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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
Q

What are the uses of Amlodipine and Nifedipine?

A

HTN
Raynauds
Angina

26
Q

What are the side effects of Amlodipine and Nifedipine?

A

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
Q

Nonselective B-blocker that primarily reduces CO?

A

Propranolol

28
Q

What are the side effects of propranolol?

A

Bronchospasm
Bradycardia–negative chronotrope
CHF–negative ionotrope
Masking of hypoglycemia symptoms

Depression–crosses BBB
Worsening symptoms of PVD

29
Q

Moderately selective B1 blockers that are less likely to have bronchospasm, hypoglycemic awareness and depression compared to propranolol?

A

Metoprolol
Atenolol
Bisoprolol (long acting)
Nadolol (long acting)

30
Q

What is the combined aB blocker that has B1 blockade with vasodilatory effects used during HTN urgency?

A

Labetolol

31
Q

What is a combined aB blocker that has B1 blockade with vasodilator effects used for acute coronary syndrome and CHF?

A

Carvedilol

32
Q

B1-selective blocker used for AV nodal blockade in unstable patients and has a short half life?

A

Esmolol

33
Q

What ate the a1-adrenergic receptor antagonist?

A

Terazosin

Doxazosin

34
Q

What is the mechanism of action of the a1 receptor antagonists?

A

Blocks post-synaptic a1-adrenergic receptors on vascular smooth muscle

35
Q

What are the uses of the a1 receptor antagonists?

A

BPH

Second tier meds–use when other condition around–not for isolated HTN

36
Q

What are the side effects of the a1- receptor antagonists?

A

Orthostatic hypotension
Fluid retention
Worsening angina

37
Q

What are the two central a2-agonist used for HTN?

A

Clonidine

a-methyldopa–used for HTN of pregnancy only

38
Q

What is the mechanism of action of the central a2-agonists?

A

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
Q

What are the side effects of the central a2-agonists?

A

Rebound HTN if abruptly stopped
Moderate orthostatic hypotension

Sedation
Dry mouth
Fatigue
Depression

40
Q

Ganglion blocking agent used to decrease CO and systemic vascular resistance?

A

Reserpine

41
Q

What is the mechanism of action of Reserpine?

A

Blocks transport of NE, DA, and 5HIAA into storage granules in PNS and CNS

Less NT available when nerves are stimulated

42
Q

What are the side effects of reserpine?

A

Sedation
Mental depression
Parkinsonism symptoms

43
Q

Direct vasodilator used for HTN urgency and in patients with BOTH advanced CHF and HTN?

A

Hydralazine

44
Q

What is the mechanism of action of the direct vasodilators?

A

Hydralazine and minoxidil

Relax smooth muscle of peripheral arterioles

45
Q

Direct vasodilator used for refractory HTN and hair loss

A

Minoxidil

46
Q

What are the side effects of hydralazine?

A

Drug-induced lupus

Reflex tachycardia

47
Q

What are the side effects of minoxidil?

A

Pericardial effusion
Hirsutism
Reflex tachycardia

Pharm U4 (8 decks)

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