Antihypertensive Drugs Flashcards
A unique formulation of which of the following antihypertensive medications is worthy of CONSIDERATION for this patient because it can be administered once every 7 days?
Clonidine
Selection of antihypertensive drugs for noncompliance
preferred:
once-daily dosages regimens
or
transdermal clonidine
reflex tachycardia when used alone
hydralazine
minoxidil
dihydropyrides
Labetalol
beta 1 and alpha 1 antagonist
treatment of hypertensive emergency
nicardipine or clevidipine with labetalol and/or esmolol
digoxin action
slows rate of AV node conduction
Fenoldopam
pure D1 agonist
can be used in hypertensive emergency
scleroderma crisis drug tx
ACE inhibitors
Nitrate toxicity
pronounced vasodilation resulting in: orthostatic hypotension, tachycardia
throbbing headache
tolerance w/ repeated exposure
Monday’s disease
Sildenafil complication
profound hypotensive crisis when nitroglycerin administer
Phosphodiesterase type 5 inhibitors
Increase cGMP (cGMP does not get deactivated)
sildenafil
vardenafil
tadalafil
Avanafil
intracellular molecule that is responsible for vasodilation in the corpus cavernosum to improve erectile function
cGMP (cyclic guanosine monophosphate)
Management of afib without CHF
beta-blocker
CCB
Digoxin
Management of afib with CHF
beta blockers
Digoxin (Increase cardiac output)
(never CCB)
Thyroxine
will enhance the renal clearance (CLr) of digoxin when used to treat CHF and control ventricular rate
Drugs that enhance digoxin toxicity
quinidine, amiodarone, captopril, verapamil, diltiazem, cyclosporin
decreases renal clearance and/or volume distribution
Drugs that reduce digoxin toxicity
thyroxine (increase clearance)
cholestyramine (decrease GI absorption)
Hypothyroidism decreases renal clearance
ECG changes relates to the BENEFICAL effects of digoxin on rate control
pro-longed P-R interval
Sites of action of Digoxin
AV node - prolonged refractory period = slowed conduction = prolonged PR interval
Ventricle
- accelerated repolarization = shortened Q-T interval
- changes in phase 2 or 3, or in direction of repolarization = depressed S-T segment or inverted T-wave
appropriate drugs to use in combination for the treatment of a 59-year-old woman during the EARLY stages of chronic heart failure (CHF)
Furosemide + captopril + metoprolol
3-step treatment of CHF
step 1: initiate ACE inhibitor to reduce workload. add beta blocker if stable systolic dysfunction
step 2: persistent symptoms add aldosterone antagonist
step 3: still persistent add digoxin, ARB
**for african-american patients add hydralazine/isosorbide dinitrate (bidil)
Ivabradine
slows rate without affecting force of contraction
selective and specific inhibitor of the hyperpolarization activated cyclic nucleotide-gated channels (If channels; funny current) - inhibition of If ion current flow prolongs diastolic depolarization, slows firing in the SA node.
CYP3A4
