Antihypertensives Flashcards
examples of thiazides
hydrochlorothiazide
chlorthalidone
examples of loop diuretics
furosemide
ethacrynic acid
example of potassium sparing
spironolactone
examples of ACEIs
enalapril
fosinopril
example of ARBs
losartan
cansesartan
examples of CCBs vascular
nifedipine - longacting
amlodipine
examples CCBs cardiac
verapamil
diltiazem
examples beta receptors blockers
propranolol
metoprolol
example of alpha 1 receptor antagonist
prazosin
example of alpha 2 receptor agonist
clonidine
examples of vasodilators
hydralazine
minoxidil
nitroprusside
what is BP regulated by
cardiac output and total peripheral resistance
what does cardiac output depends on
venous return
heart rate
contractility
what does total peripheral resistance depend on
resistance vessel diameter
arterial tone
potential drugs that cause hypertension
estrogens
NSAIDS
antidepreesents, amphetamines
conditions that may cause hypertension
renal artery stenosis
coarctation of the aorta
phaeochromocytoma
hyperaldosteronism
what are the 3 major compensatory responses to a decrease in blood pressure
RAAS system
activate sympathetic NS
increase RAAS
decrease renal perfusion pressure
what is the result of decreased renal perfusion pressure
increase sodium retention causing increased blood volume
result of increased RAAS
aldosterone increases sodium retention
angiotensin 2 increases afterload and preload
result of increased SNA
increased afterload and preload, decreased inotropy and increase heart rate
non pharms for hypertension
sodium restriction weight loss exercise reduced alcohol intake smoking cessation relaxation
problems with increasing the dose
causes little improvement in effect
hypokalemia
glucose intolerance
increased LDL
when are loop diuretics most useful
in renal impairment (GFR<50ml/min) and edematous states
side effects of thiazides
decreased insulin release increased LDL levels erectile dysfunction decrease blood volume hypokalemia, hypercalcemia
side effects of loop diuretics
deafness if given with aminoglycoside antibiotic
vascular volume contraction
hypokalemia
hypocalcemia
side effects of potassium sparing diuretics
hyperkalemia
impotence
gynecomastia
how do aceis inhibit the raas
decrease angiotensin 2 causing a decrease in TPR and aldosterone
how do arms inhibit the ras
block all angiotensin 2 receptors resulting in decreases TPR and decreased aldosterone
problems with raas inhibitors
rash
hyperkalemia
proteinuria angioedema
cough (ACEI)
why do you use RAAS inhibitors in people with CHF and diabetic nephropathy
it is metabolically neutral so doesnt affect glucose and prevents remodelling
what is there little reflex tachycardia in RAAS inhibitors
baroreceptors reset so there is no NE release
can you use RAAS inhibitors in pregnancy
no
which type of channels do calcium channel blockers block
L type
which clacium channel blockers work primarily in vascular
dihydropyridines
increase TPR
which calcium channel blockers work predominantly on the cardiac
non-dihydropyrinidines
increase cardiac output
what are dihydropyridines used for
angina
raynauds (decreased perfusion of blood to extremeties)
secondary for hypertension
hypertensive crisis
what are non-dihydropyridines used for
hypertension if also a concern about heart rate control in atrial fibrillation
angina
calcium channel blockers useful where beta blockers are contraindicated which is when
asthma diabetes bc cant sense hypo/hyperglycemia COPD peripheral vascular disease elderly african americans
when should beta blockers be used and for how long
post MI
heart failure
6 months
problems with betablockers
not metabolically neutral
erectile dysfunction
may cause type 2 diabetes
what does prazosin do
vasodilates arteries adn veins
decreases insulin resistance
useful for prostatic hyperplasia
problems with prazosin
fluid retention with long term
initial large decrease in BP
orthostatic hypotension
clonidine mechanism of action
acts on central vasomotor centers to decrease sympathetic nerve activity from CNS
why does clonidine have to be tapered
rebound hypertension upon rapid cessation of the drug
what is clonidine commone use
adjunct to general anesthetic
what is used to lower blood pressure in pregnancy
hydralazine
what are vasodilators taken with
beta blocker and diuretic
problems with hydralazine
lupus like syndrome increase SNA headache nausea hypotension tachycardia angina pectoris
new use for minoxidil
topical for baldness
problems with minoxidil
headahce nausea hypotension tachycardia pericardial effusion
key difference of sodium nitroprusside compared to other vasodilators
dilates veins and arterioles
what is sodium nitroprusside used for and why
hypertensive encephalopathy
surgery(sudden onset)
because it works in 1 min and is offset in 5
why can you only use sodium nitroprusside for short term
potential for cyanide toxicity as that is the metabolite
target blood pressure
140/90
