Antihypertensives Flashcards
MOA Diuretics
-Inhibits reabsorption of sodium and water
-Works on volume of blood and SVR
Three types of diuretics
- Thiazide like: Hydrochlorothiazide,, chlorthalidone, Indapamide
- Loop diuretics: furosemide
- Mineralocorticoid receptor antagonist: spironolactone
Key notes of diuretics
-1st line therapy Thiazide for uncomplicated hypertension
-Don’t start initial therapy on potassium sparing
-S/E: Hypotension, weakness, hypokalemia, hyponatremia, hyperuricemia, hyperglycaemia, hyperlipidimia
Contraindication to diuretics
-Sulpha allergy, gout, anuria, hyponatremia
MOA of ACE “pails”
-Blocks angiotensin II (prevents absorption of sodium and water)
-Works on volume of blood and SVR
Key notes of ACE
-1st line therapy in non-black patients with uncomplicated HTN and for patients with DM, ischemic heart disease, recent MI, HF, or CKD
-S/E: dry cough (switch to ARB), hyperkalemia, angioedema very rare, can worsen renal failure, volume depletion or those receiving NSAIDS (hypotension effect)
Contraindication to ACE
-Pregnancy
-Artery stenosis
-Hx of angioedema
MOA of ARBs “sartan”
-Blocks angiotensin II (prevents absorption of sodium and water)
-Works on volume of blood and SVR
Key notes of ARBS
-1st line therapy in non-black patients with uncomplicated HTN and for patients with DM, ischemic heart disease, recent MI, HF, or CKD
-S/E: hyperkalemia, can worsen renal failure, volume depletion or those receiving NSAIDS (hypotension effect)
-DO NOT USE ARBS and ACE together for HTN risk of hyperkalemia and renal impairment
Contraindication to ARBs
-Pregnancy
-Artery stenosis
-Hx of angioedema
MOA of Beta blockers “lol”
-Blocks beta receptors in the heart causing reduced heart rate and contractility
-Decrease renin secretion so less angiotensin II and aldosterone
-Works on heart rate, contractility and SVR
Examples of beta blockers
-Non selective (nadolol, propranolol, sotalol, timolol): can be helpful in comorbid migraines, stage fright, tremor, tachycardia
-Beta 1 cardioselective (metoprolol, atenolol, bisoprolol, acebutolol)
-Non selective combo B and alpha 1 blocker (carvedilol, labetalol)
Key notes on beta blockers
-1st line in patients <60 years or who have stable angina, HF or history of MI
-Not as effective as ACE/ARBS or diuretics as initial therapy for patients >60 years
-S/E: fatigue, bradycardia, decrease exercise capacity, less common (hyperglycaemia, depression, heart failure, heart block)
Contraindications to beta blockers
-Severe asthma/COPD, PVD, 2/3 degree blocks, decompensated HF
MOA of calcium channel blockers “dipine”
-Relaxes smooth muscles by blocking calcium binding to receptors in muscle
-works on heart contractility and SVR
