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Pharm > Antihypertensives > Flashcards

Antihypertensives Flashcards

1
Q

Which drug can be used for opiate, ethanol and smoking withdrawal?

A

Clonidine

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2
Q

How to alpha 2 agonists (clonidine and methyldopa) treat hypertension?

A

Agonize presynaptic alpha 2 receptors in the CNS to decrease sympathetic output, which decreases TPR and HR

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3
Q

Side effects of A2 agonists

A

Sedation
Depression (clonidine more severe)
Postural hypotension
Edema (due to hypotension inducing activation of renin-angiotensin-aldosterone)
Coombs test positive-hemolytic anemia- methyldopa
Dry mouth (clonidine)

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4
Q

Major side effect of methyldopa

A

Coombs test positive-hemolytic anemia

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5
Q

How do TCAs affect A2 agonists?

A

TCAs decrease the effects of A2 agonists

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6
Q

What can occur if you suddenly stop taking clonidine?

A

Hypertension crisis

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7
Q

Reserpine MOA

A

Reserpine: inhibits vesicular membrane-associated transporter (VMAT), prevents dopamine and norepinephrine vesicle uptake, depletes norepinephrine in nerve terminal vesicles

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8
Q

Does reserpine cross the BBB?

A

Yes

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9
Q

Side effects of reserpine

A

Depression (decrease NE, serotonin in CNS)
Diarrhea
Increase gastric acid secretion

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10
Q

Contraindications for reserpine

A

Depression

History of peptic ulcers

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11
Q

Guanethidine MOA

A

Taken up by NET and replaces norepinephrine from vesicle, cytosolic NE then is degraded by MAO—depleting NE in vesicle
Inhibits vesicle fusion with membrane, inhibits vesicular norepinephrine release

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12
Q

Does guanethidine cross the BBB?

A

NO

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13
Q

Side effects of guanethidine

A

Orthostatic hypotension
Diarrhea
Edema
Sexual dysfunction (delayed or retrograde ejaculation)

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14
Q

Which drugs can cause hyperlipidemia?

A

B blockers

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15
Q

Which drug dilates both arteries and veins?

A

Nitroprusside

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16
Q

Hydralazine MOA

A

Acts through the release of NO and mainly dilates the artery

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17
Q

What is a major ADR of hydralazine?

A

Drug-induced reversible lupus (SLE) like syndrome (especially in people who are slow acetylators)

18
Q

Nitroprusside MOA

A

MOA: release of NO from the drug molecule (NO donor), this stimulates guanylyl cyclase and increases cGMP in smooth muscle.

19
Q

What is a major ADR of nitroprusside?

A

Cyanide poisoning

20
Q

MOA of diazoxide and minoxidil

A

Potassium channel opening drugs

Induce hyperpolarization—leading to arterial vasodilation

21
Q

What else can diazoxide be used for?

A

To treat insulinoma because it reduces insulin

22
Q

Side effects of potassium channel opening drugs

A

Decrease insulin (diazoxide, treat insulinoma),
Hypertrichosis (minoxidil)
Hypotension
Salt and water retention

23
Q

Which drugs are ACEIs?

A

Catopril, enalapril, lisinopril

24
Q

Which drugs are angiotensin receptor blockers?

A

Losartan, valsartan

25
Q

MOA of Aliskiren

A

Renin inhibitor. Not as effective as ACEIs.

26
Q

Major ADR of RAAS drugs

A

Hyperkalemia, should not be used with potassium sparing diuretics

27
Q

ADR of ACEIs

A

Cause accumulation of bradykinin –> dry cough

Rare: angioedema

28
Q

When should RAAS drugs not be used?

A

Bilateral renal artery stenosis because they can cause renal failure
PREGNANCY –> can cause craniofacial abnormalities and renal dysgenesis in the fetus

29
Q

First choice for diabetic nephropathy

A

ACEIs (dilate efferent artery of the glomerulus ad decrease GFR –> delays deterioration of kidney function)

30
Q

Which is constricted more by angiotensin II: afferent or efferent?

31
Q

Main drugs to remember for treatment of hypertensive crisis

A

Nitroprusside/nitroglycerin
Diazoxide
Fenoldopam
Lebetalol

32
Q

Stage I HTN treatment in non black people

A

Monotherapy

thiazide, ACEI, ARB, CCB

33
Q

Stage I HTN treatment in black people

A

Thiazide, CCB

34
Q

Treatment for patients with HTN and diabetes or kidney disease

A

ACEI, ARB (delay deterioration of kidney)

35
Q

Treatment choice for heart failure

A

ACEI/ARB + BB + diuretic + spironolactone

36
Q

Treatment choice for post-MI

A

ACEI/ARB and BB

37
Q

Treatment choice for coronary artery disease

A

ACEI, BB, diuretic, CCB

38
Q

Treatment choice for diabetes

A

ACEI/ARB, CCB, diuretic

39
Q

Treatment choice for chronic kidney disease

40
Q

Treatment choice for recurrent stroke

A

ACEI, diuretic

41
Q

Treatment choice for thoracic aortic disease

42
Q

Treatment choice for pregnancy

A

Labetolol, nifedipine, methyldopa

Pharm (7 decks)

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