Lecture 8 - Antihypertensive Therapies Flashcards
Which are the first line drugs given to HTN patients with no comorbidities?
Thiazide diuretics
ACE inhibitors or ARBs
CCBs
______ is a weak diuretic that inhibits Carbonic anyhdrase (H+/Na+ exchanger) at the PCT. It is used to treat metabolic ______ and Glaucoma. Keep in mind this is the only diuretic that causes metabolic ______.
Acetazolamide
Alkylosis
Acidosis
Furosemide (Lasix) is a loop diuretic that acts on the thick _____ loop of Henle by inhibiting the co transport of K+/Na+/2Cl-. Loop diuretics are the strongest diuretics and are used to treat _____ edema, HTN, and Hyper____ (be on the lookout for patients with Ca++ kidney stones –> not good candidates for loop diuretics.) Keep in mind Loop diuretics cause metabolic ______, which is the opposite of Acetazolamide.
What does the mnemonic OHH DAANG stand for in terms of Loop diuretic side effects?
Ascending loop
Pulmonary
Hypercalcemia
Alkylosis
O - Ototoxicity
H - Hypokalemia
H - Hypomagnesemia
D - Dehydration A - Allergy A - Alkylosis N - Nephritis G - Gout
Thiazide diuretics act on the _____ of the nephron by inhibiting co-transport of Na+ and Cl-. They include Metolazone and Chlorthalidone, as well as Hydrochlorothiazide.
DCT
Keep in mind Thiazide diuretics acting in opposition to Loop diuretics, so they can be used to TREAT _______ (which is something the loops cause). The mnemonic Hyper GLUC describes their side effects. What does GLUC stand for?
Hypercalciuria
Glycemia
Lipidemia
Uricemia
Calcemia
BOTH Thiazide and Loop diuretics have what effect of Kalemia, and how does this compare to diuretics that act on the Collection Ducts?
They both decrease Kalemia by promoting loss of K+ in the urine, while those that act on the Collecting Ducts will INCREASE Kalemia.
Spironolactone and Triamterene are diuretics that act on the _____ ____ in the nephron.
What is their effect on Kalemia?
Spironolactone blocks _____ receptors, and Triamterene blocks _____ channels. Look out for patients using Spironolactone drugs to show signs of _____ as a side effect.
Collecting Duct
Increase Kalemia
Aldosterone receptors
Na+ channels
Gynecomastia
Nadolol and Propranolol are __-_____ Beta blockers.
Non-selective
_____ and ____ are non-selective Beta blockers that also block Alpha receptors. Which one is a first-line drug for CHF and which is good for treating HTN emergencies?
Carvedilol
Labetalol
Carvedilol for CHF and Labetalol for HTN emergencies
One of the biggest concerns for use of ACE inhibitors is they are _____, so make sure NOT to give them to pregnant patients or patients who may become pregnant. The suffix -____ indicates an ACE inhibitor, while the suffix -____ indicates an ARB.
Teratogenic
- pril
- artan
Alpha 1 agonists cause smooth muscle contraction, so Alpha 1 blockers are good for HTN. Patients with benign _____ hyperplasia can also be treated with these. Dizziness and ______ hypotension are common side effects.
Prostatic Hyperplasia
Othorstatic Hypertension
Because Alpha 2 agonists counteract Alpha 1 agonism, they can help lower BP. ______ is one that is useful for pregnant patients, but it can cause a hemolytic anemia. _____ is another Alpha 2 AGONIST that can be used, but it can cause rebound ______ after sudden withdrawal from a high dose.
Methyldopa
Clonidine
Sodium ______ is used to treat HTN emergencies via NO activity. It is given IV. One of the side effects of metabolizing this drug is ______ toxicity. Remember that _______ (Viagra) has the same mech of action.
Sodium Nitroprusside
Cyanide
Sildenafil
Hypertensive Urgency is classified as Systolic > _____mmHg and/or Diastolic > _____mmHg.
Hypertensive Emergency is classified as Systolic > _____ and Diastolic > _____. This is the one that shows evidence for end organ damage.
160mmHg
100mmHg
180
120
