Antihypertensives Flashcards
clonidine MOA
stimulate medullary a2 receptors –> decrease peripheral sympathetic activity
diuretics are the first choice for HTN in which patients? (5)
Age 65+ African descent CHF stroke osteoporosis
side effects of clonidine (2)
xerostomia
sedation/CNS
a-1 antagonist MOA
dilation
block a1 —> reduce vasoconstriction
side effects of a1 antagonists (3)
Postural hypotension
increased renin/water retention
Reflex tachycardia
only indication for B-blocker monotherapy?
young and white
B-blockers are the preferred drug for HTN w/ (3)
Angina
post-MI
migraine
B-blockers MOA (3)
reduce cardiac output
reduce renin secretion
decrease sympathetic vasomotor tone
labetalol use (2)
decrease BP in HTN emergencies
pregnancy HTN emergenies
Carvedilol use
long term monotherapy for HTN & CHF
hydralazine MOA
nitric oxide –> dilates arterioles but not veins
hydralazine big side effects (2)
ischemic arrhythmias
SLE in slow acetylators
Sodium nitroprusside side effects (5)
Cyanide accumulation Metabolic acidosis Arrhythmias Excessive hypotension Death
Indapamide MOA
direct vasodilator, probably a Ca channel blocker
Minodoxil MOA, effects
opens K+ channels, stabilizes membranes
dilates arterioles, not veins
Minodoxil use
severe and refractory HTN
chronic oral HTN tx (3)
Hydralazine
Minodoxil
CCBs
IV Emergency tx of HTN (3)
Nitroprusside
Fenoldopam
some CCBs
fenoldopam MOA & effect
specific agonist to D1 receptor —> relaxes arteriolar smooth muscle
fenoldopam side effects (3)
reflex tachycardia
headache
flushing
nifedipine characteristics (3)
strongest vasodilator
increases HR
most likely to produce reflex tachycardia
CCB effects for HTN (3)
Relaxes all smooth muscles
decreased cardiac contractility
slowed SA/AV node
verapamil 4 characteristics
strongest cardiac effects
worst vasodilator
decreases HR
SA & AV node depression
nifedipine specific side effects (2)
reflex tachycardia
gingival hyperplasia
verapamil specific side effect
constipation
CCB general side effects (4)
headache
flushing
dizziness
peripheral edema
why will vasodilators effects diminish over time (2)
reflex tachycardia
increased renin secretion
vasodilator side effects (many)
reflex tachycardia, increased contraction
increased renin secretion, fluid retention
headaches, flushing, palpitations, dizziness
1st choice drug for HTN in diabetes, chronic renal disease, left ventricular hypertrophy
ACE inhibitor
ACE inhibitor effects (2)
Decreased afterload: AngII-induced vasoconstriction
Decreased preload: decreased aldosterone release
ACE inhibitor contraindications (3)
2nd & 3rd trimester of pregnancy
NSAID use- decreases vasodilation
Bilateral renal aa. stenosis
ACE inhibitors are the drug of choice for which pts? (7)
CKD Type 2 diabetes Age 65+ MI CHF stroke, asthma
ARBs are a good drug for who? (4)
CHF
stroke
CKD
Type 2 Diabetes
