HTN Drugs Flashcards
Captopril
Action: ACE inhibitor
Usage: stage 1/2 HTN, CHF, Diabetic kidney disease
Toxicity: Bradykinin (excess) cough reflex, hyperkalemia, teratogenic
Other: 12 hr fx.
Losartan
Action: Angiotensin II Type I Receptor Antagonist (ARB)
Usage: Stage 1/2 HTN, CHF
Toxicities: Hyperkalemia, teratogenic
Other: No cough reflex (doesn’t increase bradykinin levels)
Aliskiren
Action: Renin inhibitor
Usage: HTN secondary to renal failure/diabetes. “High Renin” HTN
Toxicity: Angioedema, renal impairment (watch the GFR!)
Other: not better than other RAAS inhibitors for other types of HTN
Ambrisentan
Action: Selective Endothelial A receptor antagonist
Usage: Pulmonary HTN
Toxicity: Hepatic impairment, headache
Other: Bosentan (similar class) inhibits endothelial A & B receptors
Verapamil
Aciton: Cardioselective L-type Ca2+ channel blocker
Usage: HTN, Angina, Arrhythmias
Toxicity: Cardiac depression, constipation
Other: Strong cardiac blocking effect w/ weak smooth muscle blocking effect
Nifedipine
Action: Vascular selective L-type Ca2+ channel blocker
Usage: HTN, angina, arrhythmias
Toxicities: Hypotension, flushing, dizziness
Other: Strong vascular smooth muscle blocking effect w/ weak cardiac blocking
Hydralazine
Action: Nitric oxide mechanism (not completely understood)
Usage: Hypertensive crisis, pregnancy induced HTN (non-teratogenic), heart failure
Toxicities: tachycardia, salt & water retention
Other: occasionally causes lupus-like syndrome
Minoxedil
Action: Vascular smooth muscle K+ channel activator (hyperpolarilization)
Usage: Hypertensive crisis, male pattern baldness
Toxicity: Tachycardia, salt and water retention, hirsutism
Other: Prodrug
Clonidine
Action: Selective alpha-2-adrenergic agonist (CNS acting).
Uses: Hypertension; ADHD.
Toxicity: Hypotension; bradycardia; sexual dysfunction, severe withdrawal.
Other: Acts in the CNS to decrease sympathetic outflow.
Carvedelol
Action: Both selective alpha-1- and non-selective beta-adrenergic antagonist.
Usage: Hypertension; congestive heart failure.
Toxicity: Bradycardia; heart block; bronchoconstriction.
Other: Risk of MI and angina if abrupt cessation of treatment; alpha:beta blockade > 1:10; “biased agonist” at beta-1-receptor.
Metoprolol
Action: Beta-1-adrenergic receptor antagonist.
Usage: Hypertension; angina; CHF.
Toxicity: Bradycardia; bronchospasm.
Other: Risk of MI and angina if abrupt cessation of treatment.
Labetalol
Action: Selective alpha-1- and non-selective beta-adrenergic antagonist.
Usage: Hypertension.
Toxicity: Bradycardia; heart block; bronchoconstriction; impaired ejaculation.
Other: Risk of MI and angina if abrupt cessation of treatment; alpha:beta blockade ~1:3- 1:7.
Propranolol
Action: Non-selective beta-adrenergic receptor antagonist.
Usage: Hypertension; angina; congestive heart failure; arrhythmia; essential tremor; migraine.
Toxicities: Bradycardia; bronchoconstriction; heart block; depression/sedation.
Other: Risk of MI and angina if abrupt cessation of treatment.
Prazosin
Action: Alpha-1-adrenergic antagonist.
Usage: Hypertension (like 5th line…) ; BPH (relax sphincters).
Toxicities: Orthostatic hypotension.
Other: Less tachycardia than nonselective antagonists.
