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Pharmacology > Hypertension Drugs > Flashcards

Hypertension Drugs Flashcards

1
Q

Target BP according to JNC 7 for:
no comorbidities?
DM?
CKD?

A

no comorbidities: <140/90
DM: <130/80
CKD: <130/80

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2
Q

Target BP according to JNC 8 for:
no comorbidities: >/= 60 years old? < 60 years old?
DM?
CKD?

A

> /= 60 years old: < 150/90, < 60 years old: < 140/90
DM: <140/90
CKD: <140/90

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3
Q

inhibits Na/Cl transporter in DCT
causes moderate diuresis and and reduced excretion of Ca (increased reabsorption)
first line for hypertension
heart failure, hypercalciuria, nephrogenic diabetes insipidus, renal calcium stones

A

thiazide diuretic

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4
Q

types of thiazide diuretic

A 
Hydrochlorothiazide
Chlorthalidone
Indapamide
Metolazone
Chlorothiazide
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5
Q

side effects of thiazide diuretics

A

hypokalemic metabolic alkalosis
hyperlipidemia
hyperuricemia
sulfa allergy

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6
Q

inhibits Na/K/2Cl transporter in thick ascending limb of loop of henle
causes powerful diuresis and increased Ca excretion
used for pulmonary edema, hypercalcemia, acute renal failure, anion overdose

A

loop diuretic

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7
Q

types of loop diuretic

A

Furosemide
Bumetanide
Torsemide
Ethacrynic acid (phenoxyacetic acid derivative)

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8
Q

side effect of loop diuretics

A 
dehydration
ototoxicity
sulfa allergy (EXCEPT ethacrynic acid)
hyperuricemia
nephritis
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9
Q

CNS sympathetic outflow blocker
activates alpha 2 adrenergic receptors –> decreases central sympathetic outflow
used for hypertension
side effect: rebound hypertension

A

clonidine

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10
Q

dose limit for clonidine

A

900 mcg

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11
Q

antidote for rebound hypertension

A

phentolamine

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12
Q

CNS sympathetic outflow blocker
activates alpha 2 adrenergic receptors –> decreases central sympathetic outflow
used for pre-eclampsia
side effect: hemolytic anemia (POSITIVE COOMBS TEST)

A

Methyldopa

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13
Q

ganglion blocker
competitively blocks Nn nicotinic Ach receptors
used for hypertension (obsolete), hypertensive emergencies
side effect: POSTURAL HYPERTENSION, dry mouth, blurred vision, constipation, sexual dysfunction

A

Hexamethonium

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14
Q

nerve terminal blocker
irreversibly blocks vesicular monoamine transporter (VMAT)
used for hypertension (obsolete)
side effects: sedation, severe psychaitric depression, suicidal ideation

A

reserpine

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15
Q

nerve terminal blocker
inhibits vesicular release of NE from presynaptic neuron
used for hypertension (obsolete)
side effects: sedation, severe psychiatric depression, suicidal ideation

A

guanethidine

guanadrel

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16
Q 
which part of the nephron is acted on:
carbonic anhydrase inhibitors?
loop diuretics?
thiazide diuretics?
potassium-sparing diuretics?
osmotic diuretics?
A

carbonic anhydrase inhibitors: PCT
loop diuretics: Na/K/2Cl transporter in thick ascending limb of LoH
thiazide diuretics: Na/Cl transporter in DCT
potassium-sparing diuretics: collecting duct
osmotic diuretics: all parts, ESPECIALLY PCT

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17
Q

primary site for calcium absorption due to Na-Ca changer

A

loop of henle

18
Q

potassium escape mechanism located in which part of nephron?

A

thick ascending limb of loop of henle

19
Q

adrenergic blocker
alpha 1 selective antagonist
used for benign prostatic hyperplasia, hypertension
side effects: FIRST DOSE –> ORTHOSTATIC HYPOTENSION, less chance of reflex tachycardia

A

Prazosin

Doxazosin, Terazosin, Tamsulosin, Silodosin, Alfuzosin

20
Q

most selective for prostatic smooth muscle

A

Tamsulosin

21
Q

adrenergic blocker
non-selective beta blocker
blocks sympathetic effects on heart and BP
reduces renin release
used for prophylaxis and hypertension
side effects: bronchospasm, AV block, heart failure, CNS sedation, erectile dysfunction
masks symptoms of hypoglycemia in diabetics

A

Propranolol, Pindolol, Timolol, Labetalol, Carvedilol, Nadolol, Levobunolol, Metapranolol

22
Q

has combined alpha and beta blockade (may be used in pheochromocytoma)

A

Carvedilol and Labetalol

23
Q

what drugs are used to control BP in pheochromocytoma?

A

Phenoxybenzamine
Phentolamine
or Labetalol

24
Q

older oral vasodilator
alters intracellular Ca++ metabolism
relaxes arteriolar smooth muscle –> vasodilation –> decreases afterload
used for hypertension
side effects: REFLEX TACHYCARDIA, DRUG-INDUCED LUPUS

A

Hydralazine

25
Q

older oral vasodilator
opens K+ channels in vascular smooth muscle –> hyperpolarization –> muscle relaxation and vasodilation
used for hypertension, alopecia
side effects: REFLEX TACHYCARDIA, HYPERTRICHOSIS

A

Minoxidil

Diazoxide

26
Q

older oral vasodilator specific for arterioles

decreases afterload

A

Minoxidil

Diazoxide

27
Q

Medications that cause drug induced lupus?

A

Hydralazine
Isoniazid
Procainamide
Penicillamine

28
Q

how does minoxidil cause hypertrichosis?

A

minoxidil stimulates hair follicles (telogen phase) to differentiate into growth follicles (anagen phase)

29
Q

calcium channel blocker
non-dihydropyridine CCB
block voltage-gated L-type Ca channels (cardiac > vascular –> more for arrhythmias since cardioselective)
used for supraventricular tachycardia (OPD setting)
side effects: CONSTIPATION, pretibial edema, GINGIVAL HYPERPLASIA, heart failure, AV block, sinus node depression

A

verapamil

diltiazem

30
Q

dihydropyridine CCB
block voltage-gated L-type Ca channels (vascular > cardiac)
used for angina, hypertension
side effects: PRETIBIAL EDEMA, FLUSHING, CONSTIPATION

A

Nifedipine

amlodipine, felodipine, nicardipine, nisoldipine, clevidipine, isradipine

31
Q 
parenteral vasodilator
relaxes venous and arteriolar smooth muscle by increasing cGMP (preload unloader)
decreases both preload and afterload
used for hypertensive emergency
side effect: CYANIDE TOXICITY
light sensitive
A

Nitroprusside

32
Q 
parenteral vasodilator
dopamine agonist (D1 receptor)
causes arteriolar vasodilation of afferent and efferent arterioles
increases renal blood flow
used for hypertensive emergency
side effects: HYPOKALEMIA
short half life
A

Fenoldopam

33
Q

angiotensin antagonist
ACE inhibitor
inhibits ACE and formation of angiotensin II
decreases aldosterone secretion
used for hypertension, heart failure, post-MI, diabetic nephropathy
side effects: COUGH, TERATOGEN, HYPERKALEMIA

A

captopril

enalapril, benazepril, fosinopril, lisinopril, quinapril, ramipril, trandolapril, moexipril, perindopril

34
Q

why use ACE inhibitors in patients with diabetic nephropathy?

A

ACE inhibitors decrease albumin excretion and slow progression from micro- to macro-albuminuria
(renoprotective effect)

35
Q

angiotensin receptor blockers
blocks angiotensin (AT1 receptors) in vascular smooth muscle and adrenal cortex
decreases aldosterone secretion
used for hypertension, heart failure, diabetic nephropathy
side effects: HYPERKALEMIA

A

losartan

candesartan, valsartan, irbesartan, erprosartan, telmisartan, azilsartan, olmesartan, valsartan

36
Q

slows ventricular remodeling and increases survival in heart failure
delays progression of diabetic nephropathy

A

ACE inhibitors
captopril
enalapril, benazepril, fosinopril, lisinopril, quinapril, ramipril, trandolapril, moexipril, perindopril

ARBs
losartan
candesartan, valsartan, irbesartan, erprosartan, telmisartan, azilsartan, olmesartan, valsartan

37
Q

combination treatment with ISDN for heart failure more effective than ACE-Is in blacks

A

hydralazine

older oral vasodilator

38
Q

how do ARBs/ACE-Is cause hyperkalemia?

A

ACE-Is/ARBs reduce aldosterone levels –> potassium retention

39
Q

renin antagonist
inhibits renin
prevents conversion of angiotensinogen to angiotensin I
used for hypertension

A

aliskerin

40
Q

management for malignant hypertension

accelerated form of severe hypertension associated with rising BP and rapidly progressing end-organ damage

A

powerful vasodilators (nitroprusside, fenoldopam, diazoxide) combined with diuretics (furosemide) and beta blockers to lower BP to 140-160/90-110

Pharmacology (31 decks)

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