Antihypertensives II Flashcards by Tyler Yee

What are the alpha-adrenergic receptor blockers?

Prazosin
Terazosin
Doxazosin

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What do alpha-adrenergic receptor blockers cause?

Decreased peripheral vascular resistance

Decreased venous capacitance

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What calcium channel is more important in smooth muscle?

Both L-type and T-type calcium current

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What calcium channel is more important in cardiac muscle?

L-type calcium current

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What do dihydropyridines inhibit?

ONLY T-type calcium current channels!

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What are the only drugs that inhibit L-type calcium channels?

Verapamil
Diltiazem
(never DHPs)

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What inhibits T-type calcium channels?

DHPs
Diltiazem
Verapamil

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How do calcium channel blockers work?

By decreasing the voltage of calcium channels so that they are not easily activated; effectively prolongs the inactivation time of the channels/refractory period

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What do DHPs such as Nifedipine cause?

Reflex HR
Reflex Contractility
Reflex AV conductance

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Why do DHPs cause a reflex in HR/contractility/AV conductance?

Because they cause vasodilation in the periphery but do not affect the L-type channels in the myocardium so the myocardium compensates

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What are the DHPs?

Nifedipine: short-acting
Felodipine: long-acting
Amlodipine: long-acting

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What are the direct vasodilators?

Hydralazine

Minoxidil

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What two ways does hydralazine work?

) Activates Ca-activated potassium channels in SM causing hyperpolarization
) Inhibits IP3-induced Ca release from SR in SM

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How does Minoxidil work?

Activates ATP-dependent K channels causing hyperpolarization of SM cells

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What are the aldosterone antagonists?

Spironolactone

Eplerenone

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Where can the RAAS blockers block?

Renin
ACE
A-II receptor

What are the renin antagonists?

Aliskiren

What are the ACE inhibitors?

Captopril

Lisinopril

What are the A-II receptor antagonists?

Losartan

What receptor does A-II bind and work on?

AT-1 (angiotensin 2 receptor type-I) angiotensin I does not affect a receptor

What does A-II cause?

Vasoconstriction and renin formation inhibition

What does A-III cause?

Activation of aldosterone and reabsorption of Na and water

What does renin do?

Cleaves angiotensinogen to angiotensin I

Three categories of diuretics:

Potassium sparing
Thiazide
Loop diuretics

What are the potassium sparing diuretics?

Amiloride | Triamterene

What are the thiazide diuretics?

Hydrochlorothiazide

What are the loop diuretics?

Furosemide | Torsemide

What are the first three drugs to start a patient with hypertension based on their ethnicities and co-morbidities?

1. ) ACE inhibitor or A-I receptor antagonist 2. ) Calcium entry blocker 3. ) Thiazide diuretic

What antihypertensives do not work well on Africans?

ACE inhibitor or A-II | Calcium blockers

What antihypertensive do you give to Africans?

Thiazide diuretics

What second or complimentary drugs do you give as antihypertensives?

1.) Direct vasodilator/alpha-receptor blocker + diuretic or 2.) Direct vasodilator + Beta-adrenergic receptor blocker

At what blood pressure do you start antihypertensive agents?

140/90 mmHg | Unless > 60 years old then 150/90 mmHg