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Cardiology Week 4 > Hypertension Drugs > Flashcards

Hypertension Drugs Flashcards

1
Q

what do loop diuretics act on?

A

the sodium reabsorbing protein in the loop of henle

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2
Q

by not absorbing Na what do we inherently block reabsoroption of?

A

Water

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3
Q

name the loop diuretic

A

furosemide

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4
Q

what is the adverse effect of loop diuretics?

A

alkalosis…high serum pH

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5
Q

3 things affecting the BP

A

cardiac output
vasculature resistance
blood volume

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6
Q

what is the mechanism of thiazide diuretics?

A

block the sodium and chloride symporter in the distal convuluted tubule…so less Na and less H2O

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7
Q

adverse effects of thaizide diuretics?

A

alkalosis and hypokalemia

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8
Q

name the two thiazide diuretics

A

hydrochlorothiazide

chlortalidone

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9
Q

mechanism of K+ sparing diuretics

A

inhibit the ENaC or epithelial sodium channel in the collecting duct

or it blocks the effects of aldosterone on the collecting duct

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10
Q

what is the ENaC diuretic?

A

traimterene

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11
Q

what are the two aldosterone inhibiting diuretics?

A

spironolactone and eplerenone

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12
Q

spironolactone toxicity

A

gynecomastia

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13
Q

explain how loop and thiazide diuretics cause hypokalemia

A

leads to increased sodium downstream and in collecting duct there is a Na and K antiporter so you get more Na flowing into blood since high conc down stream and more K leaving blood into the collecting duct

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14
Q

what is the mechanism of hydralizine?

A

somehow increases concentration of cyclic GMP which leads to vasodilation through NO pathway

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15
Q

what is the mechanism of diazoxide?

A

makes K+ channels stay open longer causing hyperpolarization and not letting contraction of SMC to occur

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16
Q

what is the mechanism of calcium channel blockers (hydropyridines/non)

A

block calcium channels and lower smooth muscle contraction strength

17
Q

name the two hydropyridines

A

amlodipine
nifedipine
nimodipine

18
Q

name the two non hydropyridines

A

verapimil

diltiazem

19
Q

toxicity of calcium channel blockers

A

gingival enlargement…big gums

20
Q

of the calcium channel blockers, which do you give during pregnancy?

A

nifedipine

21
Q

name the two ACE inhibitors

A

captopril

lisinopril

22
Q

name the two ARB inhibitors

A

Losartan

Valsartan

23
Q

what is the mechanism of ARB drugs

A

they block the angiotensis receptors where it would lead to alodsterone and vasoconstriction

24
Q

name the three toxicities of ARB and ACE inhibitors

A

dry cough
angioedema
hyperkalemia

25
Q

how do ACE inhibs lead to angioedema

A

by blocking the ACE, the secondary role of ACE to breakdown bradykinin does not occur so you get leaky capillaries that cause angioedema

26
Q

should ACE inhibitors be given during pregnancy?

A

eh…its debatable

27
Q

how does clonidine affect blood pressure?

A

it is an A2 agonist that actually decreases the sympathetic effects..

28
Q

what do beta antagonist disrupt?

A

blood sugar…so be careful giving to diabetics

29
Q

how do beta antagonists affect folks with asthma?

why is this problem moot now?

A

beta blockers block B2 in the lungs and lead to vasoconstriction…can worsen asthma

most beta blockers are specific to B1 and the heart now

30
Q

3 types of sympathetic drugs to give for HBP

A

beta blockers- metoprolol atenolol esmolol
a1 antagonist- prazosin
a2 agonist-clonidine

31
Q

of the sympathetic drugs for hypertension, which are riskiest with pregnancy?

A

beta blockers

32
Q

what group has highest risk of angioedema with ACE and ARB?

A

african americans have three times the risk…so not a first line drug

33
Q

what is the threshold of BP for initiating treatment?

A

140/90

34
Q

in what circumstances does the threshold for BP treatment change and what does the threshold move to?

A

if patient has CVD, CKD, diabetes, or high risk of CVD

130/80

35
Q

what is most dominating risk factor is developing ASCVD?

A

AGE

36
Q

if patient has BP of 135/85 and has greater then 10% chance of having ASCVD in next ten years…do we treat HBP?

A

Yes

37
Q

name the four preferred first line HBP medication classes

A

thiazide diuretics
ACE inhibitors
ARBs
calcium antagonists

it is common to combine any of these to dual treat…except ACE and ARB since they sorta do same thing

Cardiology Week 4 (5 decks)

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