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Pharm Midterm 1 > Antihypertensives > Flashcards

Antihypertensives Flashcards

1
Q

Stage 1/First line Anti-HTN

A

Ca channel blockers
Thiazides
ACEIs
ARBs

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2
Q

ACE inhibitors

A

Captopril
Enalapril
Lisinopril

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3
Q

ARBs

A

Lorsatan

Valsartan

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4
Q

Renin inhibitor

A

Aliskiren

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5
Q

Ca channel blockers

A

Verapamil
Diltiazem
Nifedipine
Amlodipine

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6
Q

Thiazides

A

Chlorthalidone
Hydrochlorothiazide
Metolazone

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7
Q

Loop Diuretics

A

Ethacrynic Acid
Furosemide
Torsemide

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8
Q

K sparing diuretics

A

Amiloride
Triamterene
Spironolactone
Eplerenone

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9
Q

What are the 2nd line Anti-HTNs

A

Beta blockers

Aldosterone antagonists

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10
Q

Beta blockers

A

Atenolol
Metoprolol
Propranolol
Pindolol

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11
Q

Alpha blockers

A

Doxazosin
Prazosin
Terazosin

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12
Q

Mixed alpha/beta blockers

A

Labetalol

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13
Q

Central alpha 2 agonists

A

Clonidine

Methyldopa

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14
Q

What are the 3rd line Anti-HTNs

A

Direct Vasodilators

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15
Q

Direct vasodilators

A

Hydralazine

Minoxidil

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16
Q

Non-selective endothelin receptor blocker

A

Bosentan

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17
Q

Synthetic PGI2

A

Epoprostenol

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18
Q

What do ACEIs do

A

Decrease PVR, BP
Decrease diabetic nephropathy
Decrease albuminuria

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19
Q

DOC pts post MI

A

ACEI/ARB (but beta blocker first)

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20
Q

Elevated creatinine in pts with bilateral renal stenosis

A

ACEI

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21
Q

Major AE is Hyperkalemia

A

ACEI

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22
Q

No effect on bradykinin

A

ARBs

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23
Q

Least selective Ca channel blocker

A

Verapamil

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24
Q

Can cause reflex tachycardia

A 
Ca channel blockers
Alpha blockers (short term)
Direct vasodilators
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25
Q

Contraindicated in CHF due to negative inotropic effects

A

Verapamil

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26
Q

Great for HTN but not arrhythmias

A

Dihydropyridines

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27
Q

What are the Dihydropyridines

A

Nifedipine

Amlodipine

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28
Q

What are the Nondihydropyridines

A

Verapamil

Diltiazem

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29
Q

Major AE is Hypokalemia

A

Thiazides

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30
Q

1st line in pts with HTN and severe LV dysfunction

A

Spironolactone

Eplerenone

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31
Q

Pregnancy beta blocker

A

Pindolol

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32
Q

Decrease NE and renin via beta 1

A

Beta blockers

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33
Q

DOC only for CAD or LV dysfunction and HTN

A

Beta blockers

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34
Q

Minimal change in CO RBF, GFR

A

Alpha blockers

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35
Q

Tx in HTN with BPH

A

Alpha blockers

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36
Q

Alpha or Beta blockers safe in pregnancy

A

Labetalol

Pindolol

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37
Q

Does not affect CO

A

Methyldopa

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38
Q

DOC in pregnancy induced HTN

A

Methyldopa

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39
Q

Contraindications for methyldopa

A

Hemolytic anemia
Hepatitis
Can cause +ve coombs test

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40
Q

DOC eclampsia emergency in pregnancy

A

Hydralazine

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41
Q

Coadminister with diuretic and beta blocker

A

Minoxidil

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42
Q

Pregnancy category X

43
Q

Lowers pulmonary, peripheral and coronary resistance

A

Epoprostenol

44
Q

Requires continuous IV infusion

A

Epoprostenol

Bosentan

45
Q

Can cause Lupus-like syndrome (NAT)

A

Direct vasodilators

46
Q

How do ACEIs lower BP

A

Decrease Na and H2O retention

Increase renin

47
Q

When do you give ACEIs

A

Young whites

CHF

48
Q

What do you have to add to ACEIs for blacks and old

49
Q

Can cause angioedema

A

ACEIs

ARBs (much lower risk)

50
Q

Contraindications for ACEIs

51
Q

What do ARBs block

A

ATII receptor

52
Q

Do ARBs have nephrotoxicity

53
Q

When do you give ARBs

A

Young whites
CHF
Post-MI

54
Q

Contraindications for ARBs

A

Pregnancy

Bilateral renal artery stenosis

55
Q

How does Aliskiren act

A

Inhibits ATII and aldosterone

56
Q

What Ca channel blocker has cardiac and vascular SM effects

57
Q

Why use Diltiazem over Verapamil

A

More selective

Better side effect profile

58
Q

How do Ca channel blockers work

A

Bind L-type (heart and muscle)
Relax muscle
-ve inotropism and/or vasodilation

59
Q

How are Dihydropyridines different from Nondyhydropyridines

A

Greater affinity for vasculature

Don’t cause decrease in CO

60
Q

Works with blacks and whites

A

Ca channel blockers

61
Q

Why don’t you need to add a diuretic with a Ca channel blocker

A

Intrinsic natriuretic effect

62
Q

Which Ca channel blockers do you give to angina, migraine or SVT

A

Nondihydropyridines

63
Q

What is the difference between 1st and 2nd gen dihydropyridines

A

Longer half life

64
Q

AE of Verapamil

A

Constipation

65
Q

AE of Dihydropyridines

A

Hypotension
Peripheral edema
Bradychardia
Heart block

66
Q

DOC Black and old with normal kidney, heart

67
Q

Effect of Thiazides

A

Increase Na and water excretion

Decrease ECF, CO, RBF

68
Q

What can be used to counteract Na and water retention by other Anti-HTN drugs

69
Q

Contraindication of Thiazides

70
Q

DOC poor renal fn or unresponsive to other diuretics

71
Q

Loop diuretic effect on HTN

A

Decrease Renal vascular resistance

Increase RBF

72
Q

What decreases K lost due to thiazide/loop

A

Amiloride

Triamterene

73
Q

Aldosterone antagonists to inhibit vasoconstriction

A

Spironolactone

Eplerenone

74
Q

Risk of hyperkalemia

A

K sparing diuretics

75
Q

Most widely used beta blockers

76
Q

Beta 1 selective

A

Atenolol

Metoprolol

77
Q

Nonselective beta 1 and 2

A

Propranolol

Pindolol

78
Q

Mechanism of beta blockers

A

Decrease CO, contractility, HR, sympathetics, NE, renin, ATII, aldosterone

79
Q

Who are beta blockers more effective in

A

Young white

80
Q

Contraindication of Propranolol

A

Asthma

COPD

81
Q

What Sx do beta blockers mask

A

Hypoglycemia

82
Q

What can abrupt beta blocker withdrawal cause

A

Angina/MI in heart disease pts

83
Q

What should you give with an alpha blocker for HTN

A

Propranolol

Diuretic

84
Q

What is the action of alpha blockers

A

Decrease PVR and MAP

Relax arterial and venous SM

85
Q

What causes orthostatic hypotention

A

Doxazosin
Prazosin
Terazosin
Labetalol

86
Q

Ameliorate AE of alpha blockers

A

Give beta blocker

87
Q

Increases rate of CHF

88
Q

Does not cause reflex tachy or increased CO

89
Q

When to use Labetalol

A

Long term tx

Emergency (IV)

90
Q

Contraindication for Labetalol

A

Pheochromocytoma

91
Q

Doesn’t decrease RBF or GFR

A

Central alpha 2 agonists

92
Q

Effect of Clonidine

A

Decrease PVR and CO

93
Q

When do you give Clonidine

A

2nd line when no response with 2+ drugs

94
Q

What do you administer alpha 2 agonists with

95
Q

Common AE for alpha 2 agonists

A 
Sedation
Xerostomia
Dizziness
HA
Sexual dysfunction
96
Q

What can happen with abrupt withdrawal of alpha 2 agonists

A

Rebound HTN

97
Q

What is never 1st line

A

Direct vasodilators

98
Q

How do direct vasodilators act

A 
Open K channels
Arteriolar dilation (ONLY)
99
Q

When do you give Minoxidil

A

Severe malignant HTN

Male pattern baldness

100
Q

What do you give with a direct vasodilator

A

Loop

Beta blocker

101
Q

What is used for pulmonary HTN

A

Bosentan

Epoprostenol

102
Q

Pt with ischemic stroke

A

ACEI
ARB
Thiazide

103
Q

Pt with acute or chronic CAD

A

Beta blocker
ACEI
ARB

104
Q

Pt with LV dysfunction

A 
Beta blocker
Thiazide/Loop
ACEI
ARB
Hydralazine and Isosorbide dinitrate (if black)

Pharm Midterm 1 (36 decks)

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