Antihypertensive Flashcards
Drugs that decrease mortality from heart disease?
BB
ACEI
Thiazide Diuretics
Stage 1 Hypertensive
Thiazide Diuretic
or ACEI, ARB, BB, CCB
Stage 2 Hypertensive
Thiazide Diuretic + ACEI
or Thiazide diuretics + ARB + BB + CCB
Prehypertension
No drugs
Hypertension + Angina Pectoris
BB or CCB
Hypertension + BPH
Alpha Blocker
Hypertension + Diabetes
ACEI or ARB
Hypertension + Heart failure
ACEI, ARB, BB, Spironolactone
Hypertension + after MI
BB
Hypertension + hyperlipidemia
Alpha blocker or CCB
Pregnant with Pre-eclampsia
Labetalol
or Hydralazine, nifedipine, nitroglycerin
Thiazide diuretics MOA
Inhibit Na/Cl cotransport
excretion of: Na+, K+, Cl-, Mg2+,HCO3-
retention: Ca2+, uric acid
Thiazide diuretics side effects
hyponatremia, hypokalemia, hypomagnesia
hypercalcemia, hyperuricemia
Metabolic alkalosis
Another Thiazide diuretic side effect other than ion
increase plasma cholesterol and TGs
except indapamide
chlorothiazide
Thiazide Diuretic
hydrochlorothiazide
Thiazide Diuretic
chlorthalidone
Thiazide Diuretic
Indapamide
Thiazide Diuretic
Metolazone
Thiazide Diuretic
Furosemide
Loop Diuretic
Bumetanide
Loop Diuretic
Torsemide
Loop Diuretic
Ethacrynic acid
Loop Diuretic
Loop diuretic MOA
Inhibit Na+/K+ dichloride co transport
excretion of: Na+, K+, Cl-, Mg2+,HCO3-, Ca2+
Loop diuretic side effect
hyponatremia, hypokalemia, hypomagnesia
hypocalcemia
Metabolic alkalosis
Ototoxicity
Loop diuretic drug interaction
with aminoglycosides
increased risk of ototoxicity
Mannitol
Osmotic Diuretic
Urea
Osmotic Diuretic
Osmotic Diuretic MOA
Inhibit reabsorption of water and electrolytes in Proximal tubule
increase osmotic pressure in PT
Osmotic Diuretic side effect
increased ICP
increased intraocular pressure
acute renal failure
Carbonic anhydrase inhibitor MOA
Increase excretion of Na+, K+, HCO3
Actelazolamide
Carbonic Anhydrase inhibitor
Dorzolamide
Carbonic Anhydrase inhibitor
Carbonic anhydrase inhibitor side effects
hyperchloremic metabolic acidosis
hypokalemia
Spironolactone
K+ sparing diuretic
Aldosterone Antagonist
Amiloride
Triamterene
K+ sparing diuretic
Block Na+ reabsorption
K+ sparing diuretic side effects
Hyperkalemia, metabolic acidosis
Special spironolactone side effects
decrease libido
Special triamterene side effects
nephrolithiasis
What else can spironolactone treat?
hirsutism
What can Amiloride be used for?
to treat nephrogenic DI caused by lithium
-pril drugs
ACEI
suffix of ACEI
-pril drugs
side effect of ACEI
Dry cough
when to use enalapril?
iv for hypertensive emergency
ACEI Side effects
hyperkalemia, acute renal failure
ACEI contraindication
pregnancy: 2/3 trimester
fetopathy: oligohydramnios, IUGR, hypocalvaria, renal failure
Angiotensin 2 receptor blockers (ARB)
-sartan drugs
ARB side effect opposite to ACEI
no dry cough
ARB contraindication
pregnancy
ARB side effects
acute renal failure
ARB MOA
Block AT-1 RECEPTORS
Reduce vasoconstriction
-olol drugs
BB (b1)
Nebivolol
selective B1 with antioxidant
Carvedilol
alpha + beta blocker
Labetalol
selective alpha, nonselective Beta blocker
BB indication
anxiety
migraine headaches
tachyarrhythmia
coronary artery disease
BB contraindications
asthma
heart block
BB adverse effects
bronchospasm
fatigue
glucose intolerance
BB caution
hypoglycaemia
abrupt withdrawal = hypertension
CCB
-DIPINE drugs
Diltiazem
CCB
Verapamil
CCB
-dipine drugs work on?
vascular tissue
other CCB drugs work on?
heart
CCB MOA
block L-type Ca2+ channel
CCB side effects
-dipine: flushing, reflex tachycardia, ankle edema
other CCB: decrease contractility, av block
Nimodipine use
acute subarachnoid hemorrhage
CCB indication
angina pectoris
peripheral vascular disease
tachyarrhythmia
Clonidine
Alpha 2 agonist
Clonidine side effects
edema
rebound hypertension wth sudden withdrawal
alpha methyl dopa
alpha 2 agonist
used in pregnancy and renal dysfunction
Alpha methyl dopa side effects
+ve coombs test
hemolytic anemia
Guanethidine
Adrenergic neuronal blocking drugs
Guanethidine MOA
Inhibit release of NE
Guanethidine Side effects
fluid retention
Guanethidine contraindication
Antidepressant
Reserpine
Adrenergic neuronal blocking drugs
Reserpine MOA
destroys storage vesicles
depletes NE, DA and serotonin
Reserpine Side effect
Psychotic depression and suicide
-zocin
Alpha blockers
alpha blocker use
BPH and lower BP
Alpha blocker side effect
1st dose syncope
orthostatic hypertension
urinary incontinence
hydralazine MOA
relax arteriolar smooth muscle
Hydralazine side effects
reflex tachycardia
palpitation
SLE like syndrome
hemolytic anemia
sodium nitroprusside MOA
dilate resistance and capacitance vessels
sodium nitroprusside side effects
cyanide and thiocyanate retention
sodium nitroprusside use
treatment for hypertensive crisis (IV)
Minoxidil MOA
after salvation activate K+ channels
Minoxidil side effects
hypertrichosis
Diazoxide MOA
activate K+ channels to relax smooth muscle
Diazoxide side effects
hyperglycaemia (decrease insulin release)
hypertrichosis
Diazoxide use
treat hypertensive emergencies (IV)
Treat insulinoma
Fenoldopam MOA
D1 agonist
Fenoldopam side effects
Headache
Nausea
Other action of ACEI
reduce preload and after load