Antihypertensive Drugs Flashcards
Nerve terminal blocker that blocks storage processing of NE, used as OBSOLETE Tx for HPN
Reserpine
SimD: Guanethedine
SE: severe psychiatric depression, suicidal ideation
Nicotinic cholinergic antagonist (ganglion blocker) used as OBSOLETE Tx for hypertension
Causes ORTHOSTATIC/POSTURAL HYPOTENSION
Hexamethonium
SimD: Trimethaphan
A1 selective adrenergic antagonist used as TOC for BPH
SE: FIRST DOSE ORTHOSTATIC HYPOTENSION
Prazosin
SimD: Doxazosin, TERAZOSIN, TAMSULOSIN, Silodosin
Beta nonselective adrenergic antagonist used as TOC for angina prophylaxis and hypertension
Propranolol
SimD: pindolol, timolol, labetalol, carvedilol
Drugs used to control BP in patients with Pheochromocytoma
Phenoxybenzamine
Phentolamine
LABetalol
Vasodilator used for HF (in combination with ISDN), HPN and preeclampsia
Hydralazine
SE: Reflex tachycardia, MI, Drug-induced Lupus
More effective combo wd ISDN for HF than ACEI
Drugs that causes drug-induced lupus
HIPP Hydralazine Isoniazid Procainamide Penicillamine
Difference between SLE and Drug-induced Lupus
Presence of antihistone Ab on drug-induced lupus
Vasodilator used for HPN and ALOPECIA with known SE of HYPERTRICHOSIS
MinOxiDil
Moon Of Desire
MOA on hypertri - stimulates hair follicles in telogen phase to differentiate into growth follicles in anagen phase
Difference between non-dihydropyrimidine VS dihydropyrimidine CCBs
Non-dihydropyrimidine CCBs are more CARDIAC than vascular - NonC
Dihydropyrimidine CCBs are more VASCULAR than cardiac - DV
Non-dihydropyrimidine CCBs used for SVT, angina, hypertension, migraine
Keyword: SVT
Verapamil
SimD: Diltiazem
Common SE of Verapamil
Constipation, PRETIBIAL EDEMA
Also known to cause GINGIVAL HYPERPLASIA
Dihydropyrimidine CCBs used for angina and HPN
Nifedipine
SimD: Amlodipine, Nicardipine, Felodipine, Nisoldipine
Constipation, PRETIBIAL EDEMA, dizziness
Vasodilator used for HYPERTENSIVE EMERGENCY and MALIGNANT HYPERTENSION
Nitropusside
MOA: relaxes both venous and arteriolar smooth m. Hence dec both preload and afterload
Vasodilator known to cause CYANIDE TOXICITY as SE
Nitropusside
Dopamine agonist used for hypertensive emergency
Vasodilation of efferent and afferent arterioles in kidneys -> inc UO
FenolDOPAM
SE: Hypotension, hypokalemia
RAA System
Angiotensinogen cleaved by Renin from JG apparatus -> Angiotensin I (inactive metabolite) -> converted by ACE (peptidyl dipeptidase) -> Angiotensin II which is an active vasoconstrictor acting on AT1 receptors
Is there an Angiotensin III?
Yes. Found at adrenal glands also functioning as a vasoconstrictor
Why are ARBs better than ACEIs?
Because Other than ACE inhibited by ACEIs, other enzymes can still convert Ang1 to Ang2 hence antihypertensive effect will not be absolute
Antihypertensive drugs that slows down ventricular remodelling (inc survival in heartfailure and is RENOPROTECTIVE
ACE Inhibitors
Renoprotective bec it dec albumin excretion hence slowing down progression of microalbuminuria to macroalbuminuria
Common SE of Captopril
SimD: Enalapril, Benzelapril, Fosinopril, Lisinopril, Quinril, Ramipril, Trandolapril
COUGH
Also a known teratogen and may also cause hyperkalemia
Benefits of ACEI use (Captopril, Enalapril, etc.)
Slows ventricular remodelling and inc survival in HF
Delays progression of diabetic nephropathy
Treatment of hypertension with co-morbids
Post-MI: Use Thiazides + Beta blockers
T2DM: Use THiazides + ACEI > ARBs
Example of ARBs
LosARtan, Candesartan, Valsartam, Irbesartan, Eprosartan, Telmisartan
Why do patients taking Angiotensin antagonists (ACEI and ARB) develop hyperkalemia?
They reduce aldosterone levels causing potassium retention
Example of Renin antagonist
ALISkiREN
ALIS ka RENin!
Management of MALIGNANT HPN (SBP >200)
Vasodilator (Nitropusside, Fenoldopam, Diazoxide) + Diuretic (Furosemide) + Beta blocker to lower BP to 140-160/90-110
