Antihypertensives Flashcards
Chlorthalidone (Hygroton)
Hydrochlorothiazide (Dithiazide)
Indapamide (Natrilix)
A)
CHLO and INDA: Thiazide-like diuretic
HYDROCLOROTHIAZIDE: Thiazide
B) 1. Hypertension CHLORTHALIDONE and HCT: 2. Oedema (HF, hepatic cirrhosis) CHLOR: 3. Nephrogenic diabetes insipidus HCT: 3. Prev. of RENAL CALCULI (assoc. with hypercalciuria)
C) CHLORTHALIDONE: 6.25 - 50 mg ONCE daily HCT: 12.5 - 100 mg daily (1-2 doses) INDAPAMIDE: IR: 1.25 - 2.5 mg MANE CR: 1.5 mg MANE
D)
- BLOOD PRESSURE (low)
- VOLUME Status (increase risk of renal impairment in hypovolaemia)
- ELECTROLYTES (low Na+, low K+, low Mg2+, high uric)
- RENAL
- HEPATIC
E) Labels: 16 CHLORTHALIDONE: (B) #Might take up to 4 weeks to reduce BP #Take in the MORNING; no later than 6pm **DR - excessive thirst, weakness, confusion, muscle aches and pain
S/E
*BP (dizziness, weakness, orthostatic hypotension)
Amiloride (Kaluril)
Triameterene (Hydrene[HCT])
A) Potassium-sparring diuretics
B)
1) Hypertension (HTN)
2) OEDEMA (HF, Hepatic Cirrhosis, Nephrotic syndrome)
AMILORIDE:
3) Prevention of Diurectic-induced HYPOKALAEMIA
4) Primary HYPERALDOSTERONISM
C)
AMILORIDE:
2.5 - 20 mg daily
TRIAMTERENE with HCT:
25 mg daily - 100 mg BD
(max 4 tabs daily)
D)
1) POTASSIUM (high K+)
2) Electrolytes (low Na+, low Cl-)
3) BLOOD PRESSURE
4) RENAL (contraindicated)
5) HEPATIC (hepatic encephalopathy - rare)
E)
Labels: 11, 12+, 16
#Taken in the MORNING; 2nd dose no later than 6pm
S/E:
*LOW BP (weakness, headache, impotence, muscle cramps)
*GIT (nausea, vomiting, abdo pain)
Captopril (Capoten) Enalapril (Renitec) Fosinopril (Monopril) Lisinopril (Zestril) Perindopril (Coversyl) Quinapril (Accupril) Ramipril (Tritace) Trandolapril (Gopten)
A) ACE-Inhibitors
B) **1) Hypertension (HTN) ALL except RAM and TRAN **2) Chronic Systolic HEART FAILURE (HF) CTRL-P (CAP, TRAN, RAM, LIS, PER) **3) Myocardial Infarction (MI) CAPTOPRIL: **4) Diabetic NEPHROPATHY (T1DM) RAMIPRIL: **3) Progressive RENAL failure (with persistent proteinuria)
C)
TRAN: 0.5 - 4 mg ONCE
RAMI: 1.25 - 10 mg (1-2 doses)
PERI: 2.5 - 10 mg ONCE
ENAL: 2.5 - 40 mg (1-2 doses)
QUIN: 2.5 - 40 mg (1-2 doses)
LISIN: 2.5 - 40 mg ONCE
FOSI: 5 - 40 mg ONCE
CAPT: 6.25 - 50 mg TDS (max150)
D) 1) Serum ELECTROLYTES 2) ANGIOEDEMA** 3) COUGH** 4) BLOOD PRESSURE 5) RENAL** no hepatic
E)
Labels: 11, 12+, 16+
#Takes 2-4 weeks to reduce BP effectively
**DR - swelling of face, lips, tongue (angioedema)
**DR - perisistent dry cough
S/E
*LOW BP (headache, dizziness, fatigue)
Candesartan (Atacand) Eprosartan (Tevetan) Irbesartan (Avapro or Karvea) Losartan (Cozavan) Olmesartan (Olmetec) Telmisartan (Micardis) Valsartan (Diovan)
A) Sartans OR Angiotensin II Receptor Blocker (A2RB)
B) **1. Hypertension (HTN) CAND and VALS (CV): **2. Chronic Systolic HEART FAILURE (HF) IRBE and LOSA (IL): **2. Reduction of RENAL DISEASE PROGRESSION TELM and VASL (TV): **2. Prev. of CARDIOVASCULAR MORBIDITY Post-MI
C) CAND: 4 - 32 mg OLME: 20 - 40 mg TELM: 40 - 80 mg LOSA: 25 - 100 mg IRBES: 75 - 300 mg VALS: 40 - 320 mg EPRO: 400 - 600 mg
D) 1. BLOOR PRESSURE 2. Serum ELECTROLYTES (high K+) 3. RENAL** 4. Hepatic OLMESARTAN: 5. Sprue-like enteropathy** (chronic diarrhoea with nausea and vomiting, weight loss)
E)
Labels: 11, 12+, 16+, A
#Can take 2-4 weeks to reduce your BP effectively
**DR - (angioedema) swelling of lips, face and tongue
S/E
*LOW BP (dizziness, headache, diarrhoea)
Amlodipine (Norvasc)
Felodipine (Felodur ER OR Plendil ER)
Lercanidipine (Zanidip)
Nifedipine (Adalat)
A) Dihydropyridine Calcium Channel Blocker
B) 1. Hypertension (HTN) AMLO and NIFE (AN): 2. Angina NIFE: 3. Pre-term LABOUR
C) AMLO: 2.5 - 10 mg ONCE FELO: 2.5 - 20 mg ONCE LERC: 10 - 20 mg ONCE NIF (IR): 10 - 40 mg BD (max80) NIF (CR): 20 - 120 mg ONCE
D) 1. Peripheral OEDEMA** 2. Blood PRESSURE 3. Heart RATE (tachy) 4. DENTAL checks (gingival hyperplasia - infreq) 5. HEPATIC LERC: 6. RENAL
E) Labels: 9, 12+, 18 (A) - FELO and NIF swallow whole (C) - LERC 15mins before food #Take up to 2 weeks to reduce BP effectively **DR - swollen ANKLES S/E *VASODILATE (headache, flushing, dizziness, hypotension
Diltiazem (Cardizem OR Vasocardal)
Verapamil (
A) Non-dihydropyridine Calcium Channel Blockers
B) 1. Hypertension (HTN) 2. ANGINA 3. AF or Atrial Flutter VERAMAIL: 4. SVT 5. Prophylaxis of CLUSTER HEADACHES
C)
DILTIAZEM:
IR: 30-360 mg (3-4 doses)
CR: 180-360 mg ONCE daily
VERAPAMIL:
IR: 40-960 mg (1-4 doses)
CR: 120-480 (1-2 doses)*
*doses>240mg give in 2 doses
D) 1. Other Drug INTERACTIONS (slow HR) 2. Heart RATE (bradycardia) 3. Blood PRESSURE 4. ECG (av block) No renal or hepatic
E)
Labels: 5, 9, 12+, A (caps)
VERAPAMIL: 18, B (with FOOD)
#Takes up to 2 weeks to reduce BP effectively
VERAPAMIL:
#Increases the effects of ALCOHOL. Limit your intake.
#Avoid GRAPEFRUIT juice
S/E
- LOW HR (dizziness, flushing, headaches, tiredness)
- VERAPAMIL (constipation)
Atenolol (Noten) Bisoprolol (Bicor) Carvedilol (Dilatrend) Labetalol (Presolol) Metoprolol (Minax) Nebivolol (Nebilet) Oxprenolol (Corbeton) Pindolol (Barbloc) Propranolol (Deralin)
A) Beta-blocker
B) ALL except Bisoprolol *1. Hypertension (HTN) ATEN, METO, PROP, OXP, PIND (AMPOP) *2. Angina *3. Tachyarrhythmias BISO, CARV, METO, NEBI (BCMN) *2. Stable HEART FAILURE (HF) ATEN, METO, PROP (AMP) *4. Prevention of MIGRAINE *5. Myocardial Infarction (MI)
C)
BISO: 1.25 - 10 mg ONCE d
NEBI: 1.25 - 10 mg ONCE d
PIND: 7.5 - 30 mg d (2-3 doses)
CARV: 3.125 - 50 mg TWICE d (max100)
ATEN: 25 - 100 mg ONCE d
OXPR: 20 - 160 mg TWICE (max320)
PROP: 20 - 320 mg (divided doses)
METO IR: 25 - 100 mg BD or TDS (max300)
METO CR: 23.75 - 190 mg ONCE d
LABE: 100 mg BD - max2400 (3-4doses)
D) 1. Heart RATE (bradycardia) 2. Blood PRESSURE (hypotension) 3. BSL (mask hypoglycaemia) 4. Respiratory (non-selective beta-blockers) 5. Hepatic (except atenolol) ATENOLOL: 5. Renal
E)
Labels: 9, 12+
(16) - CARVEDILOL and LABETOLOL
(A) - BISO, METO, OXPR
#You may feel TIRED or LACKING in ENERGY for a few days after starting this medicine
#Withdraw GRADUALLY (rebound HTN)
**DR (except atenolol) - yellow skin or eyes, dark urine
**DR (except BAMN) - cough, SOB
**DR - (vascular/raynaud’s) cold feet or toes
S/E
*Fatigue, Impotence, Nightmares, Dizziness, Abnormal vision
Prazosin (Minipress)
Terazosin (Hytrin)
A) Selective Alpha-1 Blocker
B)
- Hypertension (HTN)
- Symptoms relief in BPH
C)
PRAZ: 0.5 - 20 mg (2-3 doses)
TERA: 1 - 20 mg ONCE d
D) 1. Blood PRESSURE 2. FIRST-DOSE HYPOTENSION** 3. Clinical Improvement (stop 4-6 weeks for BPH) 4. RENAL no hepatic
E)
Labels: 12+, 16
#Usually started at a LOW DOSE, which is slowly increased. This is to reduce the risk of your blood pressure dropping so suddenly can causing dizziness, light-headedness or fainting.
#Avoid situations where fainting can result in injury
#Tell your opthalmologist you are taking this if you are going for cataract surgery (intra-operative floppy iris syndrom)
S/E
*LOW BP (headache, weakness, dizziness, fatigue)
Clonidine (Catapress)
A) Alpha-2 Agonist (centrally-acting)
B)
- Hypertension
- Treatment of MENOPAUSAL FLUSHING
- ADHD
- Management of OPIOID WITHDRAWAL
- Acute, Chronic and Cancer PAIN (adjunct)
- Anaesthesia (adjunct)
C)
25 - 300 microg ONCE or TWICE d
Max 600 microg (2 doses)
D) 1. Blood PRESSURE 2. WITHDRAWAL SYNDROME** (rebound HTN - rapid rise, withdraw slowly) 3. MOOD (exacerbates depression) 4. BSL (transient rise) 5. RENAL (start slow) no hepatic
E)
Labels: 1, 9, 16
S/E:
*LOW BP (dizziness, fatigue, headache)
*CNS (drowsiness, sedation)
*ADHD (depression, fatigues, sleep disturbance, erectile dysfunction)
*ANTI-cholinergic (constipation, dry mouth, orthostatic hypotension)
Hydralazine (Alphapress)
A) Vasodilator
B)
- Hypertensive EMERGENCY
- REFRACTORY Hypertension
- Heart FAILURE (HF), with a nitrate
C)
25 - 300 mg (2-4 doses)
D)
- Complete BLOOD Count** (Lupus-like syndrome)
- Heart RATE (tachycardia)
- Blood PRESSURE
- RENAL (reduce dose)
- HEPATIC (reduce dose)
E)
Labels: 12, 16
S/E:
VASODILATOR (flushing, headache, dizziness, oedema, palpitations)
Methyldopa (Aldomet OR Hydopa)
A) Alpha-2 Agonist (centrally-acting)
B)
1. Hypertension (pregnancy)
C)
125 - 500 mg BD-QID
max 2g
D)
- Blood PRESSURE
- BLOOD Count** (haemolytic anaemia, leucopenia)
- MOOD (exacerbates depression)
- HEPATIC* (hepatotoxicity and pancreatitis)
- RENAL (low dose)
E) Labels: 12, 16 S/E: LOW BP (sedation**, dizziness, light-headedness, tiredness, weakness) NA (dry mouth)
Minoxidil (Loniten)
A) Peripheral Vasodilator
B)
- REFRACTORY Hypertension
- ALOPECIA
C)
2.5 - 100 mg (1-2 doses)
D)
- Heart RATE (tachycardia)
- Blood PRESSURE
- ECG (ST depression, T wave inversion)
- OEDEMA** (sodium and water retention)
E)
Labels: 16
S/E:
VASODILATOR (palpitations, headache, flushing, dizziness)
Moxonidine (Physiotens)
A) Alpha-2 Agonist (centrally-acting)
B)
1. Hypertension
C)
200 - 600 microg (1-2 doses)
D) 1. Blood PRESSURE 2. Heart RATE (bradycardia contraindicated <50bpm) 3. RENAL (reduce dose) no hepatic
E)
Labels: 1, 9, 12, 16
#Take at least 2 weeks to reduce your BP effectively
#Withdraw over a days
S/E:
Noradrenergic (dry mouth, dizziness)
LOW BP (weakness, dizziness, headache, somnolence)
