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Pharmacology > Cardiovascular 2 Anti-hypertensives > Flashcards

Cardiovascular 2 Anti-hypertensives Flashcards

1
Q

Drug class for Propranolol

A

sympatholytics: peripheral adrenergic ‘r’ blockers-beta blockers

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2
Q

MoA for Propranolol

A

adrenergic B1 & B2 receptor inhibitor: reduction in myocardial oxygen demand

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3
Q

Indications for Propranolol

A

angina, HTN, tachyarrhythmias, essential tremor, migraine Px, anxiety

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4
Q

SE/ADRs for Propranolol

A

fatigue, sleep disturbance, depression

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5
Q

Contra-indications for Propranolol

A

hypersensitivity, bradycardia, heart block, uncompensated HF, severe depression, bronchospasm

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6
Q

Dx-Dx interactions for Propranolol

A

ethanol (may increase or decrease conc)

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7
Q

Monitoring for Propranolol

A

BP, chest pain, HR, LFTs

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8
Q

What might Propranolol mask?

A

hypoglycemia

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9
Q

Drug class for Metoprolol

A

sympatholytics: peripheral adrenergic ‘r’ blocker-beta blocker

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10
Q

MoA for Metoprolol

A

selective B1 adrenergic receptor inhibitor

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11
Q

Indications for Metoprolol

A

angina, HTN, hemodynamically stable post MI

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12
Q

SE/ADRs for Metoprolol

A

fatigue, sleep disturbance, depression, bradycardia, rebound angina/HTN, hypotension

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13
Q

Contra-indications for Metoprolol

A

hypersensitivity, bradycardia, heart block, uncompensated heart failure, severe depression

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14
Q

Dx-Dx interactions for Metoprolol

A

multiple

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15
Q

Monitoring for Metoprolol

A

BP, HR, LFTs

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16
Q

Drug class for Atenolol

A

sympatholytics: peripheral adrenergic ‘r’ blockers-beta blockers

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17
Q

MoA for Atenolol

A

selective B1 adrenergic receptor inhibitor

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18
Q

Indications for Atenolol

A

angina, HTN, hemodynamically stable post MI

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19
Q

SE/ADRs for Atenolol

A

fatigue, sleep disturbance, depression, bradycardia, rebound angina, HTN, hypotension

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20
Q

Contra-indications for Atenolol

A

hypersensitivity bradycardia, heart block, uncompensated heart failure, severe depression

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21
Q

Dx-Dx interactions for Atenolol

A

multiple

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22
Q

Monitoring for Atenolol

A

BP, HR, eGFR

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23
Q

Drug class for Prazosin

A

alpha-blocker

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24
Q

MoA for Prazosin

A

selective alpha1 blocker which relaxes smooth muscle in arteries, veins, & prostate

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25
Q

Indications for Prazosin

A

HTN, off-label: PTSD, Raynaud’s phenomenon

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26
Q

SE/ADRs for Prazosin

A

postural hypotension, nausea, drowsiness, syncope, palpitations, dizziness, ‘floppy iris’ syndrome

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27
Q

Contra-indications for Prazosin

A

orthostatic hypotension

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28
Q

Dx-Dx interactions for Prazosin

A

PDE-5 blockers (Tadalafil), anti-hypertensive meds

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29
Q

Monitoring for Prazosin

A

BP, BUN, eGFR, syncopal episodes

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30
Q

PG category for Prazosin

A

C but avoid

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31
Q

Drug class for Carvedilol

A

B1, B2, A1 blockers

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32
Q

MoA for Carvedilol

A

mixed alpha, beta receptor inhibitor

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33
Q

Indications for Carvedilol

A

angina (off label), HTN, stable HF, stable post MI

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34
Q

SE/ADRs for Carvedilol

A

fatigue, sleep disturbance, depression, bradycardia, rebound angina/HTN, hypotension

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35
Q

Contra-indications for Carvedilol

A

hypersensitivity, bradycardia, heart block, uncompensated HF, severe depression, bronchospasm, severe liver failure

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36
Q

Dx-Dx interactions for Carvedilol

A

multiple

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37
Q

Monitoring for Carvedilol

A

BP, HR, eGFR, LFTs

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38
Q

Drug class for Clonidine

A

centrally acting A2 agonist

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39
Q

MoA for Clonidine

A

stimulates A2 receptors in brain stem which stimulates inhibitory neuron resulting in reduced sympathetic outflow from CNS which results in reduction in TPR

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40
Q

Indications for Clonidine

A

HTN (immediate release form), ADHD (extended release form), Narcotic addiction

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41
Q

SE/ADRs for Clonidine

A

bradycardia, drowsiness, HA, rash, xerostomia, weakness

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42
Q

Contra-indications for Clonidine

A

pre-existing CNS depression, severe CAD, caution in CKD, recent AMI, stroke

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43
Q

Dx-Dx interactions for Clonidine

A

meds altering AV/SA nodal function, ethanol

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44
Q

Monitoring for Clonidine

A

BP, mental status, HR

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45
Q

PG category for Clonidine

A

C but avoid

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46
Q

Drug class for Methyldopa

A

centrally acting A2 agonist

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47
Q

MoA for Methyldopa

A

central alpha-adrenergic inhibition decrease sympathetic outflow to heart, kidneys, peripheral vasculature

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48
Q

Indications for Methyldopa

A

HTN in PG

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49
Q

SE/ADRs for Methyldopa

A

depression, anxiety, dry mouth, hemolytic anemia, liver disease, edema

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50
Q

Contra-indications for Methyldopa

A

hepatic disease

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51
Q

Dx-Dx interactions for Methyldopa

A

MAO inhibitors

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52
Q

Monitoring for Methyldopa

A

LFT, CrCl, BP, eGFR

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53
Q

Drug class for Captopril, Lisinopril, Fosinopril

A

renin-angiotensin inhibitors: ACEI

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54
Q

MoA for Captopril, Lisinopril, Fosinopril

A

competitive inhibitor of ACE preventing conversion of A1 to A2, decreasing vasoconstriction by A2 & decreases aldosterone secretion

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55
Q

Indications for Captopril, Lisinopril, Fosinopril

A

HTN, HF, LV dysfunction after MI, diabetic nephropathy

56
Q

SE/ADRs for Captopril, Lisinopril, Fosinopril

A

cough, hyperkalemia, angioedema

57
Q

Contra-indications for Captopril, Lisinopril, Fosinopril

A

hx angioedema, concurrent use of Aliskerin in diabetic patients, bilateral renal artery stenosis, PG; not w/ ARBs

58
Q

Dx-Dx interactions for Captopril, Lisinopril, Fosinopril

A

don’t use w/ ARBs, Aliskerin

59
Q

Monitoring for Captopril, Lisinopril, Fosinopril

A

BP, serum, K+, eGFR, BUN, weight, CBC, liver function

60
Q

PG category for Captopril, Lisinopril, Fosinopril

A

D

61
Q

Drug class for Losartan

A

angiotensin receptor blockers: ARBs

62
Q

MoA for Losartan

A

selectively & competitively blocks AT1 & AT2

63
Q

Indications for Losartan

A

HTN, diabetic nephropathy in T2DM, stroke risk reduction in HTN, LVH

64
Q

SE/ADRs for Losartan

A

esp in people w/ T2DM: chest pain, fatigue, hypoglycemia, diarrhea, UTI; hyperkalemia

65
Q

Contra-indications for Losartan

A

not w/ Aliskerin or ACE inhibitors

66
Q

Dx-Dx for Losartan

A

multiple (see contra-indications)

67
Q

Monitoring for Losartan

A

BP, K+, eGFR, BUN, CBC, HR, wt

68
Q

PG category for Losartan

A

do not use

69
Q

What does Losartan increase the excretion of?

A

uric acid

70
Q

Drug class for Aliskirin

A

direct renin inhibitor

71
Q

MoA for Aliskirin

A

direct rening inhibitor that prevents conversion of angiotensinogen to AT1 which reduces conversion to AT2 producing arteriolar vasodilation

72
Q

Indications for Aliskirin

A

HTN

73
Q

SE/ADRs for Aliskirin

A

hyperkalemia, hypotension

74
Q

Contra-indications for Aliskirin

A

don’t use w/ ACEI’s or ARB’s, hereditary or prior angioedema, concomitant use w/ Itraconazole

75
Q

Dx-Dx interactions for Aliskirin

A

decrease effect of Furosemide, NSAIDs decrease effect of Aliskirin, not w/ grapefruit juice

76
Q

Monitoring for Aliskirin

A

BP, serum K+, BUN, serum creatinine

77
Q

PG category for Aliskirin

A

PG D

78
Q

Drug class for Amlodipine

A

vasodilator: CCB DHP

79
Q

MoA for Amlodipine

A

vasodilation due to blocking Ca channels in vascular smooth muscle & myocardium

80
Q

Indications for Amlodipine

A

angina (chronic stable & vasospastic), HTN

81
Q

SE/ADRs for Amlodipine

A

nausea, palpitations, peripheral edema, elderly-hypotension

82
Q

Contra-indications for Amlodipine

A

hypersensitivity

83
Q

Dx-Dx interactions for Amlodipine

A

grapefruit juice

84
Q

Monitoring for Amlodipine

A

BP, chest pain

85
Q

Drug class for Nifedipine

A

vasodilator: CCB DHP

86
Q

MoA for Nifedipine

A

vasodilation due to blocking Ca channels in vascular smooth muscle & myocardium

87
Q

Indications for Nifedipine

A

angina (chronic stable & vasospastic), HTN

88
Q

SE/ADRs for Nifedipine

A

nausea, HA, palpitations, peripheral edema, elderly-hypotension

89
Q

Contra-indications for Nifedipine

A

hypersensitivity

90
Q

Dx-Dx interactions for Nifedipine

A

grapefruit juice

91
Q

Monitoring for Nifedipine

A

BP, chest pain

92
Q

Drug class for Diltiazem

A

vasodilators: CCB NDHP

93
Q

MoA for Diltiazem

A

dilate coronary arteries & decrease myocardial oxygen demands

94
Q

Indications for Diltiazem

A

angina, HTN, A fib, A flutter, PSVT

95
Q

SE/ADRs for Diltiazem

A

edema, HA, dyspepsia

96
Q

Contra-indications for Diltiazem

A

bradycardia, SSS if no pacer

97
Q

Dx-Dx interactions for Diltiazem

A

grapefruit juice

98
Q

Monitoring for Diltiazem

A

BP, chest pain, LFTs

99
Q

Drug class for Verapamil

A

vasodilators: CCB NDHP

100
Q

MoA for Verapamil

A

dilate coronary arteries & decrease myocardial oxygen demands

101
Q

Indications for Verapamil

A

angina, HTN, A fib, A flutter, PSVT

102
Q

SE/ADRs for Verapamil

A

HA, gingival hyperplasia, constipation, fatigue

103
Q

Contra-indications for Verapamil

A

bradycardia, SSS if no pacer

104
Q

Dx-Dx interactions for Verapamil

A

grapefruit juice

105
Q

Monitoring for Verapamil

A

BP, chest pain, LFTs

106
Q

NDHP CCBs (Diltiazem & Verapamil) should not be used in combo with?

A

beta blockers

107
Q

Drug class for Hydralazine

A

vasodilator: direct acting

108
Q

MoA for Hydralazine

A

direct acting arteriolar vasodilator

109
Q

Indications for Hydralazine

A

urgent to emergent BP reduction; preclampsia & eclampsia

110
Q

SE/ADRs for Hydralazine

A

angina, orthostatic hypotension, depression, peripheral neuritis, SLE-like syndrome

111
Q

Contra-indications for Hydralazine

A

mitral valve rheumatic heart disease, CAD

112
Q

Dx-Dx interactions for Hydralazine

A

anti-hypertensive meds

113
Q

Monitoring for Hydralazine

A

BP, HR, CBC, ANA

114
Q

PG category for Hydralazine

A

PG C but avoid if possible

115
Q

Drug class for HCTZ

A

diuretics: thiazides

116
Q

MoA for HCTZ

A

Na-Cl symporter inhibition in DCT increasing Na & Cl excretion max 5% of filtered NaCl

117
Q

Indications for HCTZ

A

HTN, edema in nephrotic syndrome, lithium induced diabetes insipidus (off label)

118
Q

SE/ADRs for HCTZ

A

rare vertigo, anorexia, nausea, photosensitivity, QT prolongation, hypokalemia

119
Q

Contra-indications for HCTZ

A

sulfa sensitivity, hypersensitivity

120
Q

Dx-Dx interactions for HCTZ

A

beta blockers increase risk of hyperglycemia, may decrease renal excretion Li; NSAIDs

121
Q

Monitoring for HCTZ

A

serum K+, glucose, BP

122
Q

Drug class for Chlorthalidone

A

diuretics: ‘thiazide-like’

123
Q

MoA for Chlorthalidone

A

Na-Cl symporter inhibition in DCT increasing Na & Cl excretion max 5% of filtered NaCl

124
Q

Indications for Chlorthalidone

A

HTN, edema in nephrotic syndrome, lithium induced diabetes insipidus (off label)

125
Q

SE/ADRs for Chlorthalidone

A

rare vertigo, anorexia, nausea, photosensitivity; QT prolongation, hypokalemia

126
Q

Contra-indications for Chlorthalidone

A

sulfa sensitivity, hypersensitivity

127
Q

Dx-Dx interactions for Chlorthalidone

A

beta blockers increase risk of hyperglycemia, may decrease renal excretion Li; NSAIDs

128
Q

Monitoring for Chlorthalidone

A

serum K+, glucose, BP

129
Q

Drug class for Triamterene

A

diuretic adjunct: K+ sparing

130
Q

MoA for Triamterene

A

direct inhibitor of Na influx in DCT & CCT

131
Q

Indications for Triamterene

A

hypokalemia

132
Q

SE/ADRs for Triamterene

A

hypotension, edema, constipation, dyspnea, hyperkalemia

133
Q

Contra-indications for Triamterene

A

hypersensitivity, hyperkalemia

134
Q

Dx-Dx interactions for Triamterene

A

other K+ retaining drugs

135
Q

Monitoring for Triamterene

A

serum electrolytes, CrCl, BUN

Pharmacology (16 decks)

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