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CV > Antihypertensives > Flashcards

Antihypertensives Flashcards

1
Q

Antihypertensive drug classes (list 6)

A

diuretics, inhibitors of RAS (ACEi, ARB, renin inhibitor), CCB, sympatholytics (alpha-1/beta antagonists), vasodilators, CNS agents

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2
Q

Spironolactone site of action

A

blocks aldosterone receptor

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3
Q

CCB subclasses & differences between subclasses

A

DHP and non-DHP; DHP effect on vasculature (arteries > veins), non-DHP effect on heart and vasculature

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4
Q

What does bradykinin do?

A

Vasodilates, also causes cough

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5
Q

Diuretic classes

A

thiazide, loop diuretic, K+ sparing, osmotic

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6
Q

DHP example, MOA/result

A

Amlodipine (-ipine); acts on VASCULATURE (little heart action), vasodilates

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7
Q

ACEi example, MOA, main effect

A

ramipril; inhibit ACE» inhibit vasocontriction, aldosterone secretion, and NaCl reabs, and incr vasodilation (BK); result: decr SVR (dual effect), naturesis/diuresis

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8
Q

2 things ACE does in RAS

A

convert Angiotensin I to II, inactivate Bradykinin (NB bradykinin causes cough)

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9
Q

Beta blocker example, MOA/result

A

Propranolol (-lol); act on beta-1 receptors; decr HR &contractility, decr renin secretion, decr SNS activity

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10
Q

Spaces in RAS that can be blocked

A

Beta-1 receptor (no renin), renin (no Angiotensinongen&raquo_space; AI), ACE (no AI&raquo_space; AII, no BK inactivation), AT1 (no AII effect)

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11
Q

Most powerful diuretic

A

loop diuretics (furosemide)

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12
Q

non-DHP example, MOA/result

A

Verapamil and Diltiazem; activity on heart and vasculature, reduce HR & contractility, vasodilates

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13
Q

ARB example, MOA, result

A

Losartan (-sartan); more downstream so no effect on bradykinin (less cough, angioedema, and vasodilation); no vasoconstriction & Na retention

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14
Q

CCB (DHP & non-DHP) adverse effects

A

DHP: reflex tachycardia, prefer slow-onset long acting agents; non-DHP: cardiodepressant effects, watch out for pt w/ HF or on beta blocker

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15
Q

How many ACEi delay diabetic nephropathy?

A

AII constricts efferent glomerular vasculature; will relax efferent and lessen pressure on glomerulus

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16
Q

What does Angiotensin II do?

A

Act on AT1; vasoconstrict, NaCl reabsorption, more aldosterone

17
Q

Beta blocker types and examples

A

cardioselective (metoprolol, beta-1), non-cardioselective (propranolol, beta-1/2; carvedilol, alpha1/beta1/2), partial agonist (acebutolol, partial beta-1 agonist)

18
Q

Beta-blocker adverse effects

A

bronchoconstriction (if beta-2 blocked, non-cardioselective contra in asthma), fatigue

19
Q

ACEi adverse effects

A

cough, angioedema (swollen tongue, throat, lips; serious), hyperkalemia (decr aldosterone, can’t reabs Na+ by excreting K+), renal dysfunction (no AII to maintain GFR)

20
Q

What does aldosterone do?

A

Act on aldosterone receptor for Na+ retention

21
Q

Loop diuretic eg

A

Furosemide

22
Q

Diuretic MOA

A

naturesis and diuresis, NB antihypertensive efficacy not proportional to diuretic effect (thiazide very effective but not strong)

23
Q

ALLHAT study. What is it? What did it show?

A

looked at mortality, CV and safety of drugs; a-1 antagonist withdrawn; equal deaths & coronary heart disease, thiazide less stroke, thiazide & ACEi less HF, thiazide & CCB less withdrawal

24
Q

CNS agents (alpha-2 agonist) example, MOA, effect

A

Chlonidine; feedback inhibition of NE release; decr HR, SV & SVR; DANGEROUS drug, rarely used

25
Q

Renin inhibitor example, MOA, effect

A

Aliskiren (-ren); block ACE and non-ACE pathway; better blocking of vasoconstriction and Na+ retention, but low bioavailability

26
Q

Vasodilator example, MOA and effect

A

Hydralazine; open K+ channels (?); decr total peripheral resistance

27
Q

Omepatrilat drug type and AE

A

vasopeptidase inhibitor, toxicity concerns (angioedema) RECAP: angioedema is also a concern in ACEi

28
Q

Thiazide diuretic eg

A

Hydrochlorothiazide (HCTZ)

29
Q

Bosentan drug class and indication

A

endothelin antagonist, Primary Pulmonary Hypertension

30
Q

HTN combination therapy goals and example

A

maximize efficacy & minimize toxicity; reflex response to diuretic is incr SNS and RAS so add ACEi/ARB/renin inhibitor/beta blocker

31
Q

Alpha-1 antagonist example, effect, AE

A

Prazosin (-zosin); vasodilatory and venodilatory, AE orthostatic hypotension, not commonly used for HTN

32
Q

K+ sparing diuretic eg

A

Spironolactone

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