Drugs for Hypertension (Angina)

Question 1

the 4 first line angina drugs

Answer 1

Diuretics, ACE Inhibitors, ARBs, Calcium Channel Blockers

Question 2

the 3 second line angina drugs

Answer 2

Beta Blockers, Adrenergic Agonists/Antagonists,
Vasodilators/Nitrates

Question 3

prils

Answer 3

Angiotensin converting enzyme inhibitors (ACEI)
First-line

Question 4

sartans

Answer 4

Angiotensin receptor blockers (ARBs)
First-line

Question 5

pines

Answer 5

Calcium channel blockers (CCBs)
First-line

Question 6

Thiazide

Answer 6

diuretics
First-line

Question 7

what drugs ACT ON RAAS (BLOCK ANGIOTENSIN II &
ALDOSTERONE) and REDUCE BLOOD VOLUME &
VASODILATOR

Answer 7

ACE Inhibitors
ARBs

Question 8

what drug is just a VASODILATOR

Answer 8

Calcium Channel Blockers

Question 9

what drug just REDUCEs BLOOD VOLUME

Answer 9

Thiazide Diuretics

blocks sodium and chloride reabsorption  retain water
within the nephron (not reabsorbed) so it can be excreted as urine

Question 10

what drug is BEST at reducing BP, improving HTN-related mortality, with least risk, the cheapest…should be first line therapy

Answer 10

____thiazide

Question 11

Pharmacokinetics: Thiazide Diuretics

Answer 11

• Onset: begins 1-2 hours (PO)
• Duration: 6-12 hours
• Excreted unchanged in urine

Question 12

Adverse Reactions/Side Effects/Cautions: Thiazide Diuretics

Answer 12

hypokalemia due to K+ loss
(potassium loss)
“____thiazide”

Question 13

Mechanism of Action: ACE Inhibitors

Answer 13

Reduces Angiotensin II (by inhibiting conversion of
angiotensin I) & increases bradykinin (less breakdown).
1. Arteriole vasodilation, less effect on veins
2. Reduction of blood volume through reduction in aldosterone
3. Prevent/reverse cardiac remodeling

Question 14

Pharmacokinetics: ACE Inhibitors

Answer 14

• Good oral absorption (most all PO but also IV)
• Most have long half-life (except captopril – older drug)
• Excreted by kidney: Significant drug accumulation in renal disease

Question 15

Adverse Reactions/Side Effects/Cautions: ACE Inhibitors

Answer 15

• Hypotension- syncope - most often with first dose, high BP, and dehydrated
• Cough - 5-10% (bradykinin)
• Hyperkalemia- aldosterone effects, esp combined with K-sparing drugs or K
  supplements
• Neutropenia – rare, increased with renal impairment, collagen disorders
• Angioedema rare 1%, life-threatening
• Fetal Injury DO NOT TAKE IF PREGNANT
  “___pril”