Drugs for Hypertension Flashcards
What is the initial drug of choice for stage 1 hypertension
thiazide-type diuretics
what is the BP goal fo hypertensive age >/ 60 years old with no comorbidities?
SBP < 150
DBP <90
what is the BP goal fo hypertensive with DM?
SBP <150
DBP <90
what is the BP goal fo hypertensive with CKD?
SBP <140
DBP <90
What are the acceptable oral antihypertensive agents in pregnant women?
Methyldopa
Labetalol
Nifedipine
Drug class that is effective in pre-eclamptic and non-proteinuric hypertension
labetalol
antihypertensive that can be used extensively later in pregnancy
nifedipine
What is the effective monotherapy or as add on to methyldopa in chronic hypertension in pregnancy
hydralazine
Antihypertensive drugs that are not recommended during pregnancy
ACEi and ARBs
the first line drug in hypertension
hydrochlorothiazide
[Thiazide diuretics]
____ drug that crosses the placenta causing hypokalemia, hyponatremia, hypoglycemia, jaundice, thrombocytopenia
metolazone
[Thiazide diuretics]
what are the toxic effects of thiazide diuretics?
HYPERGLUC
- Hyperglycemia
- Hyperlipidemia
- Hyperuricemia
- Hypercalcemia
[Diuretics]
Diuretics that cause K wasting are expected to cause what metabolic derangement?
HYPOKALEMIC metabolic ALKALOSIS
where K goes, H+ follows
[K sparing Diuretics]
K sparing diuretic are expected to cause what metabolic derangement?
HYPERkalemic metabolic ACIDOSIS
This drug inhibits Na/K/2Cl transporter in thick ascending limb loop of henle
furosemide
What loop diuretic is not a sulfur derivative that is not a sulfur derivative?
Ethacrynic Acid
What are the toxicities of loop diuretics?
Ototoxicity Hypokalemia Dehydration Allergy to sulfa Nephritis Gout
What are the effects of sympathoplegics in the VR, HR, contractile force, CO, and TPR?
- Decrease VR
- Decrease HR
- Decrease contractile force
- Decrease CO
- Decrease TPR
What is the antidote of clonidine?
Phentolamine
What is the major SE of clonidine?
sedation
what drug causes rebound hypertension and dry mouth?
clonidine
What drug causes hemolytic anemia (positive coombs test) as an idiosyncratic reaction?
methyldopa
What drug competitively blocks Nn nicotinic ACh receptors?
hexamethonium
What drug causes irreversible blockage of vesicular monoamine transporter?
Reserpine
This drug inhibits vesicular release of NE from the presynaptic neuron, causes psychiatric depression, suicidal ideation?
guanethidine
also used to treat benign prostatic hyperplasia
prazosin
major SE causes first dose orthostatic hypotension and lesser chance of reflex tachycardia
prazosin
___ is most selective for prostatic smooth muscle
tamsulosin
___ betablocker that reduces renin release.
Propanolol
used as maintenance for angina and post STEMI/NSTEMI cases to decrease HR and thus decrease myocardial oxygen demand
Propanolol
used in chronic heart failure to regular HR but not acute HF
propanolol
What are the drugs used to control BP in pheochromocytoma?
Phenoxybenzamine
Phentolamine
Labetalol
[Oral vasodilator]
Drug that alter intracellular Calcium
Hydralazine
[Oral vasodilator]
Drug that opens K channel leading to hyperpolarization
Minoxidil
[Oral vasodilator]
Drug that increase NO, increasing cGMP leading to vasodilation
Nitroprusside
Nitrates
[Oral vasodilator]
Calcium channel blockade
CCBs
[Oral vasodilator]
D1 receptor agonism
fenoldopam
What is the most common SE for all vasodilators?
Reflex Tachycardia
[Oral vasodilator]
Cause drug-induced lupus
hydralazine
[Oral vasodilator]
used in hypertensive urgencies among pregnant patients
hydralazine
What medications may cause drug-induced lupus?
Hydralazine
Isoniazid
Procainamide
Penicillamine
[Oral vasodilator]
require concomitant use of diuretics and beta blockers to block compensatory responses
monoxidil
[CCB]
causes gingival hyperplasia
verapamil
[CCB]
SE: constipation, pretibial edema, gingival hyperplasia
cardiac>vascular
verapamil
[CCB]
that is used for arrythmia
verapamil
What drugs can cause Gingival Hyperplasia?
Nifedipine
Cyclosporine
Phenytoin
Verapamil
[CCB]
have pro-arrythmogenic effec; cause reflex tachycardia
dihydropyridine Ca channel blocker
[Parenteral vasodilators]
Cyanide toxicity is a major side effect
nitroprusside
[Parenteral vasodilators]
both an arteriolar vasodilator and a venodilator
nitroprusside
[Parenteral vasodilators]
dopamine 1 agonist; causes arteriolar vasodilation of the afferent and efferent arterioles
used in hypertensive emergency
fenoldopam
How will you manage malignant hypertension?
Vasodilator + diuretics
Antihypertensive drug that cause cough and angioedema
ACEI
drug class that are used in post-MI infarction (slows ventricular remodeling); DM nephropathy (delays progression)
ACEi
ACEi should not be given inpatients experiencing ____
AKI
Hyperkalemia
ACEi and ARBs are not given together since it
increases the adverse reaction and increased incidence of CA
ACEi are not given to patients with bilateral renal artery stenosis since
it decreases the GFR of the stenotic kidney
This drug class delays the progression of DM nephropathy
ARB
This class can cause fetal hypotension, neonatal skull hypoplasia, anuria, renal failure, renal dysplasia
ARBs
Hyperkalemia is common in patients taking ACEi and ARBs because?
ACEi and ARBs reduce aldosterone levels and cause potassium retention
[What is the electrolyte imbalance]
peaked T waves
hyperkalemia
[What is the electrolyte imbalance]
T wave inversion
hypokalemia
[What is the electrolyte imbalance]
decreased PR interval
hypercalcemia
[What is the electrolyte imbalance]
increased PR interval
hypocalcemia
this drug inhibits renin thereby preventing conversion of angiotensinogen to angiotensin I
Aliskiren
[Kinin Inhibitor]
Selective antagonist of kinin B2 receptors
icatibant
[Kinin Inhibitor]
plasma C1 esterase inhibitor that decreases bradykinin formation
Cinryze
Berinert
[Kinin Inhibitor]
plasma kallikerin inhibitor
Ecallantide
