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Pharmacology > Antihypertensives > Flashcards

Antihypertensives Flashcards

1
Q

Types of Diuretics

A
  • thiazide
  • loop
  • potassium sparing
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2
Q

Thiazide Diuretic MOA

A

decrease sodium retention

decrease peripheral resistance

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3
Q

Thiazide Diuretic Meds

A
  • hydrochlorothiazide
  • chlorthalidone
  • metalozone
  • indapamide
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4
Q

Thiazide Diuretic AEs

A

hypokalemia
hyperuricemia
hyperglycemia
diuresis

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5
Q

Thiazide Diuretic Special Note

A

not effective when GFR <30

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6
Q

Loop Diuretic MOA

A
  • blocks Na+ and Cl- reabsorption in kidneys

- decreases renal vascular resistance and increases renal blood flow

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7
Q

Loop Diuretic Meds

A
  • furosemide
  • toresemide
  • bumetanide
  • ethacrynic acid
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8
Q

Loop Diuretic AEs

A

hypokalemia

diuresis

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9
Q

Loop Diuretic Special Note

A

rarely used alone in HTN; often used to manage symptoms in heart failure and edema

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10
Q

Potassium Sparing Diuretic MOA

A

inhibit sodium transport at late distal and collecting ducts

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11
Q

Potassium Sparing Diuretic Meds

A
  • Amiloride
  • Triamterene
  • Spironolactone
  • Eplerenone
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12
Q

Spironolactone and Eplerenone Special Notes

A
  • aldosterone receptor antagonists

- diminish cardiac remodeling in HF

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13
Q

Beta Blockers MOA

A

decrease CO; may also decrease sympathetic outflow and inhibit release of renin

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14
Q

Types of Beta Blockers

A

Nonselective (Beta 1&2)
Cardioselective (Beta 1)
Mixed Alpha 1, nonselective Beta (Beta 1&2)

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15
Q

Beta Blocker Med

A

metoprolol succinate or metoprolol tartate

*dosed 1-2x daily

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16
Q

Beta Blocker AEs

A
  • bradycardia
  • heart block
  • heart failure
  • dyspnea
  • bronchospasm
  • decreased libido
  • fatigue/dizziness/lethargy/depression
  • hyper/hypoglycemia
  • hyperkalemia
    • nonselective Beta blockers may cause hyperlipidemia
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17
Q

Beta Blocker Cautions

A 
HR <60 bpm
respiratory disease
abrupt discontinuation
may mask hypoglycemia
w/ diuretics may cause hypokalemia
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18
Q

Beta Blocker Contraindications

A

hypersensitivity
sinus node dysfunction, severe sinus bradycardia, heart block, cardiogenic shock, acute decompensated heart failure
may have asthma with nonselective

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19
Q

2 Types of Calcium Channel Blockers

A
  • dihydropyridines

- nondihydropyridines

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20
Q

Dihydropyridines Affinity

A

for vascular calcium channels than calcium channels in the heart -> relaxes periphery

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21
Q

Nondihydropyridines Affinity

A

affects vascular and calcium channels-> decrease CO

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22
Q

Dihydropyridine Meds

A
  • Nifedipine

- Amlodipine

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23
Q

Nondihydropyridines Meds

A
  • Verapamil

- Diltiazem

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24
Q

Both Calcium Channel Blocker AE

A
  • bradycardia
  • headache
  • flushing
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25
Q

Non-dihydropyridine AEs

A
  • heart block

- constipation

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26
Q

Dihydropyridine AEs

A
  • peripheral edema
  • gingival hyperplasia
  • tachycardia
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27
Q

CCB MOA

A

block Ca++ movement into smooth muscle -> dilating arterioles

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28
Q

CCB Cautions

A

HR <60 bpm or with beta blockers

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29
Q

Both CCB Contraindications

A
  • hypersensitivity

- decreased ejection fraction

30
Q

Non-dihydropyridine Contraindications

A
  • sinus node dysfunction
  • severe sinus bradycardia
  • heart block
  • AF/A flutter with bypass tract
31
Q

ACE Inhibitors MOA

A

inhibits angiotensin I to convert into angiotensin II

32
Q

ACE Inhibitor Med Ending

A

end in -pril

33
Q

ACE Inhibitors Common AEs

A
  • hyperkalemia
  • persistent dry cough
  • decreased GFR
  • increased serum Cr
34
Q

ACE Inhibitors Serious AEs

A
  • acute renal failure
  • blood dyscrasias
  • angioedema
35
Q

ACE Inhibitors/ARBs Monitoring

A
  • electrolytes

- renal functioning

36
Q

ACE Inhibitors/ARBs Caution

A

hyperkalemia

37
Q

ACE Inhibitors/ARBs Contraindications

A
  • pregnancy
  • hypersensitivity
  • bilateral renal stenosis
38
Q

ARBs MOA

A

blocks angiotensin II from binding to angiotensin receptor

39
Q

ARBs Meds Ending

A

-sartan

40
Q

ARBs AEs

A
  • hyperkalemia
  • renal function deterioration
  • angioedema
  • hypotension/syncope
41
Q

ARBs dose adjustment

A
  • renal impairment
  • elderly
  • volume depleted
  • diuretic therapy
42
Q

Direct Renin Inhibitors MOA

A

inhibits renin directly

43
Q

Direct Renin Inhibitor Med

A

Aliskren

44
Q

Direct Renin Inhibitor AEs

A
  • hyperkalemia

- hypotension

45
Q

Direct Renin Inhibitors Caution

A
  • severe renal impairment
  • decreased renal function
  • renal artery stenosis
46
Q

Direct Renin Inhibitor Contraindications

A

when in combination with ACE Is or ARBs

47
Q

Direct Renin Inhibitor Monitoring

A
  • K+

- serum Cr and GFR

48
Q

Direct Renin Inhibitor Interactions

A
  • ACE Is/ARBs
  • cyclosporine
  • K+ sparing diuretics, K+ supplements, K+ salt substitutes
  • furosemide concentration decreased
  • ketoconazole increases Aliskren levels
49
Q

Alpha 1 Blockers

A

blocks alpha 1 receptor causing decreased blood pressure

50
Q

Alpha 1 Blocker Meds

A

end in -azosin

51
Q

Alpha 1 Blocker AEs

A

first dose may cause syncope, dizziness, palpitations

long-term doses may cause orthostatic hypotension

52
Q

Alpha 1 Blocker Contraindications

A

hypersensitivity

53
Q

Alpha 2 Agonists MOA

A
  • decreased sympathetic outflow
  • increased parasympathetic outflow
  • decreased HR, CO, and total PR
54
Q

Alpha 2 Agonists Meds

A
  • clonidine
  • methyldopa
  • guanfacine
  • guanabenz
55
Q

Alpha 2 Agonists AEs

A
  • transient sedation initially
  • vision disturbances
  • sedation
56
Q

Methyldopa AEs

A
  • hepatotoxicity
  • hemolytic anemia
  • peripheral edema
  • orthostatic hypotension
57
Q

Clonidine AEs

A
  • dry mouth
  • muscle weakness
  • hypotension
58
Q

Alpha 2 Agonists Special Note

A

first line hypertension agent in pregnancy

59
Q

Alpha 2 Agonists Contraindications

A
  • hypersensitivity
  • concurrent use of MAO Is
  • hepatic disease
  • pheochromocytoma
60
Q

Peripheral Sympathetic Inhibitors MOA

A

decreased sympathetic tone & PR causing decreased NE from sympathetic nerve endings

61
Q

Peripheral Sympathetic Inhibitor Med

A

Reserpine

62
Q

Peripheral Sympathetic Inhibitors AEs

A

increased parasympathetic nervous effects due to decreased sympathetic effects

63
Q

Peripheral Sympathetic Inhibitors Contraindications

A
  • hypersensitivity
  • peptic ulcer disease
  • ulcerative colitis
  • history of depression or ECT (tx of severe depression)
64
Q

Peripheral Sympathetic Inhibitors Special Notes

A
  • slow to act
  • poorly tolerated
  • interacts with cough and cold OTC meds
65
Q

Direct Vasodilators MOA

A
  • relax smooth muscle in arterioles

- activate baroreceptors

66
Q

Direct Vasodilators Meds

A
  • isosorbide dinitrate/hydralazine
  • hydralazine
  • minoxidil
67
Q

Direct Vasodilators AEs

A
  • edema
  • hypertrichosis
  • tachycardia
  • Lupus-like syndrome
68
Q

Direct Vasodilators Contraindication

A
  • hypersensitivity
69
Q

Minoxidil Contraindication

A

may cause pheochromocytoma

70
Q

Isosorbide dinitrate/hydralazine Contraindication

A

may increase intracranial pressure

71
Q

Direct Vasodilators Special Notes

A

causes reflex tachycardia & fluid retention when used with diuretic & beta blockers

Pharmacology (7 decks)

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