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Renal II > Antihypertensive agents > Flashcards

Antihypertensive agents Flashcards

1
Q

prehypertension

A

120-139/80-89

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2
Q

stage I hypertension

A

140-159/90-99

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3
Q

loop diuretics target

A

Na/K/2Cl cotransporter TAL LOH

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4
Q

thiazide diuretics target

A

Na/Cl cotransporter DCL

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5
Q

carbonic anhydrase inhibitors (PCT)

A

*acetazolamide
brinzolamide
dorzolamide
methazolamide

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6
Q

loop diuretics (TAL LOH)

A

*ethacrynic acid
*furosemide
bumetanide
torsemide

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7
Q

thiazide diuretics (DCT)

A

*chlorthalidone
*hydrochlorothiazide
bendroflumethiazide
chlorothiazide
hydroflumethiazide
indapamide
methyclothiazide
metolazone
polythiazide
thrichlormethiazide

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8
Q

K-sparing diurertics

A 
Aldosterone antagonists
*spironolactone
eplerenone
Epithelial Na channel (ENaC) inhibitors
*amiloride
triamterene
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9
Q

carbonic anhydrase inhibitors MOA

*acetazolamide

A

inhibits membrane-bound and cytoplasmic carbonic anhydrase in PCT. Results in:
high Na+ and HCO3- in lumen
*high urine pH, low body pH

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10
Q

prehypertension

A

120-139/80-89

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11
Q

stage I hypertension

A

140-159/90-99

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12
Q

stage II hypertension

A

> 160/>100

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13
Q

loop diuretics target

A

Na/K/Cl cotransporter TAL LOH

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14
Q

thiazide diuretics target

A

Na/Cl cotransporter DCL

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15
Q

K-sparing diuretics target

A

ENaC channels and mineralocorticoid receptor

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16
Q

carbonic anhydrase inhibitors

A

*acetazolamide
brinzolamide
dorzolamide
methazolamide

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17
Q

loop diuretics

A

*ethacrynic acid
*furosemide
bumetanide
torsemide

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18
Q

thiazide diuretics

A

*chlorthalidone
*hydrochlorothiazide
bendroflumethiazide
chlorothiazide
hydroflumethiazide
indapamide
methyclothiazide
metolazone
polythiazide
thrichlormethiazide

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19
Q

K-sparing diurertics

A 
Aldosterone antagonists
*spironolactone
eplerenone
Epithelial Na channel inhibitors
*amiloride
triamterene
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20
Q

carbonic anhydrase inhibitors MOA

*acetazolamide

A

inhibits membrane-bound and cytoplasmic carbonic anhydrase in PCT. Results in:
high Na+ and HCO3- in lumen
*high urine pH, low body pH

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21
Q

carbonic anhydrase inhibitor indications

A

glaucoma, acute mountain sickness, metabolic alkalosis

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22
Q

loop diuretics MOA

*furosemide and ethacrynic acid

A

inhibit luminal Na/K/2Cl cotransporter in TAL LOH. Results in:
decreased intracellular Na+, K+, Cl-, Ca2+, and Mg2+
extremely efficacious

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23
Q

loop diuretic indications

A

edema, heart failure, HTN, acute renal failure, anion overdose, hypercalcemic states

24
Q

thiazide diuretics MOA

*chlorthalidone and HCTZ

A

inhibit Na/Cl cotransporter in DCT. Results in:
high luminal Na+ and Cl-
increased reabsorption of Ca2+ in DCT and PCT

25
Q

thiazide diuretic indications

A

HTN, mild heart failure, nephrolithiasis, nephrogenic diabetes insipidus

26
Q

thiazide diuretic adverse effects

A

hyperglycemia (DM relative contraindication), hyperlipidemia

27
Q

K+-sparing diuretics MOA

  • spironolactone (mineralocorticoid recepter (MR) antagonist)
  • amiloride (ENaC inhibitor)
A

decreased reabsorption of Na+ > decreased excretion of K+

28
Q

Angiotensin Converting Enzyme (ACE) inhibitors

A

*captopril
*enalapril
benazepril
enalaprilat
fosinopril
lisinopril
moexipril
perindopril
quinapril
ramipril
trandolapril

29
Q

Angiotensin Receptor Blockers (ARBs)

A

*losartan
*valsartan
azilsartan
candesartan
eprosartan
irbesartan
olmesartan
telmisartan

30
Q

Drugs that block renin secretion

A

clonidine

propranolol

31
Q

Renin inhibitors

A

aliskiren

32
Q

ACE inhibitors MOA

*captopril and enalapril

A

inhibit conversion of ANG I to ANG II and prevent degradation of bradykinin and other vasodilators

33
Q

ACE inhibitor indications

A

HTN, heart failure, left ventricular dysfunction, prophylaxis for future cardiac events, and nephropathy +/- diabetes. Not banned in sports!

34
Q

ACE inhibitor AEs

A 
cough
angioedema (swelling of face, tongue)
hyperkalemia
acute renal failure
fetopathic potential *contraindicated in pregnancy
35
Q

ARBs MOA

*losartan and valsartan

A

selectively block AT1 receptors > decrease contraction of vascular smooth muscle, aldosterone secretion, pressor responses, and cardiac cellular hypertrophy and hyperplasia

36
Q

ARB indications

A

HTN, diabetic nephropathy, HF, left ventricular dysfunction after AMI, prophylaxis for cardiovascular events

37
Q

ARB AEs

A

similar to ACEIs but less cough and angioedema

*contraindicated during pregnancy

38
Q

ARBs vs ACEIs

A

ARBs reduce activation of AT1 receptors more effectively than ACEIs
ARBs permit activation of AT2 receptors (vasodilation)
ACEIs increase bradykinin levels

39
Q

Renin inhibitor MOA

*aliskiren

A

inhibits renin and blocks ANG I > ANG II
rise in plasma renin levels but decreased activity
AEs similar to ACEIs and ARBs

40
Q

Calcium channel blockers (CCBs)

A 
Dihydropyridines (DHPs)
*amlodipine
*nifedipine
clevidipine
felodipine
isradipine
nicardipine
nisoldipine
Non-DHPs
*diltiazem
*verapimil
41
Q

K+ channel openers

A

diazoxide

minoxidil

42
Q

Dopamine agonist

A

fenoldopam

43
Q

Nitric oxide modulators

A

*hydralazine
*nitroprusside (nitropress)
organic nitrates (isosorbide dinitrate and nitroglycerin)

44
Q

CCBs MOA

A

inhibit Ca2+ influx into L-type Ca2+ channels
Non-DHPs: prominent cardiac effects
DHPs: predominantly arteriolar vasodilation

45
Q

CCB AEs

A

generally well tolerated
excessive vasodilation > dizziness, hypotension, headache, flushing, nausea
constipation, esp. verapimil
CI: verapimil/diltiazem + beta blocker (potential for AV block)

46
Q

CCBs indications

A

HTN: most useful when combined with another agent to counteract reflex cardiovascular responses
hypertensive emergencies
angina

47
Q

K+ channel openers MOA

*diazoxide and minoxidil

A

increase K+ permeability > stabilize smooth muscle cell membrane potential, reducing probability of contraction

48
Q

fenoldopam MOA, indications, and CIs

A

D1 dopamine receptor agonist, increases blood flow to kidneys
for HTN emergencies and post-op HTN
CI: glaucoma d/t increased intraocular pressure

49
Q

hydralazine MOA, indications

A

releases NO from endothelium, dilates arterioles but not veins
first-line oral therapy for HTN in pregnancy + methyldopa

50
Q

nitroprusside and organic nitrates MOA

A

dilates arterioles and venous vessels > decreases TPR and venous return
nitroprusside AEs: excessive hypotension, cyanide poisoning
nitrates AEs: orthostatic hypotension, syncope, throbbing headache

51
Q

Beta blockers

A

*atenolol
*metoprolol
acebutolol
betaxolol
bisoprolol
carteolol
esmolol
nadolol
nebivolol
penbutolol
pindolol

52
Q

alpha/beta blockers

A
  • carvedilol

* labetalol

53
Q

alpha-1 blockers

A

*prazosin
doxazosin
terazosin

54
Q

centrally acting

A

*clonidine
*methyldopa
guanabenz
guanfacine

55
Q

non-selective beta blocker

A

*propranolol

56
Q

hypertensive urgency

A

SBP > 180 or DBP > 130 AND no evidence or end organ damage

57
Q

hypertensive emergency

A

may occur at any BP but involves acute damage to at least one organ system

Renal II (3 decks)

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