antihypertensives

Question 1

hypertension medications

Answer 1

beta blockers: to stop tachycardia from compensatory increased sympathetic outflow

diuretics, ACE inhibitors: block salt and water retention from compensatory increased renin secretion

Question 2

diuretics

Answer 2

hydrochlorothiazide
chlorthalidone
furosemide

Question 3

hydrochlorothiazide

chlorthalidone

Answer 3

block Na/Cl transport in distal convoluted tubule
-treatment: HTN, mild edema
oral
dur. 8-12 hours
side effects: hypokalemia, hyperglycemia, hyperuricemia, hyperlipidemia

Question 4

furosemide

Answer 4

block Na/K/2CL transporter in thick ascending limb

• treat: HTN, heart failure, edema, hypercalcemia
• oral
  dur. 2-3 hours
• hypokalemia, hypovolemia, ototoxicity

Question 5

sympathoplegics: centrally acting: Clonidine

Answer 5

-Agonist at α2 receptors, in CNS this results in decreased SANS outflow
-treats HTN
-oral
dur 2-3 days
-SE: Sedation, danger of severe rebound hypertension if suddenly stopped

Question 6

sympathoplegics: centrally acting: methyldopa

Answer 6

-Prodrug converted to methylnorepinephrine in CNS, with result like clonidine
-SE: Sedation, induces hemolytic antibodies
treats HTN
oral, dur. 12-24 hours

Question 7

postganglionic neuron blockers: reserpine

Answer 7

-Blocks vesicular pump (VMAT) in adrenergic neurons
-HTN, huntington’s
oral
dur 5 days
SE: sedation, depression

Question 8

Alpha blockers

Answer 8

Prazosin
-Selective α1 blocker:
 • reduces peripheral vascular resistance 
• prostatic smooth muscle tone
Treat: Mild hypertension, benign prostatic hyperplasia
oral
dur 6-8 hrs
first dose: ortho

Question 9

beta blockers

Answer 9

propranolol
-Prototype nonselective β blocker:
• reduces cardiac output 
• possible secondary reduction in renin release
treat HTN
oral
dur 6-8 
SE: Bronchospasm in asthmatics • excessive cardiac depression, sexual dysfunction, sedation, sleep disturbances

Question 10

Vasodilators: calcium channel blockers

Answer 10

Verapamil, diltiazem
-Prototype L-type calcium channel blockers
• combine moderate vascular effect with strong cardiac effect
-Treat: Hypertension, angina, arrhythmias
oral
dur 6-8 hours
SE: Excessive cardiac depression • constipation

Question 11

better vasodilators than cardiodepressants

Answer 11

Nifedipine, other dihydropyridines

Question 12

older oral vasodilators

Answer 12

Hydralazine

Minoxidil

Question 13

Hydralazine

Answer 13

-Probably causes release of nitric acid (NO) by endothelial cells
• causes arteriolar dilation
-treat: HTN
Oral
dur 6-8 hours
SE: Tachycardia, salt and water retention, lupus-like syndrome

Question 14

Minoxidil

Answer 14

-Prodrug, sulfate metabolite opens K+ channels, causes arteriolar smooth muscle hyperpolarization and vasodilation
-treat: severe HTN, male pattern baldness
-oral, dur 6-8hrs
SE: Marked tachycardia, salt and water retention
• hirsutism

Question 15

IV vasodilators

Answer 15

Nitroprusside
Diazoxide
Fenoldopam

Question 16

Nitroprusside

Answer 16

-Releases NO from drug molecule
-treats: Hypertensive emergencies • cardiac decompensation
-IV
-requires constant infusion, minutes
-SE: Excessive hypotension
• prolonged infusion may cause thiocyanate and cyanide toxicity

Question 17

Diazoxide

Answer 17

-K+ channel opener in smooth muscle, secretory cells
-treat: Hypertensive emergencies
• hypoglycemia due to insulin-secreting tumors
-SE: Hyperglycemia
• edema, excessive hypotension

Question 18

Fenoldopam

Answer 18

-D1 agonist
 • causes arteriolar dilation
-treat: Hypertensive emergencies
ver short duration
SE: excessive hypotension

Question 19

renin antagonist:

Answer 19

Aliskiren
renin inhibitor
-reduces angio I synthesis
treats HTN
oral
dur 12 hrs
SE: angioedema, renal impairment

Question 20

ACE inhibitors

Answer 20

Captopril
-ACE inhibitor
 • reduces angiotensin II synthesis
-treats: HTN, diabetic renal disease, heart failure
oral
h-l: 2.2 but dur. of 12 hrs
SE: Hyperkalemia
 • teratogen
 • cough

Question 21

other ACE inhibitors

Answer 21

Benazepril, enalapril, lisinopril,

Question 22

ARB

Answer 22

Losartan
-Blocks AT1 receptor
-treats HTN
oral
dur. 6-8 hr
hyperkalemia
-teratogen