Htn Practice pt3 Flashcards
doxazosin
cardura - alpha 1 blocker
clonidine PO
catapres/kapvay - alpha 2 agonist
hydralazine
apresoline - direct vasodilator
furosemide
lasix - loop diuretic
spironolactone
aldactone/carospir - mra
loop diuretic moa
actively secreted via the nonspecific organic acid transport system into the lumen of the thick ascending limb of henles loop where it decreases na reabsorption by competing for the cl site
loop diuretic contraindications
anuria
loop diuretic adr
hyperuricemia, hypokalemia, hypomagnesemia, dizziness, aki, ototoxicity (worse with aminoglycosides)
loop diuretic ddi
increased risk of ototoxicity if used with aminoglycosides
loop diuretic notes
most efficacious diuretic/more potent than thiazides, bbw for profound fluid and electrolyte loss, preferred in patients with hf for fluid control/diuresis, consider ethacrynic acid if a patient has a true loop diuretic allergy due to sulfa,
loop diuretic PK/PD
furosemide - 40-70% bioavailability, torsemide duration 8-12 hrs, ethacrynic acid iv or oral duration differ, butemanide renal and hepatic elimination, etharynic acid and furosemide are eliminated renally
torsemide
demadex- loop diuretic
bumenatide
bumex- loop diuretic
furosemide dosing
lasix is usually dosed at 20-160mg in 2 divided doses
hydralazine moa
apresoline acts through direct vasodilation
hydralazine contraindications
coronary artery disease- causes reflex tachycardia, angina, mi
hydralazine adr
dizziness, reflex tachycardia, dile (higher in 400mgdailydose)
hydralazine notes
variable duration/effect, short half life– frequent dosing- 4x daily for htn, less reflex tachycardia risk than minoxidil
hydralazine dosing
100-200 mg in 2-3 divided doses
minoxidil contraindications
coronary artery disease (causes reflex tachycardia- more risk than hydralazine, angina, mi)
minoxidil adr
dizziness, reflex tachycardia, hypertrichosis, pericarditis
minoxidil notes
causes fluid and water retention- should be given with diuretic, to prevent tachycardia- should be given with a beta blocker, extremely potent
alpha 2 agonist moa
stimulates alpha 2 receptor reducing sympathetic outflow from cns decreasing peripheral resistance, and dec bp
alpha 2 agonist contraindciations
none
alpha 2 agonist adr
dry mouth, somnolence/fatigue/sedation, constipation,
local irritation with patch
alpha 2 agonist notes
avoid abruptly stopping- can cause rebound symptoms, patch can be used for seven days with 2-3 days onset that requires overlap with oral, last line due to cns effects
clonidine dosing
catapres/kapvay is dosed at 0.1-0.8 mg in 2-3 divided doses
