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Antihypertensive drugs Flashcards

1
Q

Recommended clinical treatment for HTN and angina pectoris

A

Beta blocker and/or Ca channel blocker

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2
Q

Recommended clinical treatment for HTN and BPH

A

Alpha blocker

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3
Q

Recommended clinical treatment for HTN and DM

A

ACE inhibitor or ARB

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4
Q

Recommended clinical treatment for HTN and HF

A

ACE inhibitor, ARB, beta blocker, and/or diuretic

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5
Q

Recommended clinical treatment for HTN and MI

A

Beta blocker
ACE inhibitor

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6
Q

Recommended clinical treatment for HTN and HLD

A

Alpha blocker
Ca channel blocker

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7
Q

Drugs used for HTN in pregnancy

A

Labetalol –> first-line
Hydralazine
Nifedipine
NTG

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8
Q

Thiazide diuretics

A

Chlorothiazide
Hydrochlorothiazide
Chlorthalidone
Indapamide
Metolazone

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9
Q

Mechanism of thiazide diuretics

A

Inhibit Na/Cl cotransport resulting in increase excretion of Na, K, Cl, Mg, and HCO3. Decrease excretion of Ca and uric acid.

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10
Q

Adverse effects of thiazide diuretics

A

Hyponatremia
Hypokalemia
Hypomagnesemia
Metabolic acidosis
Hypercalcemia
Hyperuricemia

Increase plasma cholesterol and triglycerides –> except indapamide

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11
Q

Loop diuretics

A

Furosemide
Bumetanide
Torsemide
Ethacrynic acid

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12
Q

Mechanism of loop diuretics

A

Inhibit Na/K/2Cl cotransport resulting in increased secretion of Na, K, Mg, Cl, HCO3, and Ca

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13
Q

Adverse effects of loop diuretics

A

Hyponatremia
Hypokalemia
Hypomagnesemia
Hypocalcemia
Metabolic acidosis
Ototoxicity

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14
Q

Drug interaction of loop diuretics

A

Aminoglycoside antibiotics –> increased risk for ototoxicity

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15
Q

Osmotic diuretics

A

Mannitol
Glycerol

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16
Q

Mechanism of osmotic diuretics

A

Increase osmotic pressure in proximal tubule –> inhibition of water and electrolyte reabsorption

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17
Q

Indications for use of osmotic diuretics

A

Increase intracranial pressure
Increases intraocular pressure
Acute renal failure

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18
Q

Adverse effects of osmotic diuretics

A

Excessive plasma volume expansion, which can lead to HF

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19
Q

Carbonic anhydrase inhibitors

A

Acetazolamide
Dorzolamide

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20
Q

Therapeutic effect of carbonic anhydrase inhibitors

A

Diuretic action by increasing secretion of Na, K, and HCO3

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21
Q

Indications for use of carbonic anhydrase inhibitors

A

High altitude sickness
Glaucoma
Overdose of acidic drugs –> alkalinize urine

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22
Q

Adverse effects of carbonic anhydrase inhibitors

A

Drowsiness
Paresthesia

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23
Q

K sparing diuretics

A

Spironolactone
Eplerenone
Amiloride
Triamterene

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24
Q

Mechanism of K sparing diuretics

A

Block Na reabsorption

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25
Q

Diuretic used in hirsutism because of anti-androgenic effect

A

Spironolactone

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26
Q

Drug class used in combination with spironolactone to increase survival in HF

A

ACE inhibitor

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27
Q

Diuretic used in nephrogenic diabetes insipidus caused by lithium

A

Amiloride

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28
Q

Adverse effects of K sparing diuretics

A

Hyperkalemia
Nephrolithiasis (triamterene)
Decreased libido and gynecomastia (spironolactone)

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29
Q

Treatment for hyperkalemia

A

Patiromer

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30
Q

Antidiuretic hormone antagonists/vasopressin antagonists

A

Conivaptan (V1A and V2)
Tolvaptan (selective V2)

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31
Q

Indications for use of ADH antagonists/vasopressin antagonists

A

Euvolemic and hypervolemic hyponatremia

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32
Q

Adverse effects of ADH antagonists/vasopressin antagonists

A

Infusion site reaction
Hypokalemia

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33
Q

Prevent conversion of angiotensin I to angiotensin II to reduce afterload and cause arteriolar dilation in the kidney. This decreases the release of aldosterone. Also prevents conversion of bradykinin to inactive compound, which increases vasodilation.

A

ACE inhibitors

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34
Q

Drug of choice for pts with HTN and DM with a kidney protective function

A

ACE inhibitors

35
Q

Uses of ACE inhibitors

A

HTN
HF
LV systolic dysfunction post MI
Stroke

36
Q

Adverse effects of ACE inhibitors

A

Dry cough
Hyperkalemia
Angioedema
Proteinuria
Elevated BUN and creatinine

37
Q

Contraindications of ACE inhibitors

A

Pregnancy
Angioedema
Bilateral renal A stenosis

38
Q

Risks of ACE inhibitor use in pregnancy

A

Fetopathy
Oligohydramnios
IUGR
Hypocalvaria
Renal failure

39
Q

Drug class that blocks angiotensin II receptors to reduce aldosterone release without any effect on bradykinin metabolism.

40
Q

Adverse effects of ARB

A

Hyperkalemia
Angioedema

41
Q

Contraindication for use of ARB for HTN

42
Q

Non-selective beta blockers used of HTN

A

Propranolol
Nadolol
Timolol

43
Q

Selective beta-1 blockers used for HTN

A

Metoprolol
Atenolol
Bisoprolol
Betaxolol

44
Q

Beta-adrenergic partial agonist used for HTN

A

Acebutolol

45
Q

Beta-blocker and NO release use in HTN

46
Q

Non-selective beta and alpha blockers used in HTN

A

Carvedilol
Labetalol

47
Q

Clinical uses of beta blockers

A

Coronary artery diseases
Tachyarrhythmias
Migraines
Anxiety

48
Q

Adverse effects of beta blockers

A

Bradycardia
Fatigue
Sexual dysfunction
AV block
Mask signs of hypoglycemia

49
Q

Risk of abrupt withdrawal from beta blockers

A

Rebound HTN due to upregulation of receptors

50
Q

Contraindications of beta blockers

A

Asthma
Heart block

51
Q

Dihydropyridine Ca channel blockers

A

Amlodipine
Nifedipine
Felodipine
Isradipine
Nicardipine
Clevidipine

52
Q

Mechanism of dihydropyridine Ca channel blockers

A

Block L-type Ca channels on vascular tissues to cause vasodilation

53
Q

Adverse effects of dihydropyridine Ca channel blockers

A

Reflex tachycardia
Ankle edema
Gingival hyperplasia

54
Q

Non-dihydropyridine Ca channel blockers

A

Diltiazem
Verapamil

55
Q

Mechanism of non-dihydropyridine Ca channel blockers

A

Act on heart to decrease HR and conduction velocity

56
Q

Adverse effects of non-dihydropyridine Ca channel blockers

A

AV conduction block
Constipation

57
Q

Alpha 2 agonists used for HTN

A

Clonidine
Alpha methyldopa

58
Q

Mechanism of clonidine

A

Activates presynaptic alpha 2 receptors

59
Q

Mechanism of alpha methyldopa

A

Prodrug
Active form is an agonist at the presynaptic alpha 2 receptor

60
Q

Adverse effects of clonidine

A

Edema
Rebound HTN

61
Q

Adverse effects of alpha methyldopa

A

Autoimmune hemolytic anemia (positive Coombs)
Hepatitis

62
Q

Adrenergic neuronal blocking agents used for HTN

A

Guanethidine
Reserpine

63
Q

Mechanism of guanethidine

A

Binds to storage vesicles and inhibits release of norepinephrine

64
Q

Contraindication of guanethidine

A

Tricyclic antidepressants

65
Q

Mechanism of reserpine

A

Binds to storage vesicles and destroys them, causing depletion of norepinephrine, dopamine, and serotonin

66
Q

Adverse effects of reserpine

A

Major depression
Suicidal thoughts
GI complications

67
Q

Alpha 1 blockers use for HTN

A

Prazosin
Doxazosin
Terazosin

68
Q

Mechanism of alpha blockers for HTN

A

Selective antagonists of peripheral alpha 1 receptors to relax vascular smooth muscle and decrease arteriolar resistance

69
Q

Adverse effects of alpha blockers for HTN

A

First dose syncope –> orthostatic hypotension
Urinary incontinence in women –> alpha blockade relaxing effect on bladder
Retrograde ejaculation

70
Q

Direct acting vasodilators

A

Hydralazine
Sodium nitroprusside
Minoxidil
Fenoldopam

71
Q

Prodrug of NO that has selective arteriolar dilation action. Used for moderate to severe HTN.

A

Hydralazine

72
Q

Adverse effects of hydralazine

A

SLE like syndrome –> slow acetylators
Reflex tachycardia

73
Q

Causes venous and arterial vasodilation through cGMP. Given through IV in hypertensive crisis.

A

Sodium nitroprusside

74
Q

Cyanide poisoning symptoms

A

Lactic acidosis
HA
Vertigo
Confusion

75
Q

Adverse effects of sodium nitroprusside and its prevention

A

Cyanide poisoning –> administer with Na thiosulfate or vit B12

76
Q

Potent direct vasodilator that activates ATP-dependent K channels. Also used as a topical product for baldness.

77
Q

Side effects of minoxidil

A

Hypertrichosis
Reflex tachycardia and edema

78
Q

Direct active vasodilator that stimulates D1 and alpha-2 adrenergic receptors. It protects the kidney and is used in hypertensive emergencies.

A

Fenoldopam

79
Q

Drug that directly inhibits renin enzyme to block conversion of angiotensinogen to angiotensin I

80
Q

Adverse effects of aliskiren

A

Hyperkalemia
Angioedema

81
Q

Contraindication of aliskiren

82
Q

Ca channel blockers used in hypertensive emergencies

A

Nicardipine
Clevidipine

83
Q

Beta blockers used in hypertensive emergencies

A

Labetalol
Esmolol

Cardiovascular II (29 decks)

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