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Olsen Pharm exam 3 > Blood pressure medication > Flashcards

Blood pressure medication Flashcards

1
Q

Angiotensin converting enzyme (ACE) Inhibitor

A

Captopril

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2
Q

Actions of captopril

A

Blocks ACE from converting angiotensin I to angiotensin II, leading to a decrease in blood pressure, decrease in aldosterone production, and a small increase in serum potassium levels, along with sodium and fluid loss.

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3
Q

Indications for captopril

A

treatment of HTN, HF diabetic nephropathy and left ventricular dysfunction after an MI.

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4
Q

pharmockinetics of captopril

A

Route- oral
Onset- 15 min
Peak 30-90 min
T1/2 2hrs; excreted in urine, widely distributed, well absorbed and metabolized in the liver.

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5
Q

Adverse effects of captopril

A

tacycardia, MI, rash, pruritus, gastric irritation, aphthous ulcers (don’t eat gluten), peptic ulcers, dysgeusia, proteinuria, bone marrow suppression, cough.

Related to the effects of vasodilatation and alterations in blood flow.

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6
Q

Contraindications and cautions for captorpil

A

Contra- allergies, impaired renal function, pregnancy and lactation.

Caution- CHF

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7
Q

D-2-D for captorpil

A

allopurinol

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8
Q

Angiotnesin II Receptor blockers

A

Losartan

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9
Q

Actions of losartan

A

Selectively blocks the binding of angiotensin II to specific tissue receptors found in the vascular smooth muscle and adrenal glands; blocks the vasoconstriction and release of aldosterone associated with the renin- angiotensin- aldosterone system.

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10
Q

Indications for losartan

A

Alone or as part of combination therapy for the treatment of hypertension; treatment of diabetic nephropathy with an elevated serum creatinine and proteinuria in pts with DM II and HTN.

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11
Q

Pharmacokinetics for losartan

A 
Route- oral
Onset- varies
Peak 1-3 h
Duration- 24h
T 1/2- 2h than 6-9 hrs; metabolized in the liver and excreted in urine and feces.
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12
Q

Adverse effects for losartan

A

dizziness, HA, syncope, weakness, diarrhea, abdominal pain, symptoms of URTI, cough, back pain, fever, muscle weakness, hypotension. skin rash or dry skin
**(ARB will be given if ACE is causing a cough)

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13
Q

C &C for losartan

A

Contra- allergy, pregnancy and lactation

caution- hepatic or renal dysfunction and hypovolemia

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14
Q

D-2-D for losartan

A

phenobarbital

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15
Q

Calcium Channel Blockers

A

Diltiazem

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16
Q

Actions of diltiazem

A

inhibits the movement of calcium ions across the membranes of cardiac and arterial muscle cells, depressing the impulse ad leading to slowed conduction, decreased myocardial contractility and dilation of arterioles, which lowers blood pressure and decrease myocardial oxygen consumption.

17
Q

Indications for diltiazem

A

treatment of essential HTN in the extended-release form.

18
Q

Pharmacokinetics for diltiazem

A 
Route- oral ER
Onset 30-60min
Peak 6-11 h
Duration- 12 h
T1/2- 5-7 hrs; metabolized in liver and excreted in urine. Well absorbed.
19
Q

Adverse effects for diltiazem

A

dizziness, LH, HA, peripheral edema, bradycardia, AV block, flushing nausea.
Related to effects on cardiac output. GI symptoms, Cardiovascular symptoms.

20
Q

C &C for diltiazem

A

Contra- allergy, heart block or sick sinus syndrome, renal or hepatic dysfunction, pregnancy and lactation.

21
Q

D-2-D for diltiazem

A

Cyclosporine

22
Q

Vasodilators

A

Nitroprusside (Nitropress)

23
Q

Actions for nitroprusside

A

acts directly on vascular smooth muscle to cause vasodilation and drop of BP; does not inhibit cardiovascular reflexes and tachycardia; renin release will occur.

24
Q

Indications for nitroprusside

A

Sever hypertension, maintenance of controlled hypotension during anesthesia, acute HF.

25
Q

Pharmacokinetics for nitroprusside

A 
Route-IV
Onset- 1-2 min
Peak-  Rapid
Duration- 1-10min
T1/2- 2 min; metabolized in the liver and excreted in urine. rapidly absorbed and widely distributed.
26
Q

Adverse effects of nitroprusside

A

Apprehension, HA, retrosternal pressure, palpiations, cyanide, toxicity, diaphoresis, N/V, abd pain, irritation at the injection site.
**very potent and you need to worry about cyanide poisoning.

27
Q

C & C for nitroprusside

A

Caution- peripheral vascular disease, CAD, CHF, or tachycardia

28
Q

D-2-D for nitroprusside/ vasodialors

A

Based on individual drug

29
Q

Various vasodilators

A

Diazoxide (Hyperstat)- IV for hospitalized pts w/ severe HTN; increases blood glucose levels.

Hydralazine (Apresoline)- Maintains increase renal blood flow.

Minoxidil (Loniten)- Used only for sever and unresponsive HTN

Nitroprusside (Nitropress)- used for HTN crisis; maintain hypotension during surgery

30
Q

Alpha-specific adrenergic agent

A

Midodrine

31
Q

Action of midodrine

A

Activates alpha-receptors in arteries and veins produce and increase in vascular tone and increase in blood pressure.

32
Q

Indications for midodrine

A

symptomatic treatment of orthostatic hypotension.

33
Q

Pharmacokinetics for midodrine

A

absorbed from GI tract, metabolized in the liver, and excreted in urine.

34
Q

C &C for midodrine

A

Contra- supine hypertension, CAD, pheochromcytoma, and urinary retention.

Caution- pregnancy and lactation, visual problems

35
Q

Adverse effects of midodrine

A

related to stimulation of alpha-receptors

36
Q

D-2-D of midodrine

A

cardiac glycosides, beta blockers, alpha-adrenergic agents and corticosteroids.

37
Q

Beta blockers

A

Lead to a decrease in HR and strength of contraction as well as vasodilatation.
Labetalol (Normodyne, Trandate)- blocks alpha and beta receptors to lower BP w/o tachycardia or decreased renin levels.
other - carvediol (Coreg)- CHF and HTN
guanadrel (Hylorel)- HTN if not responding to thiazide diuretics.
guanethidine (Ismelin)- HTN and renal hypertension.

Propanolol (Inderal)- blocks beta adrenergic receptors in SNS causing decreased HR, BP, decreased arrhythmias and decreased renin.
AE- brady, CHF, arrhytmias, CVA, Pulmonary edema, impotence, fatigue, bronchospasm.
C &C- allergy, brady, heart blocks, shock, CHF, bronchospams, COPD, asthma, Caution DM, hepatic dysfunction.
D2D- clonidine, NSAIDS, epi, insulin

Atenolol (Tenormin)- does not usually block beta 2- receptor sites including sympathetic bronchodilation. Used to treat HTN, angine and some cardiac arrhythmias in pts with COPD, asthma, rhinitis.

38
Q

Diuretic

A

Thiazide diuretics- Hydrochlorothiazide (HydroDIURIL). First line treatment for HTN.
Actions- Inhibits reabsorption of Na and Cl in distal renal tubles increasing the excretion of Na, Cl and H2O.

Decrease serum sodium levels and blood volume.

Olsen Pharm exam 3 (5 decks)

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