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Pharm > Antihypertensives > Flashcards

Antihypertensives Flashcards

1
Q

Sympatholytics

A
  1. Beta-adrenergic blockers
  2. Centrally acting alpha2 agonists
  3. Alpha-adrenergic blockers
  4. Alpha1 - and beta1 - adrenergic blockers
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2
Q

End in *olol

A

beta blockers

A-M are cardiac selective (beta1)
N-Z are non-selective (both)

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3
Q

Beta blocker w/ intended responses are to reduce cardiac output by diminishing SNS response; reduce HR, decrease strength of contractions, decrease BP

Used to treat hypertension, stable angina, dysrhythmias (e.g., SVT), migraines, glaucoma, anxiety

A

metoprolol (Lopressor)

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4
Q

Side effects of beta blockers

A
  • Decreased HR (bradycardia)
  • Decreased BP (hypotension); orthostatic hypotension
  • Bronchospasm (asthma and COPD patients can’t have nonselective beta blockers)
  • Other: dizziness, depression, fatigue, erectile dysfunction
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5
Q

Do NOT stop taking beta blockers because it can cause

A

rebound hypertension

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6
Q

Life Span Considerations for beta blockers

A

Pediatric:
* Not researched
* Consult pediatric cardiologist

Pregnancy and breastfeeding:
* Category C; not recommended unless absolutely necessary
* Excreted in breast milk

Older adults:
* More sensitive to effects; usually prescribed lower dosages
* Can cause mental confusion
* May significantly decrease tolerance to cold

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7
Q

Centrally-acting Alpha2 agonist that decreases sympathetic response; stimulate alpha2 receptors, which decreases sympathetic activity, decreases cardiac output, decreases epi, norepi, and renin release

A

clonidine (Catapres)

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8
Q

Side effects of clonidine

A

drowsiness, dry mouth, dizziness, bradycardia, edema (can cause sodium and water retention)

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9
Q

End in *zosin

AKA alpha adrenergic blockers

Dilates peripheral blood vessels and used to treat HTN

A

Alpha blockers

Ex: prazosin

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10
Q

Side effects of alpha blockers

Ex: prazosin

A

orthostatic hypotension, nausea, nasal congestion caused by vasodilation, edema, weight gain

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11
Q

Can alpha blockers be given with drugs for erectile dysfunction?

A

No, may result in profound hypotension

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12
Q

Combine effects of alpha blockers and beta blockers

Intended responses same as beta blockers, with slightly
different mechanism

A

Alpha1-Beta1 blockers

Ex: carvedilol (Coreg)

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13
Q

Act directly on peripheral arteries causing them to
dilate; leads to lower BP and decreased heart workload

A

Direct vasodilators

Ex: hydralazine

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14
Q

Side effects of direct vasodilators

A

tachycardia and hypernatremia

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15
Q

Adverse reactions of direct vasodilators

A
  • Stevens-Johnson syndrome
  • Report sustained increase in pulse >20 beats/min to prescriber immediately
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16
Q

Is hydralazine safe to use in pregnancy and breastfeeding?

A

yes

17
Q

End in *pril

Vasodilation of blood vessels, diuresis, lowered blood pressure, decreased workload of heart.

Used to treat HTN, HF, and post MI to limit damage to myocardium

A

ACE Inhibitors

Ex: enalopril (Vasotec)

18
Q

Side effects of ACEi

A

persistent dry cough, dizziness, postural hypotension, N/V, tachycardia, hyperkalemia, angioedema (life-threatening swelling of face, tongue, lips, larynx), renal failure, fatigue

19
Q

Contraindications for ACEi

A
  • Pregnancy (risk of fetal renal damage; tetratogenic)
  • Potassium-sparing diuretics
  • Salt substitutes that contain potassium

African American adults & older adults may not respond to ACEi monotherapy

20
Q

End in *sartan

Intended responses are the same as ACEi; better tolerated

Used to treat HTN, diabetic nephropathy, HF

A

Angiotensin II Receptor Blockers (ARBs)

Ex: valsartan (Diovan)

21
Q

Side effects of ARBs

A

Dizziness, hypotension, hyperkalemia

22
Q

Block calcium from entering muscle cells of heart and arteries; decrease strength in heart contractions; relax vascular smooth muscle (vasodilation of coronary arteries)

A

Calcium Channel Blockers (CCBs)

Ex: nifedipine (Procardia) and diltiazem (Cardizem)

23
Q

Two subtypes of CCBs

dihydropyridines—prototype nifedipine (-pines)
non-dihydropyridines—prototype diltiazem

What is the difference between the two?

A

dihydropyridines are non-specific
more effect of vasodilation
less effect on heart function

non-dihydropyridine are cardiac specific
less effect on vasodilation
more effect on heart function

24
Q

CCBs side effects

A

constipation, nausea, headache, flushing, rash, edema (legs), hypotension, drowsiness, dizziness, bradycardia

25
Q

CCBs adverse reactions

A

dysrhythmia, worsening heart failure (with verapamil and diltiazem), Stevens Johnson syndrome

26
Q

Important pt teaching for CCBs

A

-Monitor vitals for bradycardia & hypotension
-Monitor for s/sx of HF: dyspnea, weight gain, and edema
-Teach pt to avoid grapefruit juice
-Teach pt to eat high fiber diet and have good oral hygiene

Pharm (19 decks)

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