Antihypertensive Drugs Flashcards by Yazan adnan

What drugs can induce hypertension

Nasal decongestant

NSAIDs

How well did you know this?

Not at all

Perfectly

How do drugs that aim to reduce BP generally work

They aim to reduce TPR or cardiac output

BP=TPRxCO

How well did you know this?

Not at all

Perfectly

What are the first line antihypertensive drugs

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

How well did you know this?

Not at all

Perfectly

What’s first line diuretics for antihypertensive

Thiazides - hydrochlorothiazide, indapamide and chlorthalidone

How well did you know this?

Not at all

Perfectly

Thiazides mechanism of action

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

How well did you know this?

Not at all

Perfectly

Thiazides adverse effects

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

How well did you know this?

Not at all

Perfectly

What are the second line diuretics for antihypertensive drugs

Loop diuretics 
Furosemide
Torsemide 
Bumetanide
Ethacrync acid

How well did you know this?

Not at all

Perfectly

Loop diuretics mechanism of action

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

How well did you know this?

Not at all

Perfectly

Loop diuretics side effects

Hypokalemia
Hypocalcemia
Hypomagnesemia
Ototoxicity

How well did you know this?

Not at all

Perfectly

ACE I suffix

-pril

How well did you know this?

Not at all

Perfectly

ACE I mechanism of action

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

How well did you know this?

Not at all

Perfectly

Which RAAs are not prodrugs

Captopril and lisinopril

How well did you know this?

Not at all

Perfectly

What does ACE I cause leading to side effects

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

How well did you know this?

Not at all

Perfectly

What are ACE I first line for and why

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

How well did you know this?

Not at all

Perfectly

ACE I contraindications

Pregnancy
History of angioedema
Presistant cough
Bilateral renal artery stenosis

How well did you know this?

Not at all

Perfectly

List AT blockers

-sartan
Losartan
Valsartan

How well did you know this?

Not at all

Perfectly

When are ARBs given instead of ACE I

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

How well did you know this?

Not at all

Perfectly

What effect does losartan have on uric acid

Increase excretion of uric acid and decrease blood levels

How well did you know this?

Not at all

Perfectly

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

ACE I > AT blockers / ARBs

How well did you know this?

Not at all

Perfectly

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

ACE I = AT blockers

How well did you know this?

Not at all

Perfectly

Can AT blockers be given to pregnant women

No they are teratogenic

Aliskiren mechanism of action

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

Can aliskiren be given to pregnant women

No it’s Teratogenic

What are the types of calcium channel blockers

Dihydropyridine and non dihydropyridine

List the Dihydropyridine CCB

Nifedipine and amlodipine

Dihydropyridine mechanism of action

Blocks Ca2+ channels on blood vessels only causing vasodilation

List non Dihydropyridines

Diltiazem and verapamil

Non dihydropyridine mechanism of action

Blocks Ca2+ channels on blood vessels and heart

Adverse effects of dihydropyridines

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

Non dihydropyridine side effects

Constipation

Which drugs that alter the CNS are used in hypertension

Non selective a antagonists a1 antagonists B blockers Centrally acting agents

List non selective a-antagonists used in hypertension

Phentolamine- reversible | Phenoxybenzamine- irreversible

Non selective a-antagonists indication

Pheochromacytoma

List a1 antagonists used in hypertension

Doxazosin and terazosin

a1 antagonists mechanism of action

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

a1 antagonists Adevrse effects

Orthostatic hypotension, nasal congestion and heart failure

B-blockers mechanism of action

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

List centrally acting agents

Clonidine and methyldopa

Centrally acting agents mechanism of action

Central a2 receptors agonists

Which centrally acting agent is safe in HYN in pregnancy

Methyldopa

Centrally acting agents adverse effects

Rebound HTN if discontinued abruptly and that leads to hypertensive crisis

List the direct vasodilators

Hydralazine and minoxidil

Direct vasodilators mechanism of action

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

Hydralazine mechanism of action

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

Hydralazine side effects

SLE and reflex tachycardia

Minoxidil mechanism of action

Opening of K+ channels in smooth muscle membranes

Minoxidil side effects

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

What is the initial therapy drug strategy

Low dose dual therapy | ACE-I or ARB + CCB or Diuretic

Why is low dose dual therapy better than highdose monotherapy

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

What triple therapy drug strategy

ACEi or ARB + CCB + Diuretic

When are B-blockers added to therapy?

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

Medications used for hypertension in pregnancy

Methyldopa, labetolol and nifedipine