta-blockers inhibit ________ (CICR), preventing the formation of the ________ and hence decreasing __________.
Beta-blockers inhibit calcium-induced calcium release (CICR), preventing the formation of the actin-myosin complex and hence decreasing heart contractility
What are the 3 non-selective beta blockers?
PropanololPindololCarvedilol
What are the 3 beta-1 selective beta-blockers?
AtenololBisoprololMetoprolol XL
When is Nebivolol non-selective?
In high doses & in slow metabolizers
What are beta-blockers indicated in?
- Hypertension2. Cardiac failure3. following AMI4. Abnormal heart rhythm5. Anxiety disorders## FootnoteHCAAA
What are the adverse effects of beta-blockers?
- Hypotension2. Brachycardia3. AV nodal block4. Reduced exercise capaciy5. Bronchoconstriction6. Clinical depression (beta-blocker blues)
What group of individuals are beta-blockers contraindicated in?
Asthmatic & diabetic patients
What is the class of diuretics mainly used to treat HTN?
Thiazides
What are the 5 classes of first-line antihypertensives?
- ACEI2. ARBs3. Beta-blockers4. DHP calcium channel blockers5. Thiazides
Thiazides inhibit ________ reabsorption by blocking the ________ in the _______.Tubular fluid in the collecting duct is hence more ________, reducing H2O ________ in the collecting duct.
Thiazides nhibits NaCl reabsorption by blocking the Na/Cl transporter in the DCT.Tubular fluid in the collecting duct is hence more hypertonic, reducing H2O reabsorption in the collecting duct.
What are 2 thiazides?
HydrochlorothiazideIndapamide
What class of drugs interfere with action of thiazide diuretics?
NSAIDs reduce renal prostaglandin synthesis
What are thiazides indicated in?
- Hypertension2. Congestive heart failure3. Nephrolithiasis
Which salt experiences enhanced reabsorption in the DCT due to the action of thiazide diuretics?
Calcium
What are the adverse effects of thiazide diuretics?## Footnote2 hypos + 3 hypers
- Hypokalaemic metabolic alkalosis2. Hyponatraemia3. Hyperuricaemia4. Hyperglycaemia5. Hypercalcaemia## FootnoteOnly sodium & potassium hypo, urea + glucose + calcium all hyper
What are the second-line antihypertensives?
- Hydralazine2. Alpha-adrenergic antagonists3. Mineralocorticoid receptor antagonists
Alpha-1 antagonists inhibit alpha-1 adrenergic receptors on ________, causing vasodilation and hence reducing _____________.
Alpha-1 antagonists inhibit alpha-1 adrenergic receptors on vascular smooth muscles, causing vasodilation and hence reducing total peripheral resistance.
What are examples of alpha-adrenergic antagonists?
PrazosinAlfuzosinTerazosin## FootnoteAll the -osin
