Antihypertensives Flashcards
What are the 8 families of drugs used to treat hypertension?
Angiotensin 2 inhibitors, renin inhibitors, beta blockers, ACE inhibitors, diuretics, A1 inhibitors, calcium channel blockers, a2 agonists.
What are the 3 families of diuretics used in treating hypertension?
Thiazides, loop and potassium sparing drugs
Big picture effect of ACE inhibitors?
They can lower blood pressure without the the reflex of increasing cardiac output or contractility.
3 more specific effects of ACE inhibitors?
Drop angiotensin 2 levels. Increase bradykinin levels, so VD. Because angiotensin 2 isn’t out there, aldosterone levels are dropped as well.
3 indications for ace inhibitors?
After MI, Diabetic neuropathy, and heart failure.
2 big time adverse effects of ACE inhibitors?
Dry cough and angioedema (swollen tongue).
MOA for ARBs and how are they difference than ace inhibitors?
Block the angiotensin 2 receptor. Same effects of ace inhibitors except they don’t lead to increased levels of bradykinin
What is noteworthy about losartan, Valsartan, and Candesartan?
- Way more affinity for AT1 receptors
- Not a pro drug
- Irreversibly binds
What is the MOA for aliskiren?
Renin inhibitor
What 3 drug classes are a no go in pregnancy?
Ace, arbs and renin inhibitor
How does clonodine work and what is a patient population that these would work well in?
Alpha 2 agonist so it decreases sympathetic tone. Renal disease patients because it does not decrease any renal function.
How does alpha methyldopa work and what patients is it a good choice for?
A2 agonist, so shut down sympathetic. Pregnant ladies.
What is the prototypical beta blocker to use, but what is its limitation?
Propranolol. It is not selective so cant use it in asthma patients.
Which 2 beta blockers do you use in patients?
Met or ate.
What is the single most important thing about treatment with beta blockers or a2 agonist?
Must taper off, don’t stop abruptly or it will cause dangerous rebound hypertension.
