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Pharm U4 > Antihypertensives > Flashcards

Antihypertensives Flashcards

1
Q

What Loop diuretic is used for HTN?

A

Furosemide

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2
Q

What thiazide diuretics are used for HTN?

A

Hydrochlorothiazide
Chlorthalidone
Metolazone

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3
Q

What renal ENaC inhibitor is used for HTN?

A

Amiloride

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4
Q

What aldosterone receptor antagonist is used for HTN?

A

Spironolactone

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5
Q

What is Eplerenone and what is its mechanism of action?

A

Potassium-sparing diuretic–Blocks aldosterone and inhibits Na+ reabsorption in distal tubule

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6
Q

What is Eplerenone used for?

A 
Reduction in CHF mortality
Combination with other diuretics to prevent hypokalemia
Edema
Primary and secondary aldosteronism
HTN
anti-testosterone agent
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7
Q

What are the side effects of Eplerenone and what is its benefit of use?

A

Hyperkalemia

much lower incidence of gynecomastia and mennorhagia

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8
Q

What is contraindicated with the use of eplerenone?

A

Renal failure
ACEi and ARB use
DM

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9
Q

Short acting ACEi?

A

Captopril

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10
Q

Long acting ACEi?

A

Lisinopril
Benazepril
Quinapril
Ramipril

Enalapril–normal acting

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11
Q

What is the mechanism of action of the ACE inhibitors?

A

Blocks endothelial ACE from converting angiotensin I to angiotensin II (potent vasoconstrictor)

Also prevents breakdown of bradykinin–potent vasodilator

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12
Q

What are the uses of ACE inhibitors?

A

CHF
LV hypertrophy
Post MI–prevents LV remodeling

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13
Q

What are the side effects of the ACE inhibitors?

A

Dry cough
Angioedema
Decreased renal function
Hypotension

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14
Q

What are the angiotensin II receptor blockers?

A

Losartan
Valsartan
Irbesartan

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15
Q

What is the mechanism of action of the angiotensin II receptor blockers?

A

Competitive inhibition of angiotensin II in vascular endothelium

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16
Q

What are the uses of ARBs?

A

Fall in peripheral vascular resistance
Little change in HR or CO
Same uses as ACE-i

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17
Q

What are the side effects of the ARBs?

A

Angioedema
Decreased renal function
Hypotension
Dry cough–less frequent than with ACEi

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18
Q

What is the renin inhibitor used for HTN thats not very effective?

A

Aliskiren

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19
Q

What are the non-dihydropyridine Ca++ channel blockers used for HTN tx?

A

Diltiazem

Verapamil

20
Q

What is the mechanism of action of Diltiazem and verapamil

A

Non-dihydropyridine Ca++ channel blockers

Interact with L-type voltage gated plasma membrane Ca channel

Decreased Ca++ entry into vascular smooth muscle cell–prevents contraction

Causes–decreased contractility, firing rate of aberrant pacemaker sites and conduction velocity

Prolongs repolarization in SA node and AV node–decreases HR

21
Q

What are the uses of Diltiazem and verapamil?

A

HTN
Anti-anginal–chronotropic effects–decreased myocardial oxygen demand
SVT

22
Q

What are the side effects of Diltiazem and Verapamil?

A 
Leg edema
Bradycardia
AV nodal block
Hypotension
Worsening heart failure

Constipation
HA
flushing

23
Q

What are the dihydropyridine Ca++ channel blockers used for HTN?

A

Amlodipine

Nifedipine

24
Q

What is the mechanism of action of Amlodipine and Nifedipine?

A

Dihydropyridine Ca++ channel blockers

Interact with L-type voltage gated plasma membrane Ca channel

Decreased Ca++ entry into vascular smooth muscle cell–precent contraction

Causes–dilation of epicardial coronary arteries

Have less heart-specific activity

25
What are the uses of Amlodipine and Nifedipine?
HTN Raynauds Angina
26
What are the side effects of Amlodipine and Nifedipine?
Leg edema HF AV nodal block Reflex tachycardia--lipophilic agents gain entry to brain and depress vasomotor center--> rapidly dropping BP--causing more reflex sympathetic activation Constipation HA Flushing
27
Nonselective B-blocker that primarily reduces CO?
Propranolol
28
What are the side effects of propranolol?
Bronchospasm Bradycardia--negative chronotrope CHF--negative ionotrope Masking of hypoglycemia symptoms Depression--crosses BBB Worsening symptoms of PVD
29
Moderately selective B1 blockers that are less likely to have bronchospasm, hypoglycemic awareness and depression compared to propranolol?
Metoprolol Atenolol Bisoprolol (long acting) Nadolol (long acting)
30
What is the combined aB blocker that has B1 blockade with vasodilatory effects used during HTN urgency?
Labetolol
31
What is a combined aB blocker that has B1 blockade with vasodilator effects used for acute coronary syndrome and CHF?
Carvedilol
32
B1-selective blocker used for AV nodal blockade in unstable patients and has a short half life?
Esmolol
33
What ate the a1-adrenergic receptor antagonist?
Terazosin | Doxazosin
34
What is the mechanism of action of the a1 receptor antagonists?
Blocks post-synaptic a1-adrenergic receptors on vascular smooth muscle
35
What are the uses of the a1 receptor antagonists?
BPH | Second tier meds--use when other condition around--not for isolated HTN
36
What are the side effects of the a1- receptor antagonists?
Orthostatic hypotension Fluid retention Worsening angina
37
What are the two central a2-agonist used for HTN?
Clonidine | a-methyldopa--used for HTN of pregnancy only
38
What is the mechanism of action of the central a2-agonists?
Stimulation of central a2a adrenergic receptors Reduction in sympathetic outflow from vasomotor systems in brainstem Inhibition of renin release--secondary to decreased sympathetic tone
39
What are the side effects of the central a2-agonists?
Rebound HTN if abruptly stopped Moderate orthostatic hypotension Sedation Dry mouth Fatigue Depression
40
Ganglion blocking agent used to decrease CO and systemic vascular resistance?
Reserpine
41
What is the mechanism of action of Reserpine?
Blocks transport of NE, DA, and 5HIAA into storage granules in PNS and CNS Less NT available when nerves are stimulated
42
What are the side effects of reserpine?
Sedation Mental depression Parkinsonism symptoms
43
Direct vasodilator used for HTN urgency and in patients with BOTH advanced CHF and HTN?
Hydralazine
44
What is the mechanism of action of the direct vasodilators?
Hydralazine and minoxidil Relax smooth muscle of peripheral arterioles
45
Direct vasodilator used for refractory HTN and hair loss
Minoxidil
46
What are the side effects of hydralazine?
Drug-induced lupus | Reflex tachycardia
47
What are the side effects of minoxidil?
Pericardial effusion Hirsutism Reflex tachycardia

Pharm U4 (8 decks)

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