Chapter 25 Antihypertensive Drugs

Question 1

Centrally acting A2 receptor agonists

Answer 1

• Clonidine
• Stimulates A2 adrenergic receptors in the brain
• Decreases NE production and results in decreased BP

Question 2

Peripherally acting A1 receptor blockers

Answer 2

• Prazosin
• Block A1 adrenergic receptors
• Results in decreased BP

Question 3

Peripherally acting dual A1 and B receptor blockers

Answer 3

• Carvedilol
• Reduction in HR from the B1 blockage
• Vasodilation from the A1 receptor blockage
• Decreased BP

Question 4

Beta Blockers

Answer 4

• Reduce BP by reducing HR through blockage of B1 adrenergic receptors
• suffix is olol

Question 5

Adrenergic drugs

Answer 5

• Adverse effects: orthostatic hypotension, syncope, headaches, nausea, constipation, drowsiness
• Asthma and glucose metabolism issues with B blocker combinations
• Interact with CNS depressants (alcohol, benzodiazepines, opioids)

Question 6

ACE Inhibitors

Answer 6

• captopril and enalapril
• suffix pril
• May be in combination with a thiazide diuretic (coversyl)
• block angiotensin converting enzyme
• Cardiovascular effects: prevents the breakdown of bradykin and substance P (potent vasodilators) which decreases SVR/afterload which decreases BP
• Renal effects: prevents NA+ and H20 reabsorption by inhibiting aldosterone
• Adverse effects: headache, dizziness, mood changes, hyperkalemia, dry non productive cough, angioedema (bradykin)
• Contraindicated in pregnancy
• Catopril and lisinopril are not prodrugs so they should not be used in a patient with liver dysfunction
• Interactions: NSAIDS reduce effect, lithium toxicity

Question 7

ARBs

Answer 7

• Angiotensin 2 receptor blockers
• Block vasoconstriction and the release of aldosterone which decreases SRV/afterload
• Do not cause a dry cough
• losartan
• suffix rtan
• Adverse effects: respiratory infections, headache, dizziness, diarrhea
• Interactions: lithium toxicity, phenobarbital decrease effect

Question 8

Vasodilators

Answer 8

• Directly relax arteriolar and venous smooth muscles
• hydralazine hydrochloride, minodixil, nitroprusside
• Adverse effects: dizziness, headache, anxiety, hypotension,