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Maddy - CPR II - some pharm > Drugs for Hypertension > Flashcards

Drugs for Hypertension Flashcards

1
Q

MOA prazosin

A

alpha 1 antagonist

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2
Q

effects prazosin

A

vasodilation of veins and arterioles leading to decrease in overall PVR and BP

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3
Q

clinical app prazosin

A

tx HTN
- late choice in JNC8 due to ALLHAT data showing increase likelihood of stroke and CHF w/ doxazosin in comparison to chlothalidone

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4
Q

toxicities prazosin

A

palpitations, edema, orthostatic hypotension, syncope

  • dizziness, HA, drowsiness, depression, nervousness
  • decreased energy, weakness
  • nausea, diarrhea, constipation
  • urinary frequency, retrograde ejaculation
  • blurred vision
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5
Q

tamsulosin, terazosin (doxazosin) MOA

A

similar to prazosin but differ w/ respect to a1a, a1b, and a1d subtype selectivity

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6
Q

clinical app tamsulosin, terazosin (doxazosin)

A

help kidney stones pass

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7
Q

MOA clonidine

A

alpha 2 agonist

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8
Q

effects clonidine

A
  • transient increase in BP at first
  • reduce sympathetic outflow –> decrease in PVR, renal vascular resistance, HR, and BP
  • pain relief
  • benefits in ADHD
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9
Q

clinical app clonidine

A
  • tx for hypertension
  • tx of ADHD
  • pain relief for CA pts
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10
Q

toxicities of clonidine

A
  • drowsiness
  • HA, fatigue, dizziness, behavioral changes
  • xerostomia
  • REBOUND HTN IF DOSE IS MISSED
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11
Q

MOA a-methyldopa

A

alpha 2 agonist

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12
Q

effects a-methyldopa

A

sympatholytic for HTN due to reduced sympathetic outflow

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13
Q

clinical app a-methyldopa

A

management of severe hypertension

- drug of choice for gestational hypertension

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14
Q

toxicities a-methyldopa

A
  • angina pectoris aggravation
  • bradycardia, HF, orthostatic hypotension
  • bell’s palsy
  • positive Coombs test
  • SLE-like syndrome
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15
Q

why are B-blockers contraindicated in peripheral vascular dz

A

they cause cold extremities especially in infants

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16
Q

MOA atenolol

A

B1 selective antagonist

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17
Q

what beta blocker has the highest beta 1 selectivity

A

bisoprolol

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18
Q

MOA captopril

A

competitive ACE inhibitor

19
Q

effects captopril

A

prevents conversion of angiotensin I to angiotensin II, blocking vasoconstriction

  • decreases plasma renin and increases aldosterone
  • lowers BP
20
Q

clinical app captopril

A

HTN

- HF with reduced EF

21
Q

toxicities captoptil

A
  • cough

- angioedema

22
Q

describe enalapril

A

an ACEI that is a prodrug with an active form available for IV

23
Q

MOA losartan

A

nonpeptide angiotensin II receptor antagonist with selectivity for AT1

24
Q

effects losartan

A

blocks vasoconstrictor and aldosterone-secreting effects of angiotensin II
- induces complete inhibition of RAAS compared to ACEI

25
Q

clinical app losartan

A
  • diabetic nephropathy

- HTN

26
Q

toxicities of losartan

A
  • adverse effects more common in those w/ diabetic nephropathy
  • hypotension
  • cough but less than ACEI
27
Q

noteworthy about valsartan

A

not a prodrug requiring activation

28
Q

noteworthy about candesartan

A

relatively irreversibly binds

29
Q

MOA aliskiren

A

direct renin inhibitor

30
Q

effects aliskiren

A

decreases formation of angiotensin II

31
Q

clinical app aliskiren

A

tx HTN alone or in combo w/ other antihypertensive drug

32
Q

toxicities aliskiren

A

few (~1%)

  • skin rash
  • diarrhea
  • cough
33
Q

MOA hydralazine

A

direct vasodilation of arterioles

34
Q

effects hydralazine

A

decreases systemic resistance

35
Q

clinical app hydralazine

A

hypertensive emergency in pregnancy

36
Q

toxicities hydralazine

A

drug-induced lupus like syndrome

- toxicities in every body system

37
Q

MOA nitroprusside

A

causes peripheral vasodilation by direct action on venous and arteriolar smooth m.

38
Q

effects nitroprusside

A
  • reduces peripheral vascular resistance

- will increase CO by decreasing afterload

39
Q

clinical app nitroprusside

A

HTN

- acute decompensated heart failure

40
Q

toxicities of nitroprusside

A

toxicities in every body system

41
Q

MOA minoxidil

A

produces vasodilation by directly relaxing arteriolar smooth m

42
Q

effects minoxidil

A

lowers arteriolar vascular resistance

43
Q

clinical app minoxidil

A
  • HTN that is symptomatic or associated w/ target organ damage
44
Q

toxicities of minoxidil

A

toxicities in every body system

Maddy - CPR II - some pharm (18 decks)

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