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Pharmacology > Drugs for hypertension: Part 3 > Flashcards

Drugs for hypertension: Part 3 Flashcards

1
Q

Centrally acting alpha 2 agonists names

A

Clonidine (Catapres), Methyldopa (Aldomet) -safe in pregnancy

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2
Q

Centrally acting alpha 2 agonists

A

Acts within the brainstem - suppresses sympathetic outflow to heart and blood vessels ( vasodilation and reduced CO)

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3
Q

Adverse effects of Centrally acting alpha 2 agonists

A

Dry mouth / sedation / sedation / fluid and sodium retention

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4
Q

Adverse effects of Clonidine

A

Rebound hypertension if abruptly discontinued

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5
Q

Adverse effects of Methyldopa

A

Hemolytic anemis and liver dysfunction

Used during pregnancy

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6
Q

Adrenergic neuron blockers names

A

Guanethidine (Ismelin), Guanadrel (Hylorel), Resperpine

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7
Q

Adrenergic neuron blockers

A

Potent
Inhibits / depletes norepinephrine
Decreases sympathetic stimulation of heart / vessels

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8
Q

Adverse effects of adrenergic neuron blockers

A

Severe orthostatic hypertension

Depression

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9
Q

Adrenergic neuron blockers are last choice agents for chronic hypertension d/t…

A

The risk of postural hypotension

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10
Q

Direct acting vasodilators

A

Reduces BP by promoting dilation of arteries

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11
Q

Why is there very little OH with direct acting vasodilators?

A

Because there is no significant dilation of arterioles

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12
Q

Adverse effects of direct acting vasodilators

A

Reflex tachycardia, renin release, fluid retention

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13
Q

Calcium channel blockers examples

A

Nifedipine (Procardia) Verapamil (Calan), Diltiazam (Cardizem)

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14
Q

Calcium channel blockers…

A

Promote dilation of arteries

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15
Q

Verapamil and Diltiazem also have..

A

Direct suppressant effects on the heart

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16
Q

Adverse affects of calcium channel blockers

A

Reflex tachycardia (less with Verapamil and Diltiazem)

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17
Q

Virapamil and Diltiazaem are used cautiously in patients with…

A

Bradycardia, heart failure or AV block

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18
Q

Nifedipine adverse effects

A

May increase mortality in patients with MI and unstable angina

19
Q

Blocking of calcium prevents…

A

Vasospasticity

20
Q

Should you see beta blockers and calcium blockers together?

A

No (too much heart suppression)

21
Q

Nifedipine is now being used to treat….

A

Pre-term labor

22
Q

ACE inhibitors examples

A

Captopril (Capoten), Enalapril (Vasotec), Lisinopril (Prinivil)

23
Q

ACE inhibitors

A

Prevent formation of angiotensin II which prevents angiotensin II - mediated vasoconstriction and aldosterone-mediated volume expansion

24
Q

What do ACE inhibitors do for DM patients with renal damage?

A

Slows kidney injury

25
Q

Adverse effects of ACE inhibitors

A

Constant irritated cough
First-dose hypotension
Angioedema
Hyperkalemia (Avoid K supplements and K sparing diuretics)

26
Q

Should ACE inhibitors be taken during pregnancy?

A

NO - reduces placental blood flow

27
Q

Angioedema

A

Swelling from the chest up - can cause trachea to swell and airway to close

28
Q

Angiotensin II receptor receptor blockers examples

A

Losartan (Cozaar), Valsartan (Diovan)

29
Q

ARBS are similar to…

A

ACE inhibitors (Newer, better version)

30
Q

ARBS

A

Prevent angiotensin II mediated vasoconstriction and release of aldosterone

31
Q

Adverse effects of ARBS

A

Dizziness / drowsiness

Angioedema

32
Q

ACE inhibitors __________ while ARBS

A

Stop the formation of angiotensin II

Blocks angiotensin from being able to act

33
Q

Treatment algorithm for HTN

A

> Lifestyle changes
Single drug
Second drug (after failure of first is assessed)

34
Q

What are the first-line drugs chosen for HTN?

A

Thiazides and beta blockers unless they are diabetic

35
Q

Dosing of HTN medication should..

A

Start low and gradually increased (after 1 year should be decreased)

36
Q

Preferred drugs for renal disease

A

ARBS, ACE inhibitors and loops

37
Q

Preferred drugs for diabetes

A

ACE inhibitors, ARBS, CCB, and diuretics

38
Q

What should be the first step for African Americans with hypertension?

A

Decreased salt in diet

39
Q

Hypertension in African Americas..

A

Develops at an earlier age and has higher mortality rates

40
Q

What drugs are less effective in African Americans?

A

Beta blockers and ACE inhibitors

41
Q

What drugs are more effective in African Americans?

A

Calcium channel blockers and alpha 2 blockers

42
Q

Pregnant women will..

A

Continue to take most hypertensive drugs that were taken prior to pregnancy

43
Q

When is drug therapy indicated during pregnancy?

A

180/110

44
Q

What drugs are contraindicated with pregnancy?

A

ACE and ARBS because they decrease placental blood flow

Pharmacology (38 decks)

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