Antihypertensives and HF

Question 1

ACE Inhibitors

Answer 1

MOA- inhibit breakdown of bardykinin (which vasodilate)

• prevent secretion of aldosterone (cause -sodium and water retention)
• prevent formation of angiotensin II (vasoconstrict)

Therapeutic- HF, hypertension

Adverse effects - fatigue, dizziness, mood changes, headaches, non productive COUGH, HYPERKALEMIA, acute kidney failure although is protective

Drug - ends in -pril

*do not take with NSAIDs

Question 2

ARB’s (Angiotensin Receptor Blockers)

Answer 2

MOA - block angiotensin II from binding to receptors, decrease afterload

Therapeutic- hypertension, used in adjunct for HF

Adverse Effects - upper respiratory infections, headaches

Drug - end in -sartan

Question 3

Vasodilator

Answer 3

MOA - relax arterial and venous smooth muscle
(Cause peripheral vasodilation)

Therapeutic- hypertension

Adverse Effects- dizziness, headache, anxiety, tachycardia, edema, dyspnea, nausea, vomiting, diarrhea, hepatitis, vitamin B6 deficiency and rash

Drug - hydralazine

Question 4

Direct Renin Inhibitors

Answer 4

MOA - binds directly to renin and blocks conversion of angiotensin to angiotensin I and II

Therapeutic- mild to moderate hypertension

Adverse Effects- headaches, dizziness, fatigue and GI effects

Drug - aliskiren

Question 5

Adrenergic Blockers

Answer 5

Arterial and venous dilation, block or inhibit adrenergic receptors

Therapeutic- hypertension

Adverse Effects- first dose phenomenon, orthostatic hypotension (dry mouth, dizziness, depression, edema, constipation sexual dysfunction)

Drug - end in -zosin

Question 6

Carbonic Anhydrase Inhibitors

Answer 6

Therapeutic- edema due to HF

Adverse Effects- acidosis, hypokalemia, drowsiness, anorexia, paresthesia, hematuria

End in -amide

Question 7

Loop Diuretics

Answer 7

Therapeutic- reduce BP, edema associated with HF

Adverse Effects- hypokalemia

Drug - furosemide

Question 8

Aldosterone antagonist

Answer 8

Therapeutic- severe stages of HF

Drug - Spironolactone (potassium soaring diuretic)

Question 9

Omega 3

Answer 9

Adjective therapy for chronic HF

Question 10

Phosphodieterase

Answer 10

Short term management of acute HF

Adverse effects- ventricular dysrhythmia (hypotension, angina, hypokalemia, tremor and thrombocytopenia)

Drug - milrinone

Question 11

Cardiac Glycosides

Answer 11

MOA - increase cardiac output and slow the heart rate

Therapeutic- systolic HF and atrial fibrillation

Adverse effects- headache, confusion, colour vision, halo vision, anorexia and vomiting

Drug - digoxin

Question 12

Inotropic

Answer 12

Positive inotropic - increase cardiac output by increasing force of myocardial contraction

Drug- digoxin

Question 13

Chronotropic

Answer 13

Negative- reduce heart rate

Drug- beta blockers