First-line BP Meds Review Flashcards
First-line BP Meds
Thiazides, ARBs, ACEIs, CCBs
Thiazides decrease levels of
K, Na, Mg, Cl, H2O
Thiazides decrease excretion of
Ca, uric acid, glucose levels may increase
Thiazide MoA
Block Na/Cl symport, reduce blood volume
Long term, reduces vascular resistance
CCBs MoA
DHP: Block influx of Ca into vascular muscle - vasodilation
Non-DHP: Block influx of Ca into cardiac muscle - slow HR
Muscle weakness, Flushing, Swelling in the lower extremities, Gingival hyperplasia, Headache are side effects of which BP med
CCBs
Reflex tachycardia
Body senses lower BP and increases HR to compensate
Bradykinin significance
causes vasodilation and cough. ACEI blocks ACE, which normally breaks down bradykinin.
Does an ARB cause cough?
Nerp
Angiotensinogen (from __) -> ____-> ATI
Angiotensinogen is from liver
Renin (secreted from kidneys)
Where is angiotensinogen produced
Liver
Where is renin produced
Kidney
What does ATII do?
lysis to make AT1 and AT2
What does AT1 do?
Vasodilation, apoptosis
What does AT2 do?
Causes vasoconstriction
What does ACE do?
Break down bradykinin, convent ATI to ATII
ACEI increases which electrolyte
K
ACEI ADEs
ANGIOEDEMA, COUGH, taste disturbances, decreased GFR, rash
ARBs MoA
Blocks ATII from binding to ATI receptor to cause vasoconstriction
ARBs ADEs
Dizziness, COUGH, headache, N/V, Increased K+ levels, Decreased GFR.
ARBs effect on electrolytes
Increased K
Aldosterone
Na retention
Under which circumstance would you use 2 first-line anti-hypertension meds?
adults with stage 2 hypertension and an average BP more than 20/10 mm Hg above their BP target.
Under which circumstance would you use 1 first-line anti-hypertensive med?
adults with stage 1 hypertension and BP goal <130/80 mm Hg with dosage titration and sequential addition of other agents to achieve the BP target.
HCTZ
thiazide
chlorthalidone
thiazide
Amlodipine
DHP CCB
Verapamil
Non-DHP CCB
Diltiazem
Non-DHP CCB
Captopril
ACEI
Enalapril
ACEI
Valsartan
ARB
