HTN Day 1 Flashcards
Types of diuretics
- Thiazides
- Loop
- K+ sparing (aldosterone blockers & K+ sparing)
Which ACE-I is available IV?
Enalapril
What is unique regarding captopril?
(ACE-I)
- Must dose 2-3x/day
- Must take on empty stomach
What is the only direct renin inhibitor?
Aliskiren
MOA of thiazides
Inhibit Na reabsorption in DCT
MOA of loop diuretics
Inhibit active transport of Na, Cl, K in ascending Loop of Henle (causing excretion)
MOA of aldosterone blockers
- Compete w/aldosterone
- Prevent Na reabsorption and K excretion
MOA of K+ sparing diuretics
- Block Na reabsorption and K excretion
- INDEPENDENT of aldosterone
MOA of ACE-I
- Inhibit ACE which blocks production of AT II
- Results in lack of bradykinin breakdown (vasodilator)
- Dilate efferent arteriole of kidney
MOA of calcium channel blockers
Inhibits Ca influx (contraction) of cardiac/vascular smooth muscle
Types of Ca channel blockers
- Dihydropyridines
2. Non-dihydropyridines
MOA of dihydropyridines
Inhibits Ca influx into VASCULAR smooth muscle
MOA of non-dihydropyridines
Inhibits Ca influx into CARDIAC smooth muscle
Dihydropyridine drug examples:
Amlodipine (Norvasc)
Nifedipine
Non-dihydropyridine drug examples:
Verapamil
Diltiazem
First line options for HTN:
- Thiazide diuretics
- ACE-I
- ARBs
- Ca Channel blockers
Which drugs are first line for HTN in DM and CKD patients?
ARBs and ACE-I
How do thiazides affect electrolytes?
DECREASE K, Na
INCREASE Ca, gluc, uric acid
How do loop diuretics affect electrolytes?
DECREASE everything (K, Na, Ca, Mg) EXCEPT uric acid
Which drugs should be given cautiously with sulfa allergic pts?
Thiazides
Loop diuretics
What is a rare but serious ADE of ACE-I and ARBs?
Angioedema
What is spironolactone commonly used for?
Class IV heart failure
Aldosterone blocker diuretic
How are K+ sparing diuretics used for HTN?
In combo w/thiazides
Which drug can be used for migraine prophylaxis?
- Verapamil (non-dihydro CCB)
- Can cross BBB
Drug examples of aldosterone blocker diuretics:
Spironolactone
Eplerenone
Drug examples of K+ sparing diuretics:
Triamterene
Amiloride
What are examples of ARBs?
Losartan
Valsartan
Which drugs have interactions with K+ supplements, sparing diuretics, and NSAIDs?
ACE-I
ARBs
Why shouldn’t nifedipine be used sublingually?
Severe hypotension
Reported increase risk for MI and death
Which drugs can increase Lithium concentrations?
Thiazides
Which drugs can initially increase urination?
Thiazides
What are ADEs of spironolactone?
Gynecomastia in men
Menstrual irregularities
Which drugs can cause hyperkalemia?
K+ sparing diuretics
ACE-I
ARBs
