Antihypertensives and Heart Failure Flashcards
List 4 categories of antihypertensive agents
. Diuretics
. Direct vasodilators
. Agents that block production or action of angiotensin
. Sympathoplegic agents
Diuretics MOA and indication in HTN and congestive HF
Increase rate of urine flow, reducing edema. Reduce BP by reducing blood volume and increasing sodium output
What class of diuretics are appropriate for most patients with mild or moderate HTN and normal renal and cardiac function?
Thiazide diuretics
True or false: HCTZ is preferred to chlorthalidone because it has a longer duration of action
False. Chlorthalidone has a longer duration of action than HCTZ and is more effective
What is one of the most common adverse effects of diuretics?
Potassium depletion, with the exception of potassium sparing diuretics
Renin is released by _________ cells in the _________
Juxtaglomerular, kidney
Aliskiren drug class and MOA
Renin inhibitor. Directly inhibits renin, preventing the formation of angiotensin I and II
Enalapril drug class and MOA
Angiotensin converting enzyme inhibitor (ACEi). Inhibit the conversion of angiotensin I to angiotensin II, reducing peripheral vascular resistance and lowering blood pressure
Which is the only ACEi that is NOT eliminated primarily by the kidneys?
Fosinopril
True or false: All ARBs are acidic drugs
True
What is RAAS? What is its function?
Renin-angiotensin-aldosterone system. It is a critical regulator of blood volume and systemic vascular resistance (BP control)
Nifedipine drug class and MOA
Calcium channel blocker. Inhibits calcium influx into arterial smooth muscle cells
Common adverse effects of CCBs
. Tachycardia
. Palpitations
. Chest pain
True or false: CCBs inhibit Ca movement across membranes of myocardial and arterial muscle cells, altering action potential and blocking muscle cell contraction
True
(Parasympathetic/sympathetic) neural activation can cause HTN in some patients
Sympathetic
Antihypertensive agents that act on the CNS can have what side effects?
. Sedation
. Mental depression
. Sleep disturbances
. Nightmares
Agents that reduce release of norepinephrine from sympathetic nerve endings can have what side effects?
. Inhibition of ejaculation
. Hypotension
Ganglion blocking agents MOA
Competitively block nicotinic cholinoceptors on postganglionic neurons in both sympathetic and parasympathetic ganglia
What agents can be used for HTN during pregnancy?
. Methyldopa
. Labetalol
Adrenergic neuron blocking agent MOA
Prevent normal physiological release of norepinephrine from postganglionic sympathetic neurons
Example of an adrenergic neuron blocking agent
Reserpine
Adverse effects of adrenergic neuron blocking agents
Brain: sedation, nightmares and severe mental depression
GI: mild diarrhea, GI cramps, increased gastric acid secretion
