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Cardio > Antihypertensive Drugs > Flashcards

Antihypertensive Drugs Flashcards

1
Q

Direct arterial vasodilators

A 
Hydralazine
Minoxidil
Diazoxide
Nitroprusside
Fenoldopam
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2
Q

Hypertensive crisis

A

BP > 180/120

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3
Q

Hypertensive urgency

A

elevated BP, no acute or progressing organ injury

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4
Q

Hypertensive emergency

A

acute or progressing target-organ damage

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5
Q

Side effects of direct arterial vasodilators

A

Na/H20 retention

Tachycardia/angina

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6
Q

SE of hydralazine

A

lupus-like syndrome

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7
Q

SE of Minoxidil

A

Hair growth

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8
Q

Ca2+ Channel Blockers

A

Nifedipine
Amlodipine
Verapamil
Diltiazem

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9
Q

Baroreceptor mediated reflex tachycardia d/t potent vasodilating effects; do not alter conduction through AV node

A

Dihydropyradines – Amlodipine, Nifedipine

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10
Q

Decrease HR, slow AV conduction (Ca2+ channel blockers)

A

Non-Dihydropyradines – Verapamil, Diltiazem

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11
Q

Receptor on heart that increases contractility and HR

A

Beta 1

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12
Q

Receptor on arterioles that vasoconstricts skin/viscera

A

Alpha 1

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13
Q

Receptor on arterioles that vasodilates skeletal muscle

A

Beta 2

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14
Q

Receptor on lungs that bronchodilates

A

Beta 2

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15
Q

Receptors on kidney that increases renin release

A

Alpha 1 and Beta 2

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16
Q

Alpha 1/Alpha 2 blockers

A

Phenoxybenzamine

Phentolamine

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17
Q

Mechanism of alpha1/alpha2 blockers

A

inhibits smooth muscle catecholeamine uptake in peripheral vasculature – vasodilation and decrease BP

18
Q

Alpha 1 blockers

A

Prazosin
Terazosin
Doxazosin

19
Q

Mechanism of alpha 1 blockers

A

Smaller increase in HR
Do not stimulate renin release
Does not block alpha2 – thus NE can inhibit its own release

20
Q

What is the first dose effect?

A

Happens with alpha 1 blockers – orthostatic hypotension, transient dizziness, faintness, palpitations, syncope w/i 1-3 hours of 1st dose; reflex tachycardia; first dose at bedtime to minimize effects

21
Q

Beta blockers and receptors

A

Propranolol (B1/B2)
Metoprolol (B1)
Atenolol (M1)
Labetalol (B1/B2/a1)

22
Q

Where are B1 receptors and what do they do?

A

Heart, Kidney

Stim. increase HR, contractility, renin release

23
Q

Where are B2 receptors and what do they do?

A

Lungs, liver, pancreas, arteriolar smooth muscle

Stim. causes bronchodilation and vasodilation, mediated insulin secretion and glycogenolysis

24
Q

Cardioselective B blockers

A

Metoprolol

Atenolol

25
Q

Adverse effects of B-blockers

A

glucose intolerance, masked hypoglycemia, bradycardia, dizziness, bronchospasm, increase TG and decreased HDL, CNS–depression, fatigue, sleep disturbances, Decreased CO, exacerbation of HF, impotence, exercise intolerance

26
Q

Central alpha 2 agonists

A

Clonidine
Guanabenz
Alpha-methyldopa

27
Q

Adverse effects of alpha 2 agonists

A

Na/H20 retention, abrupt discontinuation – rebound htn, depression, orthostatic hypotension, dizziness

28
Q

SE of Clonidine

A

Anticholinergic SR

29
Q

SE of Methyldopa

A

Can cause hepatitis, hemolytic anemia (rare)

30
Q

Neuronal and ganglionic blockers

A

Guanethidine
Guanadrel
Reserpine
Trimethaphan (ganglionic)

31
Q

Adverse effects of neuronal and ganglionic blockers

A 
Sedation (R) 
Depression (R) 
decrease CO, Na/H20 retention
increase gastric acid secretion (R) 
Diarrhea, bradycardia, use with diuretic to avoid fluid retention
32
Q

Diuretics

A

Hydrochlorothiazide
Furosemide
Amiloride

33
Q

Adverse effects of Diuretics

A

Electrolyte disturbances, hyperglycemia, hypotension, orthostasis, lipid abnormalities, photosensitivities, ototoxicity, gout flare – hyperuricemia

34
Q

Aldosterone antagonists

A

Spironolactone

Eplerenone

35
Q

Mechanism of aldosterone antagonists

A

Inhibits the renal (Na and H20 retention) and extra-renal (fibrosis, inflammation) actions of aldosterone
Decreases LVEDP

36
Q

Renin-Angiotensin System Inhibitors

A 
Aliskiren
Losartan
Captopril
Enalapril
Lisinopril
37
Q

Adverse effects of ACE inhibitors

A

Cough (up to 20% of patients) d/t increase bradykinin, angioedema, hyperkalemia (CKD or DM), neutropenia, agranulocytosis, proteinuria, glomerulonephritis, acute renal failure

38
Q

Angiotensin II receptor blockers adverse effects

A

Do not block bradykinin breakdown –> less cough SE

Orthostatic hypotension, renal insufficiency, hyperkalemia

39
Q

Role of AT1

A

Vasoconstriction, vascular proliferation, aldosterone secretion, cardiac myocyte proliferation, increase sympathetic tone

40
Q

Role of AT2

A

Vasodilation, anti-proliferation, apoptosis

41
Q

Adverse effects of Aliskiren

A

orthostatic hypotension, hyperkalemia

42
Q

Precaution of ACEi and ARB

A

Can cause acute kidney failure in certain patients –> severe bilateral renal artery stenosis
Not to be used in pregnancy

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