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Pharmacology > Antihypertensives > Flashcards

Antihypertensives Flashcards

1
Q

MOA of antihypertensives

A

Decrease BP by decreasing CO and TPR or decreasing preload by decreasing blood volume

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2
Q

Chronic hypertensive treatment can cause

A

Reflex tachycardia and increase renin with edema formation

-Give a beta blocker and a diuretic also

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3
Q

First approach to treatment of HTN

A

DASH diet, weight reduction, Na restriction, aerobic activity

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4
Q

Recommended treatment for post MI or high CAD risk

A

Beta blocker: cardioprotective

ACE inhibitor: decreases incidence of HF, stroke and MI

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5
Q

Recommended treatment for diabetes and htn

A

ACE inhibitor
ARB blocker
Delays progression of nephropathy

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6
Q

Recommended treatment for CHF and htn

A

ACE inhibitor

Usually in conjunction with beta blocker and diuretic

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7
Q

Recommended treatment for BPH and htn

A

a1 blocker

Only time this is used as a first line agent

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8
Q

Recommended treatment for not black and <55

A

ACEI, ARB

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9
Q

Recommended treatment for not black and >55

A

Calcium channel blocker or diuretics

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10
Q

Recommended treatment for black any age

A

Calcium channel blocker or diuretic

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11
Q

First line drug used in hypertensive emergency

A

Clevidipine

L type calcium channel blocker

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12
Q

Diuretics

A

Most consistent effect htn drug

Initially decrease volume and chronically decrease TPR by vasodilation

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13
Q

VMAT

A

puts NE back into vesicles in presynpatic terminal

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14
Q

NET

A

Reuptakes NE from synapse

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15
Q

Decreasing NE causes

A

Decreased TPR (a1 blockade), decreased HR (b1 blockade), postural hypotension (a1 blockade), rebound hypertension if withdrawal occurs

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16
Q

alpha methyldopa

A

a2 agonist–blocks outflow of NE

Drug of choice in pregnancy

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17
Q

Clonidine

A

a2 agonist

Useful in opiate withdrawal

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18
Q

Guanethidine

A

Gets reuptaken into presynaptic nerve terminal and displaces NE in vesicles causing a decrease in NE release

19
Q

a1 blockers

A

decrease BP by relaxing vascular smooth muscle and decreasing TPR
Not commonly used as primary agents due to orthostatic hypotension

20
Q

Beta blockers

A

Decrease HR, decrease contractility, decrease CO, decrease renin, decrease TPR
Can cause bradycardia and AV block

21
Q

Examples of nonselective Beta blockers

A

Propranolol, Nadolol, Timolol

22
Q

Examples of Cardioselective B1 blockers

A

Atenolol, Betaxolol, Bisoprolol, Metoprolol

Safer to use in people with asthma, PVD, and diabetes

23
Q

Third generation Beta blockers

A

Vasodilators
B1, B2, a1 blockade
Carvedilol and labetalol

24
Q

Direct vasodilators

A

No ANS pharmacology

Cause reflex tachycardia and edema–use a beta blocker and diuretic also

25
Q

Hydralazine

A

Prodrug of NO
Selective arteriolar dilation
Safe in pregnancy
Combine with beta blockers to decrease reflex tachycardia
Hydralazine + nitrates = life saving in HF

26
Q

Minoxidil

A

Potent direct arteriolar vasodilator
Orally
Suppresses insulin release so is only used short term

27
Q

Calcium channel blockers

A

2 classes: dihydropyridines and non-dihydropyridines

28
Q

Dihydropyridines

A

“-dipine”
Block L type Ca channels in vascular smooth muscle causing vasodilation and decreased TPR
no effect on HR or contractility

29
Q

Non-dihydropyridines

A

Verapamil and Diltiazem
Decrease Ca channels in heart tissue causing decreased HR and contractility
Used in patients with angina who can not tolerate beta blockers

30
Q

ACE inhibitors

A

“-pril”
Block angiotensin I–>angiotensin II and therefore block sodium and water retention
Increase bradykinin activity by blocking metabolism of it–causes increased vasodilating effects
Decrease aldosterone–may cause hyperkalemia
Long term benefits
May result in dry cough or angioedema

31
Q

ARB

A

“-sartan”
Directly antagonizes angiotensin II receptor
Does not affect bradykinin metabolism
No long term benefits as ACEI

32
Q

Adverse effects of ACE inhibitors and ARB’s

A

Cause hypotension and hyperkalemia
Both contraindicated in bilateral RAS
Contraindicated in pregnancy due to risk of potter syndrome

33
Q

Ca channel blockers make what worse

A

HF

34
Q

Nifidepine and pregnancy

A

Can be used

35
Q

SE of calcium channel blockers

A

GI blockage, gingival hyperplasia, lightheadedness, peripheral edema, reflex tachycardia

36
Q

1st line agents for treating hypertension

A

thiazides, ACEI, ARBs, and CCB (dihydropyridines)

37
Q

ACEI are especially good for patients who have

A

HF, MI, Diabetes

38
Q

Hypertension emergency

A

iV beta blockers, IV labetalol, Hydralazine, Nitroprusside, Fenoladpine

39
Q

Nitroprusside

A

Increase NO causing arterial and venous dilation

Can convert to cyanide–poisoning

40
Q

Fenoldapine

A

Arterial vasodilation, natriuresis, increased renal perfusion

41
Q

ACEI contraindicated in

A

Pregnancy and bilateral renal stenosis

42
Q

ACEI can help decrease

A

Diabetic nephropathy

43
Q

ACEI and GFR

A

Decreases GFR–do not take with NSAIDs

44
Q

Aliskiren

A

Direct renin inhibitor

Pharmacology (56 decks)

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