Drugs For Hypertension and Angina Flashcards
Cause powerful diuresis and increased calcium excretion
Furosemide
Bumetanide
Torsemide
Ethacrynic acid
Drugs used for HTN in pregnancy
MeHyNiLa Methyldopa Hydralazine Nifedipine Labetalol
MOA of reserpine
Irreversibly blocks the vesicular monoamine transporter (VMAT)
The primary action for HTN of nonselective beta blockers
Reduces renin release (B1)
Cause moderate diuresis and reduced excretion of calcium
Thiazides
Has combined alpha and beta blockade (may be used in pheochromocytoma)
Labetalol
MOA of hydralazine
Releases nitric oxide from endothelial cells; Alters intracellular Ca metabolism; relaxes arteriolar smooth muscle, causing vasodilation; decreases afterload
SE of hydralazine
Reflex tachycardia
Drug-induced lupus
Drugs which can cause drug-induced lupus
Hydralazine
Isoniazid
Procainamide
Penicillamine
Used for alopecia
Minoxidil
Causes first dose orthostatic hypotension
Alpha 1-selective blockers:
Prazosin, etc
MOA of Minoxidil
A potassium channel opener that hyperpolarizes and relaxes vascular smooth muscle; causes hirsutism
MOA of minoxidil
Opens K channels in vascular smooth muscle, causing hyperpolarization, muscle relaxation, and vasodilation
Non-dihydropyridine CCBs (cardiac > vascular)
Verapamil
Diltiazem
Dihydropyridine CCBs (vascular > cardiac)
Nifedipine Amlodipine Felodipine Nicardipine Nisoldipine
Used for the OPD management of SVT
Verapamil
MOA of nitroprusside
Releases nitric oxide which stimulates guanylyl cyclase that increases cGMP in smooth muscles; Relaxes venous and arteriolar smooth muscle (decreases both preload and afterload)
SE of nitroprusside
Hypotension
Headache
Cyanide toxicity
MOA of fenoldopam
Dopamine 1 agonist; Causes arteriolar vasodilation of the afferent and efferent arterioles; increases renal blood flow
Used for performance anxiety
Propranolol
Used for hypertensive emergency
Nitroprusside
Fenoldopam
Teratogen: causes renal agenesis
ACEIs
Delays progression of DM nephropathy
ACEIs
ARBs
MOA of aliskiren
Inhibits renin; prevents conversion of angiotensinogen to angiotensin 1
Drugs for malignant HTN
Vasodilators
Diuretics
Beta blockers
Slows ventricular remodeling and increases survival in heart failure;
Delays progression of DM nephropathy
ACEIs and ARBs
CCB which can also be used for SVT
Verapamil
Diltiazem
Drugs which can cause gingival hyperplasia
Nifedipine
Cyclosporine
Phenytoin
Verapamil
Ultrashort-acting nitrate used for the management of cyanide poisoning
Amyl nitrite
Which portion of the electron transport chain is affected by cyanide?
Complex IV (cytochrome oxidase)
Associated with occupational exposure to nitrates
Monday disease
Antidote for cyanide poisoning
Inhaled amyl nitrite +
IV Na Nitrite +
IV Na Thiosulfate
MOA of nitroglycerine
Releases NO, increases cGMP, and relaxes smooth muscles, especially vascular
Contraindicated in heart failure
Non-dihydropyridine CCB:
Verapamil
Diltiazem
Can be used for Raynaud’s phenomenon
Diltiazem
MOA of trimetazidine
Improves glucose utilization through FA metabolism; prevents decrease in ATP in hypoxic/ischemic tissue
MOA of ivabradine
Increases funny Na current in SA node
Used for angina prophylaxis; masks hypoglycemia in DM patients
Propranolol
Causes reflex increase in HR and contractility and reflex decrease in ejection time
Nitrates
Cause increased end-diastolic pressure and ejection time
BB or CCB
MOA of clonidine
Agonist at alpha 2 receptors; in CNS this results in decreased SANS outflow
SE of clonidine
Sedation; severe rebound HTN if suddenly stopped
How do you control rebound HTN caused by clonidine?
Reinstitution of clonidine therapy or administration of alpha blockers such as phentolamine
First line treatment for hypertension
Thiazides:
Hydrochlorothiazide
Chlorthalidone
Indapamide
MOA of methyldopa
Prodrug converted to methylnorepinephrine in CNS, with result like clonidine
SE of methyldopa
Sedation; induces hemolytic antibodies
Toxicities of CCBs
Excessive cardiac depression; constipation
Anti HTN drugs which are contraindicated in pregnancy
ACEIs and ARBs
How do you control severe tachycardia caused by minoxidil
Give Beta blockers
Which among the HTN drugs cause tachycardia?
Vasodilators
Which among the anti-HTN drugs cause postural (orthostatic) hypotension?
Alpha-blockers (alpha receptor activation prevents venous pooling
How do you relieve cough caused by ACEIs?
Give aspirin
MOA of diazoxide
Potassium channel opener in smooth muscle, secretory cells; used for hypertensive emergencies and insulinoma
