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PLE Reviewer - PHARMACOLOGY > Drugs for Hypertension > Flashcards

Drugs for Hypertension Flashcards

1
Q

JNC7 blood pressure goals for:

  • no comorbidities?
  • diabetes mellitus?
  • chronic kidney disease?
A

JNC7 blood pressure goals:

  • no comorbidities: < 140/90
  • diabetes mellitus: <130/80
  • chronic kidney disease: <130/80
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2
Q

JNC8 blood pressure goals for:

  • no comorbidities?
  • diabetes mellitus?
  • chronic kidney disease?
A

JNC8 blood pressure goals:

  • no comorbidities: < 150/90
  • diabetes mellitus: <140/80
  • chronic kidney disease: <140/80
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3
Q

Class: thiazide (sulfur-containing) diuretic

MOA: inhibits the Na/Cl transporter in the DCT, MODERATE diuresis, reduced Ca excretion

Uses: HTN (FIRST LINE), HF, hypercalcuria, renal calcium stones, nephrogenic diabetis insipidus

SE: hypokalemic metabolic alkalosis, dilutional hyponatremia, potassium wasting, hyperglycemia, hyperlipidemia, hyperuricemia, sulfa allergy, hypercalcemia, “hyperGLUC”

Similar:
CHLORTHALIDONE
INDAPAMIDE
METOLAZONE

A

HYDROCHLOROTHIAZIDE

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4
Q

Class: loop diuretic (sulfur-derivative)

MOA: inhibits the Na/K/2Cl transporter in the TAL of the loop of Henle, POWERFUL diuresis, increased Ca excretion

Uses: HF, pulmonary edema, HTN, hypercalcemia, acute renal failure, anion overdose

SE: hypokalemic metabolic alkalosis, potassium wasting, dehydration, ototoxicity, hyperuricemia, hypomagnesemia, nephritis

Similar:
BUMETANIDE - sulfur derivative
TORSEMIDE - sulfur derivative
ETHACRYNIC ACID

A

FUROSEMIDE

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5
Q

Class: CNS sympathetic outflow blocker (sympathomimetic), alpha-2-agonist

MOA: selectively activates alpha-2 receptors, decreases central sympathetic outflow

Uses: HTN, cancer pain, opioid withdrawal

SE: sedation, rebound hypertension (treated with PHENTOLAMINE, avoided via tapering), dry mouth

A

CLONIDINE

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6
Q

Class: CNS sympathetic outflow blocker (sympathomimetic), alpha-2-agonist

MOA: selectively activates alpha-2 receptors, decreases central sympathetic outflow

Uses: pre-eclampsia

SE: sedation, hemolytic anemia (idiosyncratic positive Coomb’s test)

Similar:
GUANABENZ
GUANFACINE

A

METHYLDOPA

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7
Q

Class: ganglionic (Nn) blocker

MOA: competitively blocks Nn ACh receptors

Uses: hypertensive emergencies, HTN (obsolete)

SE: postural hypotension, dry mouth, BOV, constipation, sexual dysfunction

Similar:
TRIMETHAPHAN
MECAMYLAMINE

A

HEXAMETHONIUM

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8
Q

Class: nerve terminal blocker

MOA: irreversibly blocks vesicular monoamine transporter (VMAT)

Uses: HTN (obsolete)

SE: sedation, severe psychiatric depression, suicidal ideation

A

RESERPINE

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9
Q

Class: nerve terminal blocker

MOA: inhibit vesicular release of NE from presynaptic neuron

Uses: HTN (obsolete)

SE: sedation, severe psychiatric depression, suicidal ideation

A

GUANETHIDINE

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10
Q

Class: alpha-1 blocker

MOA: selelctively blocks alpha-1 receptors

Uses: BPH, HTN

SE: first dose orthostatic hypotension, reflex tachycardia (less)

Similar:
DOXAZOSIN
TERAZOSIN
TAMSULOSIN - most selective for prostatic smooth muscle
SILODOSIN
ALFUZOSIN
A

PRAZOSIN

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11
Q

Class: non-selective beta-blocker

MOA: blocks beta-1 and beta-2 receptors, blocks sympathetic effects on the heart and BP, reduces renin release

Uses: angina prophylaxis, HTN, arrhythmias, migraine, performance anxiety, hyperthyroidism

SE: bronchospasm, AV block, HF, CNS sedation, erectile dysfunction; masks symptoms of hypoglycemia in diabetics

Similar:
PINDOLOL
TIMOLOL
LABETALOL - combines alpha- and beta-blocker
CARVEDILOL - combined alpha- and beta-blocker
NADOLOL
LEVOBUNOLOL
METIPRANOLOL
A

PROPANOLOL

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12
Q

Class: vasodilator

MOA: alters intracellular Ca metabolism, relaxes arteriolar smooth muscle, causing vasodilation, decreases afterload

Uses: HTN, HF (in combination with ISDN, more effective than ACE-inhibitors in blacks), pre-eclampsia

SE: edema, reflex tachycardia, myocardial ischemia, drug-induced lupus

A

HYDRAZALINE

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13
Q

Class: vasodilator

MOA: opens K channels in vascular smooth muscle, causing hyperpolarization, muscle relaxation and vasodilation; (also stimulates hair follicles/telogen phase to differentiate into growth follicles/anagen phase)

Uses: HTN, alopecia

SE: edema, reflex tachycardia, angina, pericarditis, pulmonary HTN, hypertrichosis

Similar:
DIAZOXIDE

A

MINOXIDIL

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14
Q

4 drugs that can commonly cause lupus

A

HYDRALAZINE
ISONIAZID
PROCAINAMIDE
PENICILLAMINE - used for Wilson’s disease and copper intoxication

mnemonic: it’s HIPP to have Lupus!

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15
Q

Class: non-dihydropyridine Ca channel blocker

MOA: blocks voltage-gated L-type Ca channels (cardiac > vascular)

Uses: angina, HTN, SVT, migraine

SE: constipation, pretibial edema, flushing, dizziness, gingival hyperplasia, HF, AV block, sinus node depression

Similar:
DILTIAZEM

A

VERAPAMIL

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16
Q

Class: dihydropyridine Ca channel blocker

MOA: blocks voltage-gated L-type Ca channels (cardiac > vascular)

Uses: angina, HTN

SE: constipation, pretibial edema, nausea, flushing, dizziness

Similar:
AMLODIPINE
FELODIPINE
NICARDIPINE
NISOLDIPINE
CLEVIDIPINE
ISRADIPINE
A

NIFEDIPINE

17
Q

Class: vasodilator (cyanide-containing)

MOA: relaxes venous and arteriolar smooth muscle by increasing cGMP

Uses: hypertensive emergencies, acute HF, cardiogenic shock, controlled hypotension

SE: hypotension, headache, CYANIDE TOXICITY

A

NITROPRUSSIDE

18
Q

Class: dopamine agonist (D1 agonist)

MOA: arteriolar vasodilation of the afferent and efferent, increases renal blood flow

Uses: hypertensive emergencies

SE: hypotension, hypokalemia

A

FENOLDOPAM

19
Q

Drug(s) of choice for HF

A

ACE-inhibitors

angiotensin receptor blockers (ARBs)

20
Q

Class: ACE-inhibitor

MOA: inhibits angiotensin-converting enzyme and formation of angiotensin II, decreases aldosterone secretion

Uses: HTN, HF, post-myocardial infarction, diabetic nephropathy

SE: cough, taste disturbance, angioedema, hypotension, teratogenesis, hyperkalemia (reduce aldosterone levels and cause K retention); slows ventricular remodeling, increases survival in HF; delays progression of diabetic nephropathy (decreases albumin exretion and slows progression from mirco- to macro-albuminuria, “renoprotective effect”)

Similar:
ENALAPRIL
BENAZEPRIL
FOSINOPRIL
LISINOPRIL
QUINAPRIL
RAMIPRIL
TRANDOLAPRIL
MOEXIPRIL
PERINDOPRIL
A

CAPTOPRIL

21
Q

Class: ARB

MOA: blocks angiotensin receptors (AT1 receptors) in vascular smooth muscle and adrenal cortex, decreases aldosterone secretion

Uses: HTN, HF, diabetic nephropathy

SE: hypotension, teratogenesis, hyperkalemia (reduce aldosterone levels and cause K retention); slows ventricular remodeling, increases survival in HF; delays progression of diabetic nephropathy

Similar:
CANDESARTAN
VALSARTAN
IRBESARTAN
EPROSARTAN
TELMISARTAN
AZILSARTAN
OLMESARTAN
VALSARTAN
A

LOSARTAN

22
Q

Class: renin antagonist

MOA: inhibits renin, prevents conversion of angiotensinogen to angiotensin I

Uses: HTN

SE: headache, diarrhea, angioedema, renal impairment

A

ALISKIREN

23
Q

An accelerated form of severe HTN associated with rising blood pressure and rapidly progressing end-organ disease

A

malignant hypertension

24
Q

BP target of malignant hypertension

A

140-160/90-110

25
Q

Treatment of malignant hypertension

A

combination:

  • powerful vasodilator (nitroprusside, fenoldopam, diazoxide)
  • diuretic (furosemide)
  • beta-blockers

PLE Reviewer - PHARMACOLOGY (6 decks)

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