Antihypertensives Flashcards
Which drug can be used for opiate, ethanol and smoking withdrawal?
Clonidine
How to alpha 2 agonists (clonidine and methyldopa) treat hypertension?
Agonize presynaptic alpha 2 receptors in the CNS to decrease sympathetic output, which decreases TPR and HR
Side effects of A2 agonists
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)
Major side effect of methyldopa
Coombs test positive-hemolytic anemia
How do TCAs affect A2 agonists?
TCAs decrease the effects of A2 agonists
What can occur if you suddenly stop taking clonidine?
Hypertension crisis
Reserpine MOA
Reserpine: inhibits vesicular membrane-associated transporter (VMAT), prevents dopamine and norepinephrine vesicle uptake, depletes norepinephrine in nerve terminal vesicles
Does reserpine cross the BBB?
Yes
Side effects of reserpine
Depression (decrease NE, serotonin in CNS)
Diarrhea
Increase gastric acid secretion
Contraindications for reserpine
Depression
History of peptic ulcers
Guanethidine MOA
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
Does guanethidine cross the BBB?
NO
Side effects of guanethidine
Orthostatic hypotension
Diarrhea
Edema
Sexual dysfunction (delayed or retrograde ejaculation)
Which drugs can cause hyperlipidemia?
B blockers
Which drug dilates both arteries and veins?
Nitroprusside
Hydralazine MOA
Acts through the release of NO and mainly dilates the artery