Antihypertensives

Question 0

Lisinopril

also: Quinapril, Ramipril, Benazepril, Enalapril, Fosinapril, Perindopril

Answer 0

ACE Inhibitors, –> vasodilation
Use: HTN *all w/ ~long t1/2
SE: hyperK+, angioedema, cough
Contraind: pregnancy!

Question 1

General mechs for anti-hypertensive drugs (“A, B, C, D”)

Answer 1

Goal = decrease Mean Arterial Pressure (“MAP”)
A: RAAS blockers (Angiotensin system) => vasodilate
B, C: B-blockers (HR, SV), Ca channel blockers (SV) => decrease CO
D: Diuretics => decrease total blood volume

Question 2

Captopril

Answer 2

ACE Inhibitor –> vasodilation
Use: HTN *shorter t1/2 than other ACE Is
SE: hyperK+, angioedema, cough
Contraind: pregnancy!

Question 3

Valsartan, Losartan

also: Irbesartan, Candesartan, Eprosartan, Telmisartan, Olmesartan

Answer 3

“ARBs” = AngII R blockers, –> vasodilation
Use: HTN
SE: hyperK+
Contraind: pregnancy

Question 4

Aliskiren

Answer 4

Renin inhibitor –> vasodilation + block feedback renin increase
Use: HTN
SE: hyperK+

Question 5

Propanolol

Answer 5

Beta-1 AND 2 blocker –> decrease CO, peripheral vasodilation
Use: HTN
SE: bronchoconstriction, sedation, decreased libido, hypoglycemia, stroke

Question 6

Atenolol, Metoprolol, Nebivolol

Answer 6

Beta-1 blocker –> decrease CO
Nebivolol stimulates NO production!
Use: HTN
SE: (low risk) bronchoconstriction, sedation, hypoglycemia, stroke, decreased libido

Question 7

Carvedilol, Labetalol

Answer 7

Beta and Alpha-1 blockers –> decrease CO & periph. vasodilation
Use: HTN
Labetalol = safe for pregnancy

Question 8

Amlodipine, Verampamil, Diliazem, Nifedipine

also: Felodipine, Nicardipine

Answer 8

Ca-channel blockers
(act @ cardiac myocytes, sm. m cells, & SA/AV nodes)
block L-type VOCC –> decrease SV = decrease CO
Use: HTN

Question 9

Amlodipine

Answer 9

Ca-channel blocker (L-type VOCC) –> decrease SV & CO
Use: HTN, angina
*longer t1/2
SE: edema

Question 10

Verampamil

Answer 10

Ca-channel blocker (L-type VOCC) –> decrease SV & CO
* most potent @ cardiac myocytes
Use: HTN, arrhythmias
SE: edema, headache, dizziness

Question 11

x Clonidine, Guanfacine, Guanabenz

Answer 11

alpha-2 adrenergic agonist –> peripheral vasodilation

Use: HTN

Question 12

x Terazosin, Doxazosin, Prazosin

Answer 12

alpha-1 blockers, act on PNS only –> vasodilation

Use: HTN

Question 13

x Guanethidine, Reserpine

Answer 13

Neuronal adrenergic blockers;
–l NE storage & release = partial blockade of peripheral symp nn.
= BLOCK vasoconstriction
Use: HTN
SE: impotence, parkinsonian motor effects

Question 14

Sodium nitroprusside, Nitroglycerin

Answer 14

Direct vasodilators (release NO).
Use: HTN
SE: tachycardia, edema

Question 15

Diazoxide

Answer 15

Direct vasodilator, IV only;
=> open K+ channels = hyperpolarize sm. mm cells –> prevent vasoconstriction.
Use: HTN emergency (VERY potent!)
SE: tachycardia, edema

Question 16

Minoxidil (*same as Rogaine, but not topical)

Answer 16

direct vasodilator, oral;
=> open K+ channels = hyperpolarize sm. m cells –> prevent vasoconstriction
Use: HTN
SE: tachycardia, edema

Question 17

Hydralazine

Answer 17

direct vasodilator (acts on arterioles, not veins)
Use: HTN
SE: tachycardia, edema

Question 18

Fenoldopam

Answer 18

D1 selective DA agonist => vasodilation

Use: HTN