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Pharmacology > Antihypertensive Drugs > Flashcards

Antihypertensive Drugs Flashcards

1
Q

What drugs can induce hypertension

A

Nasal decongestant

NSAIDs

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2
Q

How do drugs that aim to reduce BP generally work

A

They aim to reduce TPR or cardiac output

BP=TPRxCO

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3
Q

What are the first line antihypertensive drugs

A

ACE I and ARBS
Beta blockers
Calcium channel blockers
Diuretics - thiazides

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4
Q

What’s first line diuretics for antihypertensive

A

Thiazides - hydrochlorothiazide, indapamide and chlorthalidone

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5
Q

Thiazides mechanism of action

A

Inhibition of Na+ - Cl- symporter in the distal convoluted tubule leading to
Increased secretion of —>Na,K and water

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6
Q

Thiazides adverse effects

A 
Hypokalemia, 
hypercalcemia, 
hyperuricemia(gout), 
hyper lipidimia 
Hyponatremia 
Hypovolemia 
Hyperglycaemia
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7
Q

What are the second line diuretics for antihypertensive drugs

A 
Loop diuretics 
Furosemide
Torsemide 
Bumetanide
Ethacrync acid
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8
Q

Loop diuretics mechanism of action

A

Block Na+/K+/Cl- transporter in the thick ascending limb of loop of henle

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9
Q

Loop diuretics side effects

A

Hypokalemia
Hypocalcemia
Hypomagnesemia
Ototoxicity

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10
Q

ACE I suffix

A

-pril

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11
Q

ACE I mechanism of action

A

Block conversion of ang 1 to ang2 —> decreasing TPR and aldos

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12
Q

Which RAAs are not prodrugs

A

Captopril and lisinopril

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13
Q

What does ACE I cause leading to side effects

A

Increases level of bradykinin levels (dry cough and angioedema and increased PGE -> vasodilation

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14
Q

What are ACE I first line for and why

A

ACE I inhibit progression of kidney changes hence they are 1st line drugs in patients with HTN and diabetes mellitus

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15
Q

ACE I contraindications

A

Pregnancy
History of angioedema
Presistant cough
Bilateral renal artery stenosis

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16
Q

List AT blockers

A

-sartan
Losartan
Valsartan

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17
Q

When are ARBs given instead of ACE I

A
  • Given to patients with ways of Ang 2 formation (angiotensin escape)
  • Can’t tolerate ACE-I side effects
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18
Q

What effect does losartan have on uric acid

A

Increase excretion of uric acid and decrease blood levels

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19
Q

The the case of
Hypertension + increased CV risk /metabolic complications
Which is preferred ACE I vs ARBs

A

ACE I > AT blockers / ARBs

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20
Q

In the case of
Uncomplicated hypertension + decreased CV risk
Which is preferred ACE I vs ARBs

A

ACE I = AT blockers

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21
Q

Can AT blockers be given to pregnant women

A

No they are teratogenic

22
Q

Aliskiren mechanism of action

A

Direct inhibition of renin -> preventing conversion of angiotensinogen to Ang1

23
Q

Can aliskiren be given to pregnant women

A

No it’s Teratogenic

24
Q

What are the types of calcium channel blockers

A

Dihydropyridine and non dihydropyridine

25
Q

List the Dihydropyridine CCB

A

Nifedipine and amlodipine

26
Q

Dihydropyridine mechanism of action

A

Blocks Ca2+ channels on blood vessels only causing vasodilation

27
Q

List non Dihydropyridines

A

Diltiazem and verapamil

28
Q

Non dihydropyridine mechanism of action

A

Blocks Ca2+ channels on blood vessels and heart

29
Q

Adverse effects of dihydropyridines

A

Can cause Peripheral artery disease
Causes peripheral edema
Treatment ACE I or ARBS

30
Q

Non dihydropyridine side effects

A

Constipation

31
Q

Which drugs that alter the CNS are used in hypertension

A

Non selective a antagonists
a1 antagonists
B blockers
Centrally acting agents

32
Q

List non selective a-antagonists used in hypertension

A

Phentolamine- reversible

Phenoxybenzamine- irreversible

33
Q

Non selective a-antagonists indication

A

Pheochromacytoma

34
Q

List a1 antagonists used in hypertension

A

Doxazosin and terazosin

35
Q

a1 antagonists mechanism of action

A

Inhibits a1 on blood vessels leading to vaso dilation and decrease in TPR
Also increases HDL and decreases LDL and beneficial in insulin resistance

36
Q

a1 antagonists Adevrse effects

A

Orthostatic hypotension, nasal congestion and heart failure

37
Q

B-blockers mechanism of action

A
  • Decrease CO - inotropic and - chronotropic
  • reduction in renin release from kidneys
  • vasodilation (only third generation)
38
Q

List centrally acting agents

A

Clonidine and methyldopa

39
Q

Centrally acting agents mechanism of action

A

Central a2 receptors agonists

40
Q

Which centrally acting agent is safe in HYN in pregnancy

A

Methyldopa

41
Q

Centrally acting agents adverse effects

A

Rebound HTN if discontinued abruptly and that leads to hypertensive crisis

42
Q

List the direct vasodilators

A

Hydralazine and minoxidil

43
Q

Direct vasodilators mechanism of action

A

Decrease TPR by relaxing arterioles but can lead to reflex tachycardia and fluid retention

44
Q

Hydralazine mechanism of action

A

Inhibits release of Ca2+ from sarcoplasmic reticulum in arterial smooth muscles

45
Q

Hydralazine side effects

A

SLE and reflex tachycardia

46
Q

Minoxidil mechanism of action

A

Opening of K+ channels in smooth muscle membranes

47
Q

Minoxidil side effects

A

Hypertrichosis (increase hair growth) can be used in bald people

48
Q

What is the initial therapy drug strategy

A

Low dose dual therapy

ACE-I or ARB + CCB or Diuretic

49
Q

Why is low dose dual therapy better than highdose monotherapy

A

Because all adverse effects are dose dependant except in ACE-I

50
Q

What triple therapy drug strategy

A

ACEi or ARB + CCB + Diuretic

51
Q

When are B-blockers added to therapy?

A

Can be added at any step when indicated heart failure, angina l, post MI and fibrillation

52
Q

Medications used for hypertension in pregnancy

A

Methyldopa, labetolol and nifedipine

Pharmacology (33 decks)

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