antihypertensive agents 1 Flashcards
4 categories of antihypertensive agents
- direct vasodilators
- sympathoplegic agents
- diuretics
- agents that block production of angiotension
what do direct vasodilators do for HTN?
relaxing vascular smooth muscle, dilating resistence
results: reduces pressure, increase capacitance
What do sympathoplegic agents do for HTN?
reducing peripheral vascular resistance, inhibiting cardiac function, increasing venous pooling in vessels
results: lower BP, (reduce cardiac output)
what do diuretics do for HTN?
depeletes the body of sodium
result: reduces blood volume and lowers BP
what do agents that block production or action of angiotensin do for HTN
block or reduce angiontensin
result: reduce peripheral vascular resistance and blood volume
what are the first line antihypertensives
- ACE inhibitors
- ARB’s (-sartans,
List 3 ACE-inhibitor drugs
- Lisinopril (zestril)
- Captopril
- Enalapril (vasotec)
what is Lisinopril’s dosage and name brand
2.5 - 40 mg PO qd
Zestril
what blocks angiotensinogen from turnign to angiotensin 1
aliskiren
(blocks renin)
what captopril’s dosage
12.5-100 mg PO bid/tid
what is the dosage of Enalapril? what is the name brand
2.5-20mg PO qd
Vasotec
what is the MOA of ACE inhibitors
inhibition of ACE that lowers the conversion of angiotensin 1-angiotensin 2
What are the indications of ACE inhibitors
-first line for: diabetes mellitus, renal disease
-heart failure w reduce EF
what are ACE inhibitors known as
cardiprotective and renal protective
what are the adverse effects of ACE inhibitors
- cough
- angioedema
- ACEIs: pemphigus vulgaris
What are the contraindications to ACE inhibitors
2 absolute, 2 relative
- C1 esterase inhibitror deficiency
- pregnancy
relative: Bilateral renal artery stenosis, solitary kidney
what is C1 esterase deficiency
hereditary angioedema
-recurrent angioedmea w/o uticaria or pruitius
what are possible drug interactions of ACE inhibitors
list 4
- other hypertensive drugs
- NSAIDS (can decrease effect)
- Potassium-sparing diuretics (increases hyperkalemia)
- increasing levels of lithium
what does high blood pressure do to blood vessels?
damages them (especially important in kidney)
what symptom can damage tissue (unique)
cough
what are 2 drugs part of the ARB’s group
-sartans
1. Valsartan (Diovan)
2. Candesartan (Atacand)
what is the dosage of valsartan? what is the name brand
40-320 mg PO qd
what is lithium
a mood stabalizer
what is the dosage of candesartan? what is the name brand?
4-32 mg PO qd
Atacand
what is the indiction of use for ARBs
same as ACE inhibitor, used if ACE inhibitor is not well tolerated
what is the MOA of ARBs
inhibits angiotensin 2., receptor type 1
adverse effects of ARBS
similar to ACE inhibitors
-cough and angiodema is uncommon
when are ARBs mos commonly used
patients who have allergic reactions to ACE inhibitors
3 drugs that are part of dihydropyridine CCB class
- Nifedipine
- Nicarrdipine (cardene)
- Amlodipine (Norvsac)
what are the dureations of the 3 ACE inhibitors
- nifedipine (procardia)
- Nicardipipine (cardene)
- amlodipine (norvack)
what is the dosage of Nifedipine? what is the half life?
30-90 mg PO qd
<2 hours
Procardia
what is the dosage of Nicardipine? what is the half life?
20 mgs or 30 mg, PO, TID
8-12 hours
what is the dosage/regimen of Nicardipine for a Hypertensive emergency
continuous IV
Initial:5mg/hour
titrate: by 2.5mg per hour at 5-215 min intervals
Max dose: 15mg/hour
what is the dosage of Amlodipine? what is the half life?
2.5-10 mg PO qd
half life>24 hrs
what CCB is the most potent vasodilator
dihydropyridine
