Hypertension Drugs

Question 1

Stages of Hypertension

Answer 1

Normal: <120/<80 (and)
Elevated: 120-129/<80 (and)
Hypertension Stage 1: 130-139/80-89 (or)
Hypertension Stage 2: >139/>89 (or)
Hypertensive Emergency: >180/>120 (and/or)

Question 2

ACE Inhibitors (full name, action)

Answer 2

Angiotensin-Converting Enzyme Inhibitors
- Ex: captopril, benazepril, enalapril, lisinopril
Action: prevent angiotensin l from converting into angiotensin ll
- leads to vasodilation
- decrease in aldosterone production
- blocks breakdown of bradykinin

Question 3

ACE Inhibitors (uses, SE, education)

Answer 3

Uses: HTN, heart failure, post MI
Adverse Effects: hypotension, hyperkalemia, angioedema, persistent cough
Teratogenic Effects in pregnancy
Education: monitor for SE, monitor BP daily, NOT taken with food, caution in women of child-bearing age, monitor iron intake (captopril)

Question 4

ARBs (full name, action)

Answer 4

Angiotensin ll Receptor Blockers
- Ex: losartan, olmesartan, Vaksartan
Action: blocks action of angiotensin ll
- blocks vasoconstriction
- increases renal flow
- decreases systemic vascular resistance

Question 5

ARBs (uses, SE, education)

Answer 5

Uses: HTN, diabetic nephropathy
Adverse effects: dizziness, muscle cramps/weakness, heartburn, diarrhea, angioedema, teratogenic effects (pregnancy)
Education: Monitor BP daily, monitor for SE, changes to lifestyle, may take with/without food
stop medication if pregnancy detected

Question 6

Ca Channel Blockers (names, actions)

Answer 6

Ex: amlodipine (norvasc), dilitazem (cardizem), nicardipine (cardene XL), verapamil (calan)
Actions: relaxation, vasodilation
- inhibits Ca ions
- smooth and cardiac muscle
- muscle depolarization/contraction

Question 7

Ca Channels Blockers (uses, SE)

Answer 7

Uses: HTN, CAD, angina, cardiac dysrhythmias
SE: HA, drowsiness, fatigue, peripheral edema, dizziness, palpations, nausea, flushing
Education: monitor for SE, avoid grapefruit juice, limit simvastatin use, no regard for food intake

Question 8

Direct Renin Inhibitors (ex, action)

Answer 8

Ex: Aliskiren (Tekturna)
Action: prevents conversion of angiotensin to angiotensin l

Question 9

Direct Renin Inhibitors (uses, SE, education)

Answer 9

Uses: HTN
SE: HA, dizziness, diarrhea
Education: do NOT take with a high fat meal and not recommended for pts with DM

Question 10

Diuretics

Answer 10

First line treatment
Action: decrease blood volume, decrease CO
Uses: HTN
- preferred for older pts and african americans

Question 11

Loop Diuretics

Answer 11

Lasix
Strongest for heart failure treatment
furosemide
ascending part of the loop of henle

Question 12

Thiazide Diuretics

Answer 12

First line treatment for HTN
Early distal convoluted tubule

Question 13

Potassium Sparing Diuretics

Answer 13

Weak, used in conjunction with other drugs
Late distal convoluted tubule/collecting duct

Question 14

Vasodilators (ex, action, uses, SE)

Answer 14

Ex: hydralazine, nitroprusside
Action: relax arteriolar smooth muscle
Uses: HTN emergency, HF
SE: SLE (systemic lupus erythematosus)

Question 15

Alpha1 (adrenergic blockers) (ex, action, uses, SE)

Answer 15

Ex: tamulosin, doxazosin
Action: interfere with sympathetic stimulation by blocking alpha 1 receptors
Uses: HTN, BPH (benign prostatic hypertrophy (enlarged prostate))
SE: orthostatic hypotension, dizziness, abnormal ejaculation, nasal congestion

Question 16

Alpha2 Agonists (ex, action, uses, SE)

Answer 16

Ex: clonidine
Action: stimulates alpha2 adrenergic receptors in the CNS which leads to a decrease of NE release
Uses: HTN, ADHD, severe pain
SE: dry mouth, constipation, drowsiness, vivid dreams/behavior changes. rebound HTN

Question 17

Beta-Adrenergic Blockers (ex, action, uses, SE, education)

Answer 17

Ex: atenolol, metoprolol, propanolol
Action: blocks beta1 receptors in heart
Uses: HTN, tachycardia, dysrhythmias, angina, post-MI
SE: bradycardia, HF, bronchoconstriction, impotence, fatigue, dizziness
Education: Monitor BP and HR, start on low doses
First choice for patients under 50 y.o.