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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
Non-dihydropyridine AEs
- heart block | - constipation
26
Dihydropyridine AEs
- peripheral edema - gingival hyperplasia - tachycardia
27
CCB MOA
block Ca++ movement into smooth muscle -> dilating arterioles
28
CCB Cautions
HR <60 bpm or with beta blockers
29
Both CCB Contraindications
- hypersensitivity | - decreased ejection fraction
30
Non-dihydropyridine Contraindications
- sinus node dysfunction - severe sinus bradycardia - heart block - AF/A flutter with bypass tract
31
ACE Inhibitors MOA
inhibits angiotensin I to convert into angiotensin II
32
ACE Inhibitor Med Ending
end in -pril
33
ACE Inhibitors Common AEs
- hyperkalemia - persistent dry cough - decreased GFR - increased serum Cr
34
ACE Inhibitors Serious AEs
- acute renal failure - blood dyscrasias - angioedema
35
ACE Inhibitors/ARBs Monitoring
- electrolytes | - renal functioning
36
ACE Inhibitors/ARBs Caution
hyperkalemia
37
ACE Inhibitors/ARBs Contraindications
- pregnancy - hypersensitivity - bilateral renal stenosis
38
ARBs MOA
blocks angiotensin II from binding to angiotensin receptor
39
ARBs Meds Ending
-sartan
40
ARBs AEs
- hyperkalemia - renal function deterioration - angioedema - hypotension/syncope
41
ARBs dose adjustment
- renal impairment - elderly - volume depleted - diuretic therapy
42
Direct Renin Inhibitors MOA
inhibits renin directly
43
Direct Renin Inhibitor Med
Aliskren
44
Direct Renin Inhibitor AEs
- hyperkalemia | - hypotension
45
Direct Renin Inhibitors Caution
- severe renal impairment - decreased renal function - renal artery stenosis
46
Direct Renin Inhibitor Contraindications
when in combination with ACE Is or ARBs
47
Direct Renin Inhibitor Monitoring
- K+ | - serum Cr and GFR
48
Direct Renin Inhibitor Interactions
- ACE Is/ARBs - cyclosporine - K+ sparing diuretics, K+ supplements, K+ salt substitutes - furosemide concentration decreased - ketoconazole increases Aliskren levels
49
Alpha 1 Blockers
blocks alpha 1 receptor causing decreased blood pressure
50
Alpha 1 Blocker Meds
end in -azosin
51
Alpha 1 Blocker AEs
first dose may cause syncope, dizziness, palpitations long-term doses may cause orthostatic hypotension
52
Alpha 1 Blocker Contraindications
hypersensitivity
53
Alpha 2 Agonists MOA
- decreased sympathetic outflow - increased parasympathetic outflow - decreased HR, CO, and total PR
54
Alpha 2 Agonists Meds
- clonidine - methyldopa - guanfacine - guanabenz
55
Alpha 2 Agonists AEs
- transient sedation initially - vision disturbances - sedation
56
Methyldopa AEs
- hepatotoxicity - hemolytic anemia - peripheral edema - orthostatic hypotension
57
Clonidine AEs
- dry mouth - muscle weakness - hypotension
58
Alpha 2 Agonists Special Note
first line hypertension agent in pregnancy
59
Alpha 2 Agonists Contraindications
- hypersensitivity - concurrent use of MAO Is - hepatic disease - pheochromocytoma
60
Peripheral Sympathetic Inhibitors MOA
decreased sympathetic tone & PR causing decreased NE from sympathetic nerve endings
61
Peripheral Sympathetic Inhibitor Med
Reserpine
62
Peripheral Sympathetic Inhibitors AEs
increased parasympathetic nervous effects due to decreased sympathetic effects
63
Peripheral Sympathetic Inhibitors Contraindications
- hypersensitivity - peptic ulcer disease - ulcerative colitis - history of depression or ECT (tx of severe depression)
64
Peripheral Sympathetic Inhibitors Special Notes
- slow to act - poorly tolerated - interacts with cough and cold OTC meds
65
Direct Vasodilators MOA
- relax smooth muscle in arterioles | - activate baroreceptors
66
Direct Vasodilators Meds
- isosorbide dinitrate/hydralazine - hydralazine - minoxidil
67
Direct Vasodilators AEs
- edema - hypertrichosis - tachycardia - Lupus-like syndrome
68
Direct Vasodilators Contraindication
- hypersensitivity
69
Minoxidil Contraindication
may cause pheochromocytoma
70
Isosorbide dinitrate/hydralazine Contraindication
may increase intracranial pressure
71
Direct Vasodilators Special Notes
causes reflex tachycardia & fluid retention when used with diuretic & beta blockers

Pharmacology (7 decks)

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