HTN

Question 0

ACE inhibitors (ACEI)
Ang II receptor blocker (ARB)

Answer 0

-ACEI=”-pril”
-ARB=”-sartan”
-DEC SVR to vasodilate
MOA
-ARBs=blocks ang II receptor, directly causes vasodilation
-ACEI= DEC ang II
ADE
-DEC renal fx/renal failure
-hypotension
-hyperkalemia
-cough (w/ ACEI)
-angioedema (w/ ACEI, esp blacks)
-*teratogenicity
Contraindication
-avoid ACEI/ARB combo in tx HTN
-ACE/ARB combo not preferred in blacks - not effective in DEC BP

Question 1

Thiazide (hydrochlorothiazide)
Chlorthalidone
Indapamide

Answer 1

-diuretics
-“-thiazide”
-DEC systemic vascular resistance (SVR) to vasodilate
-1st line vasodilators (DEC SVR)
-anti-HTN effects when used alone
-enhances efficacy of other antiHTN drugs
MOA
-unknown
-inhibits transporters that remove Na+ from renal tubular lumen
ADE
-dehydration
-hyponatremia (Na)
-hypokalemia (K)
-hypomagnesemia (Mg)
-hypercalcemia (Ca)
-hypercholesterolemia
-blood glucose: DEC tolerance
-postural hypotension
-DEC glomerular filtration rate
-acid/base imbalances

Question 2

Calcium channel blockers (CCB)
(non-dihydropines: diltialzem, verapamil)
(dihydropines: amlodipine, nifedipine, nicardipine)

Answer 2

-"-dipine"
MOA
1. DEC CO/DEC HR/DEC conduction
2. DEC SVR (*arterial vasodilator)
ADE 
-hypotension

Question 3

Beta-blockers
(non-selective: propranolol)
(beta1-selective: atenolol, metropolol)

Answer 3

-“-olol, -alol, -ilol”
-no longer first line drug for HTN
MOA
-beta1-receptor antagonist= Jg cells don’t release renin=DEC ang I
-mixed w/ alpha1-receptor blocking activity (added hypotensive effect): Labetalol and Carvedilol
ADE
-for HTN pt: INC rates of CV death, MI, or stroke
-can disrupt RAA
-instead use 3 amigos: thiazide diuretic, ACEI/ARB, CCB

Question 4

Alpha-blockers

daxocin, praxzosin, terazosin

Answer 4

-"-osin"
MOA
-alpha1-blocker=vasodialtion=DEC BP
-alpha2 agonist=DEC PVR, DEC NE release
ADE 
-TBC in GI

Question 5

Nitric oxide

nitroprusside

Answer 5

MOA
-rapid acting vasodilator of smooth muscles
ADE
-INC in CN

Question 6

Hydralazine

Answer 6

-direct acting vasodilator
-used for eclampsia (HTN emergency in pregnancy)
MOA
-binds K channels on vascular smooth muscles
ADE
-tachycardia
-vasoconstriction