HTN6 Flashcards
what is the trade name of doxazosin
Cardura
what is the trade name of Prazosin
Minipress
what is the trade name of Terazosin
Hytrin
what drugs are only used in combo therapy for BPH?
alpha blockers
what is the MOA of direct renin inhibitors
directly inhibits renin at beginning of RAAS
what are the adverse effects of Direct Renin Inhibitors?
angioedema
increased Scr and BUN
increased K
what is the contraindication for direct renin inhibitors?
pregnancy
what are the central a2 agonists trade and generic names?
clonidine - Catapres
Clonidine patch - Catapres-TTS
Methyldopa - Aldomet
Guanfacine (Tenex)
what is the MOA of central A2 agonists
stimulate A2 receptors in brain which inhibits release of NE
what are the effects of central a2 agonists on:
- sympathetic outflow
- vagal outflow
- decrease sympathetic outflow
2. increase vagal outflow
what makes central A2 agonists most effective?
used with a diuretic to reduce fluid retention
what central A2 agonist can be used by itself?
clonidine
what is the oral dosing of clonidine?
what is max dose?
.1 mg BID up to 1.2 mg per day
what is the transdermal dosing of clonidine
.1, 0.2, 0.3 mg/day patch every 7 days
what effect does clonidine typically have on BP
decreases diastolic BP by 10 mmHg
what dosing should be given to change from PO to transdermal patches?
day 1: patch + 100% of oral dose
day 2: 50% of oral dose
day 3: 25% oral dose
day 4: d/c PO dose
what are the adverse effects of clonidine
- sedation
- orthostatic hypotension
- depression
- dry mouth
what is the “rebound phenomenon”
heart compensating for loss of pressure and volume
what is the first line treatment for HTN in pregnancy
methyldopa
what is the MOA with peripheral adrenergic agonists
depletes norepinephrine from sympathetic nerve endings and blocks transport of NE into storage granules
what are the effects of peripheral adrenergic antagonists on sympathetic tone and PVR?
decreases sympathetic tone
decreases PVR due to vasodilation
what are the adverse effects of peripheral adrenergic antagonists?
- CNS effects (sedation, anxiety, depression)
- nasal stuffiness
- peptic ulcer
- orthostatic hypotention
what is a peripheral adrenergic antagonist
reserpine
what type of drug is hydralazine
direct arterial vasodilator
what are the effects of compensatory mechanisms seen with hydralazine
increase HR, CO and renin release
what is the dosing of hydralzine?
TID or QID
when using a thiazide diuretic, potassium does what? what does uric acid do
K decreases
uric acid increases
what is bp goal in a diabetic patient with HTN
what is most appropriate 1st line therapy?
140/90
HCTZ
a black male with DM and HTN who has been on hydroclorothiazide for a month should have what added?
a. amlodipine
b. enalapril
c. hydralazine
d. chlorthalidone
amlodipine (CCB preferred)
