Drugs Used to Treat HTN Flashcards

1
Q

Why is chlorthalidone a preferred thiazide diuretic?

A

–prolonged half-life (50hrs)

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2
Q

Is chlorthalidone a K+ sparing or a K+ losing diuretic?

A

K+ losing, b/c it acts in the distal tubule which is upstream from the Na+/K+ ATP-ase in the collecting duct

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3
Q

What is the mechanism of action of chlorthalidone?

A

–blocks the Na+/Cl- cotransporter in the distal tubule, (thus inhibiting Na+ reabsorption back into the body)

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4
Q

What is the mechanism of action of amiloride and triamterene?

A

-blocks ENaC

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5
Q

Are triamterene and amiloride K+ sparing or K+ losing diuretics?

A

K+ sparing

-thus can be considered for use in pt’s w/ hypokalemia who are on thiazide monotherapy

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6
Q

Can you use K+ sparing diuretics in pt’s with kidney disease?

A

No, do NOT use in pt’s with a GFR < 45 mL/min

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7
Q

What is the mechanism of action of HCTZ?

A

-blocks Na+/Cl- cotransporter in the DCT

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8
Q

Is HCTZ K+ losing or K+ sparing?

A

K+ losing, because it works upstream from the Na+/K+ pump in the collecting duct

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9
Q

Can HCTZ be used in pt’s with a low GFR?

A

No

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10
Q

What is a use for HCTZ in regards to calcium?

A

-Tx of calcium nephrolithiasis

  • -d/t calcium being actively reabsorbed from the DCT
  • -thus, it may cause hypercalcemia
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11
Q

What are some side effects of HCTZ?

A
  • hypokalemia
  • hypomagnesemia
  • hyponatremia
  • hypochloremic metabolic alkalosis
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12
Q

Is HCTZ a sulfa drug?

A

Yes

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13
Q

What is metolazone?

A

-a thiazide diuretic that is a cardiologist’s favorite for use as an adjunct diuretic in the Tx of CHF

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14
Q

What is the mechanism of furosemide (a loop diuretic)?

A

blocks the Na+/K+/2Cl- cotransporter in the Loop of Henle

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15
Q

What are the indications for using furosemide (a loop diuretic)?

A
  • edema associated w/ heart failure
  • HTN

-Tx for acute pulmonary edema by decreasing preload
(rapid relief of dyspnea)

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16
Q

Does furosemide work in patients with a low GFR?

A

Yes (unlike thiazides)

17
Q

What are side effects of furosemide?

A
  • hypokalemia and hyponatremia
  • hypochloremic metabolic alkalosis
  • hypocalcemia (increased risk of kidney stones)
  • hyperglycemia
  • hyperuricemia
  • ototoxicity
18
Q

What loop diuretic can be used in pt’s with a sulfa allergy?

A

-ethacrynic acid

19
Q

What is the class and mechanism of action of captopril?

A
  • ACEi

- competitive inhibitor of ACE

20
Q

What are the advantages of benazepril and lisinopril over captopril?

A

longer half-life, which allows 1x daily dosing

21
Q

What are the two major side effects of ACEi’s?

A
  • cough

- angioedema

22
Q

In treating blacks w/ HTN, what class of drugs should be included in the initial treatment?

A

-thiazide or CCB

23
Q

What are some medications that are safe during pregnancy?

A
  • methyldopa
  • nifedipine
  • labetalol

-do NOT treat w/ ACEi’s, ARB’s, or aliskiren