Hypertensive drugs Flashcards
centrally acting agent; converted to a false transmitter in CNS neurons that will activate presynaptic a2 receptors and decrease NT release; decreased SNS; reduced CO, HR, renin release and TPR
alpha-methyl DOPA
centrally acting agent: alpha2 agonist; decreased SNS activity, no reflex; reduced CO, HR, renin release and TPR
clonidine
adrenergic neuron blocker: depletes CNS and peripheral NE and 5-HT as well as adrenal catecholamines by interfering with storage vesicles; least desirable of all antihypertensives (but cheap and effective)
reserpine
adrenergic neuron blocker: inhibits the synthesis of catecholamines by tyrosine hydroxylase; good for management of pheochromocytoma
metyrosine
adrenergic neuron blocker: non-selective alpha-AR antagonist; used to diagnose pheochromocytoma or reverse severe vasoconstriction
phentolamine mesylate
alpha1 AR selective antagonists
prazosin, doxazosin, terazosin
block peripheral postjunctional AR receptors that cause contraction of vascular SM; decrease TPR; reflex increase in HR; 1st dose effect: postural hypotension; retention of Na and H2O
prazosin, doxazosin, terazosin
beta blockers that cross the BBB
propranolol, timolol, metoprolol, pindolol, alprenolol, oxprenolol, labetalol, carvedilol
non selective B blockers
nadolol, propranolol, timolol
cardioselective (block B1 more than B2) B blockers
acebutolol, atenolol, metoprolol, esmolol
ISA (partial agonists) B blockers
pindolol, alprenolol, oxprenolol
alpha and beta blockers
lametalol and carvedilol
simple beta blockers (cardioselective)
-olol (A-M)
simple beta blockers
(nonselective)
-olol (N-Z)
3rd gen B blocker; highest affinity of all B blockers for B1 (low B2 affinity); vasodilation via stimulation of endothelial NO
nebivolol
adverse effects of which group?: bronchospasm, bradycardia, renal vasoconstriction, depression, bad dreams, fatigue, impotence, elevated triglycerides, lowered HDL, worsening of peripheral vascular diseases such as Reynauds
b blockers
block AngI to AngII conversion in endothelial cells of the lung; many are prodrugs
ACE Inhibitors
ACE inhibitors
lisinopril and other -prils
block AT1 receptors to induce vasodilation; also increase Na and water excretion
angiotensin receptor antagonists
angiotensin receptor antagonists
losartan, valsartan and other -tans
which group of drugs increase bradykinin levels due to inhibition of bradykinin metabolism?
ACE inhibitors
fetotoxicity; angioedema
ACE inhibitors and angiotensin receptor antagonists
next most common adverse effect of ACE inhibitors
dry irritating cough
in comparison to ACE inhibitors, angiotensin receptor antagonists do not cause …
dry cough
directly inhibits the protease activity of renin
renin inhibitor
renin inhibitor
aliskiren
must not combine renin inhibitor with … or … in diabetics
ACE-Is or ARBs
these drugs inhibit L-type Ca channels in the heart and vasculature, reducing contraction
Ca channel blockers
3 classes of Ca channel blockers
phenylalkylamines and benzothiazipines (nondihydropyridines); dihydropyridines
phenylalkylamine
verapamil
benzothiazipine
diltiazem
dihydropyridine
nifedipine
Ca channel blockers act on …
L-type Ca channels
dihydropyridines are
selective vasodilators
non-dihyrdopyridines are …. for cardiac tissue and vasculature
equipotent
verapamil can cause … when combined with a B blocker
AV block
all CCBs can cause
gingival hyperplasia
direct vasodilators; decrease TPR by relaxing arterioles followed by reflex tachycardia, increased contractility and increased renin secretion
hydralazine, minoxidil, diazoxide
direct vasodilator: red blood cells metabolize it into NO; induces SM relaxation (both arteries and veins); decreases TPR but also venous pooling (decrease venous return and CO); used to induce hypotension for surgery
sodium nitroprusside
hypertrichosis (useful as Rogain)
minoxidil
cyanide toxicity
sodium nitroprusside
… reduce the antihypertensive effects of ACE inhibitors and B blockers
NSAIDs
use of … is dangerous in patients taking non selective B blockers and AR neuron blocking agents
EPI
