Antihypertensives + emergency Flashcards
a Diuretic used as a first line agent for treating primary hypertension
Hydrochlorothiazide
(may be less effective than chlorthalidone )
What four drug classes are used in the treatment of primary hypertension?
- Thiazide diuretics
- ACE inhibitors
- Angiotensin II receptor blockers (ARBs)
- Dihydropyridine Ca2+ channel blockers
Black and elderly patients respond well to which drugs for treatment of primary hypertension ?
1) hydrochlorothiazide
2) long-acting dihydropyridine Ca2+ channel blockers
first line treatment for hypertension in patients with heart failure, MI, and/or diabetes
-ACEi
(“ACE casino tables”)
-angiotensin II receptor blockers
Hypertensive emergency occurs when …
systolic BP >180 or diastolic BP >120 with end-organ damage
an α- and β-antagonist, can be used for hypertensive emergency
Labetalol
(“Alpha and beta organ stops”)
Many agents used in hypertensive emergencies are potent…
Potent Vasodilators
(“Dilated red smoke stack”)
Potent vasodilation (e.g. following hypertensive therapy) may cause …
hypotension followed by reflex tachycardia and increased renin levels
Vasodilation (e.g. following hypertensive therapy) reduces…
Afterload
(sailor unloads scale)
IV Ca2+ channel blockers that may be used in hypertensive emergency
Clevidipine
(“clover on nice card”)
Nicardipine
(“nice card”)
Hydralazine can ..
dilate arterioles, and decreased after-load via increasing cGMP
- **has little effect on venous circulation**
cause hypotension, which may induce a reflex tachycardia that can worsen angina
Hydralazine is often co-administered with a …
β-blocker to minimize the reflexive sympathetic activation and tachycardia
Hydralazine can rarely cause…
drug-induced lupus, which may manifest as myalgias, arthralgias, and joint swelling
what can be combined with Hydralazine in order to treat LV systolic dysfunction?
organic nitrate (e.g. nitroglycerin)
- provides a mortality benefit for some patients with heart failure
- hydralazine is a vasodilator (decrease afterload), nitrates are venodilators (decrease preload)
Nitroprusside can ..
(“Nitro-pressure speedboat”)
-cause vasodilation via nitric oxide
(“nitrous oxide exahust”)→increasing cGMP (“grumpy old fart in the water”), which is useful during the treatment of hypertensive emergency
- causes arteriolar AND venous dilation
(“both shirt sleeves and pants are dilated “)