HTN drugs (whatever is not covered elsewhere)

Question 1

amiloride

Answer 1

• block epithelial sodium channels (ENAC) in the collecting ducts
• causes small increase in Na+ excretion while retaining K+
• risk of hyperkalemia

Question 2

phentolamine

Answer 2

• α-receptor blocker
• vasodilator
• early drug, not tolerated well
• risk of hypotensive episodes, orthostatic hypotension, tachycardia, arrhythmias

Question 3

phenoxybenzamine

Answer 3

• α-receptor blocker
• vasodilator
• early drug, not tolerated well
• risk of hypotensive episodes, orthostatic hypotension, tachycardia, arrhythmias, AND miosis

Question 4

prazosin

Answer 4

• competitive antagonist of postsynaptic α1-adrenergic receptors
• causes vasodilation of veins and arterioles, which leads to a decrease in TPR
• risk of orthostatic hypotension, edema, and retrograde ejaculation

Question 5

clonidine

Answer 5

• α2 adrenergic receptor AGONIST, crosses BBB
• reduces sympathetic outflow which decreases TPR, HR, and BP
• risk of rebound HTN if dose missed

Question 6

α-methyldopa

Answer 6

• selective AGONIST for α2-adrenergic receptors
• used as sympatholytic for hypertension due to reduced sympathetic outflow
• drug of choice for gestational HTN
• risk of Bell’s palsy, angina pectoris, bone marrow suppression

Question 7

minoxidil

Answer 7

• produces vasodilation by directly relaxing arteriolar smooth muscle
• stimulation of hair growth
• risk of ECG changes, pericardial effusion, PE

Question 8

fenoldopam

Answer 8

• Dopamine-1 receptor antagonist
• IV drug used for hypertensive emergency
• contraindicated in pts with increased intraocular pressure (glaucoma) or intracranial pressure and those with sulfite allergy

Question 9

Enalaprat

Answer 9

• ACEi
• IV drug used in hypertensive emergency with high plasma renin activity
• Contraindicated in pregnancy and should not be used in acute MI or bilateral renal artery stenosis.