Antihypertensive Drugs

Question 1

Loop Diuretic

Answer 1

furosemide (Lasix)

MOA = acts on ascending loop of Henle, inhibits reabsorption of Na+/K+/Cl- which prevents reabsorption of water.

AE = dehydration, hypokalemia, hyponatremia, hyporcalcemia, ototoxicity, hyperglycemia, increased LDLs.

Question 2

Thiazide Diuretic

Answer 2

hydrocholorothiazide (Microzide)

MOA = inhibits mechanism that favor Na+ reabsorption –> results in Na+ and K+ excretion and reabsorption of Ca+

AE = dehydration, hypokalemia, hyponatremia, hypercalcemia, ototoxicity, hyperglycemia, increased LDLs, significant K+ loss.

Question 3

Potassium Sparing Diuretics

Answer 3

spironolactone

MOA = limits reabsorption of Na+ and limits excretion of K+; blocks aldosterone receptor.

AE = hyperkalemia, nausea, lethargy, mental confusion; gynecomastia in males and menstrual irregularities in females.

Question 4

Calcium Channel Blocker

Answer 4

Dihydropyridines –> amlopidine

MOA = block Ca2+ entrance into vascular smooth muscle, which causes vasodilation. Will decrease contractility and CO

AE = dizziness, hypotension, HA, bradycardia, reflex tachycardia

Question 5

Therapeutic concerns for diuretics?

Answer 5

1. dehydration
2. OH
3. arrhythmias
4. DDI w/ NSAIDs
5. Educate pt to monitor glucose/lipid levels

Question 6

Cardio-Selective Beta Blockers

Answer 6

(“-lol”)

Used for = HTN, angina, arrhythmias, post MI survival

metoprolol (Lopressor)
carvedilol (Coreg)

MOA = Reduces sympathetic influence; reduces workload of heart b/c is selective for B1 receptors w/o causing bronchoconstriction

AE = peripheral vasoconstriction, bradycardia, OH, sexual dysfunction, dizziness, fatigue

Question 7

Central Acting Alpha2 Agonist

Answer 7

clonidine

Used for = hypertension and ADHD

A2 receptor are primarily on presynaptic neurons –> stimulate in CNS = decrease NE production = decrease sympathetic outflow = decrease peripheral resistance, renal vascular resistance, HR, BP

AE = dizziness, drowsiness, HA, dry mouth, rash w/ patch

Question 8

ACEi (Angiotensin 1 converting inhibitor)

Answer 8

(“-pril”)

Uses = HTN, Reduced ejection HF, post MI, post stroke, kidney disease

lisinopril
enalapril

MOA = Block conversion of angiotensin 1 to angiotensin 2 –> increases blood vessel vasodilation, increases bradykinin which increases vasodilation, and decreases aldosterone secretion which decreases Na+ and H2O retention.

AE = dry cough, hypotension/dizziness, hyperkalemia, acute renal failure, angioedema. (more common in AA)

Question 9

ARB (Angiotensin 2 receptor blocker)

Answer 9

(“-sartan”)

Uses = alternative if ACEi intolerant, HTN, kidney disease, HF

losartan
valsartan

MOA = antagonist at AT1 receptor = blocks binding of angiotensin 2. Results decrease blood vessel vasoconstriction, aldosterone release, and decrease constriction of the efferent arterioles

AE = hypotension/dizziness, hyperkalemia