hypertension Flashcards
name 3 thiazide diuretics
hydrochlorothiazide
chlorothiazide
metolazone (thiazide like diuretic)
what do you have to monitor with thiazides?
serum K!
where do thiazides work and what do they do?
on the descending tubule and increase Na/H2O excretion
what are loops good for?
acute pulm edema and hypercalcemia
are loops good for HTN?
nope. too fast acting, and too much risk for hypovolemia (good for HTN w/ kidney dysfunction)
name 4 loops
furosemide, bumetanide, ethacrynic acid, torsemide
name 3 K sparing diuretics
spironolactone, triamterene, amiloride hydrochloride
in what way are K sparing diuretics helpful for HTN?
they are great combo drugs with thiazides (name them!) to help prevent hypokalemia
what is an osmotic agent?
mannitol
what is mannitol good for?
good for increased ICP, and to keep urine flowing in acute renal failure
what is a carbonic anhydrase inhibitor?
acetazolamide
what is acetazolamide and what is it used for?
carbonic anydrase inhibitor diuretic
tx of glaucoma, mountain sickness
name 4 CCBs
diltiazam, verapamil, amlodipine, nifedipine
how do CCBs work? what do they do?
they block Ca channels causing vascular relaxation and dilation of arterioles (not veins)
what is a side effect of verapamil?
constipation esp in elderly
first degree AV blocks (dose dependent)
what are some side effects of the dihydropyridines?
headache, dizziness, flushing, peripheral edema, palpitations (due to the vasodilation)
who should you definitely not use CCBs on? why?
CHF pts because of negative inotropic effects (shitty contractile strength)
who respond really well to CCBs?
black people
if you have a pt on warfarin or digoxin, and you want to use a CCB, which ones should you use?
dihydropyridines (show little interaction w/ other cardio drugs)
what are better for HTN? dihydropiridines or other CCBs?
dihydro’s bc they have greater affinity for vascular Ca channels than heart Ca channels (low side effect profile)
name 5 ACE inhibitors
lisinopril, captopril, benazepril, enalapril, quinapril
who should NOT get an ACE inhibitor?
pregnant pts
anyone taking an ARB
black patients
how do ACEs reduce BP?
blocks angiotensin II (vasodilates both arterioles and veins) and decreases aldosterone (decreased Na and H2O retention)
whats an annoying side effect of an ACE?
dry cough…try an ARB if this occurs
whats a kinda bad side effect of an ACE?
hyperkalemia – DONT use K supplements or K sparing diuretics
name two angiotensin II receptor blockers
Losartan, valsartan
who should get an ACE I as a FIRST LINE tx?
adults with chronic kidney disease
name 3 B blockers
Propranolol, atenolol, metoprolol
what are ARBs pretty good for?
pt’s with CKD
pt’s who dont tolerate ACEs (cough)
decreasing nephrotoxicity esp in DM pts
what are some side effects of ARBS
hyperkalemia
BAD for pregnant mothers
BAD in combo with ACEs
which beta blocker is non selective?
propranolol (acts on B1 and B2 receptors)
which B blockers are selective of B1 receptors?
atenolol and metoprolol
which B blocker is CONTRAINDICATED in asthma?
propanolol! non selective, also blocks B2 bronchodilation
what are B blockers really good for?
fantastic for post MI + HTN
name 3 alpha blockers
doxazosin, prazosin, terazosin
how do alpha blockers work?
block alpha 1 receptors and decrease PVR and relax arterial and venous smooth muscle
what do alpha blockers cause (in a bad way)?
reflex tachycardia and syncope
name 2 peripheral sympathetic inhibitor agents
guanethidine, reserpine
name 3 central sympatholytic action drugs
clonidine, guanabenz, methyldopa
