Antihypertensive Toxicities Flashcards
Beta blockers
Bradycardia
Too low BP
Bronchial constriction
Masks low blood sugar
Sedation
Fatigue
Impaired exercise tolerance
Insomnia
Unpleasant dreams
Erectile dysfunction
Alpha 1 antagonists
ORTHOSTATIC HYPOTENSION
FIRST DOSE PHENOMENON (hypotension with sudden loss of consciousness)
Dizziness
Palpitations
Tachycardia
Headache
Lassitude
Vasodilators (Hydralazine)
Persons who slowly acetylate the drug manifest syndrome characterized by arthralgia, myalgia, skin rashes, and fever that resembles LUPUS ERYHTEMATOSUS
Headache
Nausea
Anorexia
Vomiting
Diarrhea
Palpitations
Hypotension
Sweating and flushing
Nasal congetsion
Edema and/or weight gain
In patients with IHD, reflex tachycardia and sympathetic stimulation may provoke angina or ischemic arrhythmias
Vasodilators (Minoxidil)
HYPERTRICHOSIS [HIRSUTISM]
Tachycardia
Palpitations
Angina
Edema
Headache
Swearing
Vasodilators (Sodium Nitroprusside)
Accumulation of cyanide
Metabolic acidosis
Arrhythmias
Excessive hypotension
Death
Methemoglobinemia
Vasodilators (Diazoxide)
Excessive hypotension
Provoke angina
Hyperglycemia
Renal salt and water retention
Vasodilators (Fenoldopam)
Reflex tachycardia
Headache
Flushing
Increases intraocular pressure
Avoided in px with glaucoma
Calcium channel blockers
CONSTIPATION
Hypotension
Cardiac depression
Cardiac arrest
Bradycardia
AV block and heart failure
Flushing
Dizziness
Headache
Nausea
Peripheral edema
Dihydropyridines have been reported to increase risk of adverse cardiac events in patients with HTN with or without diabetes
Px receiving B adrenoceptor-blocking drugs are more sensitive to the cardiodepressant effects of CCB
Centrally acting sympathoplegic drugs (Methyl dopa)
SEDATION - most common
POSITIVE COOMBS TEST [makes cross matching blood for transfusion difficult and rarely is associated with hemolytic anemia, hepatitis, and drug fever]
Mental lassitude and impaired mental concentration
Nightmares
Mental depression
Vertigo
Lactation [increased prolactin secretion] can occur in both men and women
Centrally acting sympathoplegic drugs (Clonidine)
HYPERTENSIVE CRISIS (withdrawal particularly with high doses)
Dry mouth and sedation
Not be given to px who are at risk for mental depression and should be withdrawn if depression occurs during therapy
Concomitant treatment with TCA’s may block the antihypertensive effects of clonidine [due to a adrenoceptor blocking actions of the tricyclics]
Postnganglionic sympathetic nerve terminal blockers (Reserpine)
SEVERE MENTAL DEPRESSION
Postural hypotension at lower doses
At higher doses, sedation, lassitude, nightmares, and severe mental depression, parkinsonism symptoms
Px with history of mental depression should not receive reserpine, and the drug should be stopped if depression appears
Produces mild diarrhea and GI CRAMPS and increases gastric acid secretion
Drug should not be given to px with history of a peptic ulcer
Ace inhibitors
Severe hypotension
Acute renal failure
Hyperkalemia
Dry cough
Angioedema
Altered sense of taste
Allergic skin rashes
Drug fever
Increased teratogenic risk in first trimester exposure
CONTRAINDICATED DRUING THE SECOND AND THIRD TRIMESTERS OF PREGNANCY because of the risk of:
Fetal hypotension
Anuria
Renal failure
Fetal malformations
Death
ARBs
Similar to ACEI but coughs and angioedema can occur but are less
Renin inhibitor
Hyperkalemia
Renal impairment
Potential teratogen
Angioedema
Ganglion blocking agent
Severe orthostatic hypotension
Constipation
Blurred vision
Sexual dysfunction
