Hypertension Drugs Flashcards
treat for HTN w/ BP > than what #
130 mmHg
1st line treatment for HTN
CCB (Ca2+ channel blockers)
4 types of drugs used to treat HTN
CCB’s
+
ARBs/ACEIs
+/- Thiazides
+/- Statins
Dihydropyridines
Nondihydropyridines
CCB’s
RAA drugs
ARBs
ACEIs
type of drugs used to treat DIFFICULT hypertension
K+ sparing diuretics
aldosterone antagonists
ENaC blockers
K+ sparing diuretics
most prescribed dihydropyridine for HTN
Amlodipine
short-acting dihydropyridine that should not be used long term b/c can lead to MI and death
Nifedipine
drugs ending in -PINE (used to treat HTN)
Dihydropyridines
DILTIAZEM
nondihydropyridine to treat HTN
most effective drug class for primary prevention of stroke
CCB’s
what compromises effectiveness of ARBs, ACEIs, and diuretics
high salt diet or NSAIDs
what does not compromise effectiveness of CCBs
high salt diet or NSAIDs
SE for CCB’s; and how to help it
ankle edema; add ARBs
all______ can depress SA node
CCB’s
main problem with HTN
visceral adipocytes producing leptin
target is POMC neurons and signal transmitted to IML (increase sympathetics, increase bp)
Leptin
effects of leptin
increase cAMP, RAS, vasoconstriction, afterload, HTN, LV workload
how can Ang II and aldosterone make HTN worse
Ang II increases aldosterone; more Na+ and water reabsorption; increase blood volume makes HTN worse
ultimately decreases size of lumen and therefore vasoconstricts
maladaptive remodeling
what can ultimately happen from Ang II effects
heart failure
effects of aldosterone
increases ENaC expression
increases Na+ and water reabsorption
AT1R (Gq)
vasoconstriction
AT2R (Gi)
vasodilation
renin inhibitor (blocks effects of whole process)
ALISKIREN
Aldosterone receptor blockers
Spironolactone
eplerenone
(-PRIL); ACEIs (oldest drugs)
Lisinopril….
AT1R blockers(Gq) [-SARTAN]
Losartan
Valsartan
don’t use ARBs and ACEIs along with this drug
AZILSARTAN
ACEIs/ARB/DRI contraindications
- bilateral renal artery stenosis
- PREGNANCY (teratogens)
- renal failure
what labs to order when you start patient on ACEIs
CREATININE
FUROSEMIDE
TORSEMIDE
BUMETANIDE
ETHACRYNIC ACID
loop diuretics
CHLORTHALIDONE
HCTZ
METOLAZONE
INDAPAMIDE
Thiazide/thiazide-like drugs
where do loop diuretics act on
Thick Ascending Loop
act on NKCC2 and lead to excretion of Na+, K+, Cl-, Ca2+, Mg2+
loop diuretics
NSAIDs block effect of this drug
Loop diuretics
only used for special cases when treating HTN
loop diuretics
SE of loop diuretics
ototoxicity
blocks NCC and keeps Ca2+ in blood
Thiazide diuretics
all sorts of edema can be treated w/ this drug
thiazide diuretics
used for kidney stones(limits Ca2+ in urine) and osteoporosis (bone health)
thiazide diuretics
contraindicated in Gout
Thiazides
better thiazide than HCTZ these days
CHLORTHALIDONE
K+ sparing Diuretics (Na+ still excreted)
ENaC blockers
Aldosterone receptor blockers
Amiloride
Triamterene
ENaC blockers
K+ sparing drug that antagonizes both MR(aldosterone) and AR (androgen)
Spironolactone
only use for DIFFICULT HTN and after trying MR blocking and ENaC blocking drugs
B blockers (-LOL)
Labetalol
Carvedilol
Nebivolol
block B1 and a1
-LOL that stimulates NO production
Nebivolol
a1 blockers used to treat pheochromocytoma
phenoxybenzamine
phentolamine
what can happen when trying to take patient off of HTN meds
rebound HTN
Hydralazine
Procainamide
(both can cause what)
cause drug induced LUPUS
long acting VIP for HTN
Vasomera
what must be discontinued if patient has HTN but becomes pregnant
RAA blockers
