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STEP 1 > Antihypertensives > Flashcards

Antihypertensives Flashcards

1
Q

Patients that suffer from heart failure or have had MIs in the past do better with with what 2 medications?

A

ACE–i

beta-blockers

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2
Q

What Diabetic anti-hypertensives ward off further renal damage (2)?

A

ACEi

ARBs

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3
Q

Hydralazine, labetalol, methyldopa, nifedipine can all be used for what kind of HTN?

A

HTN in pregnancy

“Hide La baby from Meth and Knifes”

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4
Q

ARBs, CCBs, thiazide diuretics, cardio-selective β-blockers can all be used for what type of HTN?

A

Asthma HTN

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5
Q

What 2 anti-hypertensive drugs should be avoided in asthmatics?

A

Avoid non-selective β-blockers to prevent β2-receptor–induced broncho-constriction.

Avoid ACE inhibitors to prevent confusion between drug or asthma related cough

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6
Q

What is 1 consideration when using Beta Blockers for treating HTN in Diabetics

A

.

β-blockers can mask hypoglycemia symptoms

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7
Q

ACEinhibitors/ARBs,

Ca2+ channel blockers,

thiazide diuretics,

β-blockers

can all be used to treat what kind of HTN

A

HTN w/ DM

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8
Q

β blockers must beused cautiously in pts with ______ and contraindicated in ________.

A

decompensated HF

cardiogenic shock

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9
Q

In HF, ARBs may be combined with what neprilysin inhibitor?

A

sacubitril

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10
Q

Diuretics, ACEinhibitors/ARBs, β-blockers, aldosterone antagonists can be used for what kind of HTN?

A

HTN w/ HF

β-blockers (in compensated HF only)

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11
Q

What is the MOA for:

Amlodipine, clevidipine, nicardipine, nifedipine, nimodipine

A

Calcium channel blockers

(dihydropyridines, act on vascular smooth muscle)

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12
Q

What is the MOA for:

diltiazem, verapamil

A

Calcium channel blockers

(non-dihydro pyridines ,act on heart)

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13
Q

This class of antihypertensive blocks calcium channels in cardiac and smooth muscle to

decrease contractility.

A

ARBs

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14
Q

Dihydropyridines (except _____) treat: hypertension, angina (including vasospastic type), Raynaudphenomenon.

A

nimodipine

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15
Q

Adverse effects of

Non dihydropyridine: Gingival Hyperplasia, cardiac depression, AV-block, hyperprolactinemia ( mostly by ____), constipation

A

verapamil

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16
Q

Increases cGMP smooth muscle relaxation.

Vasodilates arterioles >veins;

afterload reduction.

A

Hydralizine

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17
Q

Frequently co-administered with a β-blocker to prevent reflex tachycardia.

A

Hydralazine

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18
Q

Compensatory tachycardia (contraindicated in angina/CAD), fluid retention, headache, angina, drug-induced lupus

A

Hydralazine

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19
Q

Treat with labetalol, clevidipine, fenoldopam, nicardipine, nitroprusside

A

Hypertensive emergency

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20
Q

Dopamine D1 receptor agonist → vasodilator.

Lower BP, Increase natriuresis (pee Na)

Can cause hypotension and tachycardia.

A

Fenoldopam

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21
Q

Type of Drug class

Nitroglycerin,

isosorbidedinitrate,

isosorbidemononitrate

A

Nitrates

((use with caution; they lower R side venous return to heart; some patients are pre-load dependent))

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22
Q

Dilate veins >> arteries.

↓ preload (R heart venous return)

A

Nitrates

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23
Q

Vasodilate by ↑ NO in vascular smooth muscle in ↑ cGMP and smooth muscle relaxation.

A

Nitrates

24
Q

Contraindicated in right ventricular infarction, hypertrophic cardiomyopathy, and with concurrent PDE-5 inhibitor use.

A

Nitrates

25
Q

What are the 4 myocardial O2 consumption (MVO2) determinants :

A

end-diastolic volume,

BP,

HR,

contractility.

26
Q

This medication

Inhibits the late phase of inward sodium current thereby reducing diastolic wall tension and oxygen consumption.

Does not affect heart rate or blood pressure

A

Ranolazine

27
Q

This medication is a

Short acting vasodilator (arteries = veins)

↑cGMP via direct release of NO

A

Nitroprusside

28
Q

This medication

Can cause cyanide toxicity

(by releasing cyanide)

A

Nitroprusside

29
Q

This medication

prevents degradation of natriuretic peptides:

angiotensin II & substanceP

→ ↑vasodilation, ↓ECF volume

A

Sacubitril

30
Q

This medication is

Used in combination with

valsartan (an ARB)

to treat

HFrEF.

A

Sacubitril

31
Q

This medication is

contraindicated with ACE inhibitors due to angioedema.

A

Sacubitril

32
Q

This medication is a

Direct inhibition of Na+/K+ ATPase

Presents with blurry yellow vision, hyperkalemia, and fatigue

A

DIgoxin

33
Q

This medication is an

indirect inhibition of Na+/Ca2+ exchanger.

A

Digoxin

34
Q

This medication

↑ [Ca2+]intracellular → positive inotropy.

Stimulates vagus nerve

↓HR

A

Digoxin

35
Q

This medication is indicated for

HF ( to ↑ contractility)

Atrial fibrillation ( to ↓ conduction at AV node and depression of SA node)

A

Digoxin

36
Q

The following is the management for what medication toxicity?

  • Give anti-[Medication] Fab fragments
  • Start Mg2+ infusion
  • Slowly normalize K+ (via Insulin + D5W)
A

Digoxin toxicity

37
Q

What medication can cause these Adverse effects:

  • Cholinergic effects (nausea, vomiting, diarrhea),
  • blurry yellow vision (think van Glow),
  • arrhythmias,
  • AV block.
A

Digoxin

38
Q

Hyperkalemia indicates a poor prognosis when taking what medication?

A

DIgoxin

39
Q

Digoxin functions via binding to open ____ binding sites of which transporter?

(permissive for drug binding at ),

drugs that displace drug from tissue-binding sites,

(eg: verapamil, amiodarone, quinidine).

A

K+ binding sites on the

Na+/K+ ATPase

(hence hypokalemia while on Digoxin increases risk for toxicity which results in hyperkalemia – Note digoxin is sometimes used with anti-hypertensive medication that causes hypokalemia)

40
Q

Medication is contraindicated if taking:

verapamil, amiodarone, quinidine

A

Digoxin

(s/t lowering digoxin clearance)

41
Q

What medication can cause these Adverse effects:

Luminous phenomena/visual brightness,

hypertension,

bradycardia

A

Ivabradine

42
Q

Used for Chronic stable angina in patients who cannot take β-blockers.

ChronicHFrEF

A

Ivabradine

43
Q

What class of medication are:

Quinidine, Procainamide, Disopyramide

A

Class 1A

Anti-arr

Na+ Channel Blockers

44
Q

What class of medication are:

Lidocaine,

MexileTine.

A

Class 1B

anti- arr

Na+ channel blockers

45
Q

Flecainide,

Propafenone

A

class 1C

anti-arry

(tight) Na+ channel blockers

46
Q

Metoprolol, propranolol, esmolol, atenolol, timolol, carvedilol.

(MEP, CAT)

A

Class 2

anti arryth

beta blockers

47
Q

Amiodarone, Ibutilide, Dofetilide, Sotalol

A

Class 3

anti-arryth

K+ channel blockers

48
Q

Diltiazem, Verapamil

A

class 4

anti-arry

Calcium channel blockers

49
Q

Adenosine’s effects blunted by what 2 meds/substances?

A

adenosine receptor antagonists

theophylline

caffeine

50
Q

Drug of choice in diagnosing/ terminating certain forms of SVT.

A

Adenosine

51
Q

↑ K+ out of cells hyperpolarizing the cell and ↓ICa, decreasing AV node conduction.

A

Adenosine

52
Q

Adverse effects: include flushing, hypotension, chestpain, sense of impending doom, bronchospasm

A

Adenosine

(A-doom-osine)

53
Q

Effective in torsades de pointes and digoxin toxicity.

A

Magnesium

54
Q

for subarachnoid hemorrhage (prevents cerebral vasospasm).

A

Nimodipine

55
Q

For hypertension, angina, atrial fibrillation/flutter

A

Non-dihydropyridines: Diltiazem, Verapamil

56
Q

Nicardipine, clevidipine can specifically be used for

A

hypertensive urgency or emergency

57
Q

___ cause peripheral edema, flushing, dizziness.

____ cause cardiac depression, AVblock, constipation

A

Dihydropyridine

Non-dihydropyridine

hyperprolactinemia (verapamilk)

STEP 1 (88 decks)

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