PCOL 406 Exam 2 Flashcards
Nonselective a-blockers meds
phenoxybenzamine
phentolamine
Selective a1-blockers meds
doxazosin
tamsulosin
alfuzosin
silodosin
Nonselective B-blockers meds
propranolol
timolol
pindolol
Selective B1-blockers meds
atenolol
esmolol
metoprolol
a- and B- Adrenoceptor Antagonists
carvedilol
labetalol
Alfuzosin, tamsulosin mechanism of action
competitive a1-blocker
Alfuzosin, tamsulosin pharmacological effects
relax bladder, urethral and prostate smooth muscle
Alfuzosin, tamsulosin clinical use
urinary symptoms caused by benign prostatic hyperplasia
Doxazosin, prazosin, terazosin mechanism of action
competitive a1-blocker
Doxazosin, prazosin, terazosin pharmacological effects
- causes vasodilation and decreases blood pressure
- relax bladder, urethral, and prostate smooth muscle
Doxazosin, prazosin, terazosin clinical use
- hypertension
- urinary symptoms cause by benign prostatic hyperplasia
Phenoxybenzamine mechanism of action
noncompetitive a1- and a2- blocker
Phenoxybenzamine pharmacological effect
causes vasodilation and decreases blood pressure
Phenoxybenzamine clinical use
hypertension in pheochromocytoma
Phentolamine mechanism of action
competitive a1- and a2- blocker
Phentolamine pharmacological effect
- causes vasodilation
- decreases vascular resistance and blood pressure
Phentolamine clinical use
- hypertension in pheochromocytoma
- treat necrosis and ischemia after injection of an a-adrenoceptor agonist
Acebutolol mechanism of action
B1-blocker with ISA and MSA
Acebutolol pharmacological effect
decreases cardiac rate, output, O2 demand, AV node conduction, and blood pressure
Acebutolol clinical use
- hypertension
- cardiac dysrhythmias
Atenolol mechanism of action
B1-blocker
Atenolol pharmacological effect
decreases cardiac rate, output, O2 demand, AV node conduction, and blood pressure
Atenolol clinical use
- hypertension
- angina pectoris
- acute myocardial infarction
Betaxolol mechanism of action
B1-blocker
Betaxolol pharmacological effect
- decreases cardiac rate, output, O2 demand, AV node conduction, and blood pressure
- decreases intraocular pressure
Betaxolol clinical use
glaucoma
Bisoprolol mechanism of action
B1-blocker
Bisoprolol pharmacological effect
decreases cardiac rate, output, O2 demand, AV node conduction, and blood pressure
Bisoprolol clinical use
hypertension
Esmolol mechanism of action
B1-blocker
Esmolol pharmacological effect
decreases cardiac rate, output, O2 demand, AV node conduction, and blood pressure
Esmolol clinical use
acute supraventricular tachycardia and hypertension
Metoprolol mechanism of action
B1-blocker with MSA
Metoprolol pharmacological effect
decreases cardiac rate, output, O2 demand, AV node conduction, and blood pressure
Metoprolol clinical use
- hypertension
- angina pectoris
- acute myocardial infarction
Nadolol mechanism of action
B1- and B2- blocker
Nadolol pharmacological effect
decreases cardiac rate, output, O2 demand, AV node conduction, and blood pressure
Nadolol clinical use
- hypertension
- angina pectoris
- migraine headache
Nebivolol mechanism of action
B1-blocker
Nebivolol pharmacological effect
decreases cardiac rate, output, O2 demand, AV node conduction, and blood pressure
Nebivolol clinical use
hypertension
Pindolol mechanism of action
B1- and B2- blocker with ISA and MSA
Pindolol pharmacological effect
decreases cardiac rate, output, O2 demand, AV node conduction, and blood pressure
Pindolol clinical use
hypertension
Propranolol mechanism of action
B1- and B2- blocker with MSA
Propranolol pharmacological effect
decreases cardiac rate, output, O2 demand, AV node conduction, and blood pressure
Propranolol clinical use
- hypertension
- angina pectoris
- cardiac dysrhythmias
- hypertrophic subaortic stenosis
- essential tremor
- migraine headache
- acute thyrotoxicosis
- acute myocardial infarction
- pheochromocytoma
Timolol mechanism of action
B1- and B2- blocker
Timolol pharmacological effect
- decreases cardiac rate, output, O2 demand, AV node conduction, and blood pressure
- decreases intraocular . pressure
Timolol clinical use
- hypertension
- acute myocardial infarction
- migraine headache
- glaucoma
Carvedilol mechanism of action
B1- and B2- blocker, a1-blocker
Carvedilol pharmacological effect
- causes vasodilation
- decreases heart rate and blood pressure in patients with hypertension
- increases cardiac output in patients with heart failure
Carvedilol clinical use
- hypertension
- heart failure
Labetalol mechanism of action
B1- and B2- blocker with MSA, a1-blocker
Labetalol pharmacological effect
- causes vasodilation
- decreases heart rate and blood pressure
Labetalol clinical use
hypertension
Diuretics meds
thiazides
hydrochlorothiazide
Potassium Sparing Diuretics meds
amiloride
Sympatholytics adrenoceptor antagonist meds
carvedilol metoprolol propranolol atenolol doxazosin metyrosine
Sympatholytics centrally acting drugs meds
clonidine
Angiotensin-converting enzyme (ACE) inhibitors meds
lisinopril
benazepril
enalapril
Angiotensin receptor antagonists meds
losartan
candesartan
irbesartan
Direct renin inhibitor meds
aliskiren
Vasodilators calcium channel blockers (CCBs) meds
amlodipine diltiazem nifedipine verapamil hydralazine
Vasodilators Dopamine agonist meds
fenoldopam
Primary Hypertension
cannot be attributed to a specific cause
Secondary Hypertension
results from an identifiable cause
Angiotensin II
may cause vascular injury by activating growth factors that cause vascular smooth muscle proliferation and hypertrophy as well as fibrotic changes in the vascular wall
Cardiac Output
product of stroke volume and heart rate, increased by sympathetic stimulation via activation of B1-adrenoceptors in the heart
PVR (Peripheral Vascular Resistance)
determined by the resistance to blood flow through the arterioles
Thiazide and loop diuretics common adverse effects
- blood cell deficiencies
- hyperlipidemia
- hyperuricemia
- hypokalemia
- electrolyte changes
- aggravation of diabetes
Thiazide and loop diuretics common drug interactons
- increase serum levels of lithium
- hypotensive effect decreased by NSAIDs
- augmented by ACE inhibitors
Potassium sparing diuretics common adverse effects
hyperkalemia
Potassium sparing diuretics common drug interactions
hyperkalemic effect increased by ACE inhibitors and potassium supplements
a-adrenoceptor antagonists common adverse effects
- dizziness
- first dose syncope
- fluid retention
- orthostatic hypotension
a-adrenoceptor antagonists common drug interactions
hypotensive effect increased by B-adrenoceptor antagonists and diuretics
Clonidine common adverse effects
- dry mouth
- fatigue
- rebound hypertension
- sedation
Clonidine common drug interactions
- hypotensive effect decreased by tricyclic antidepressants
- sedative effect increased by CNS depressants
B-adrenoceptor antagonists common adverse effects
- bradycardia
- bronchoconstriction
- depression
- fatigue
- impaired glycogenolysis
- vivid dreams
B-adrenoceptor antagonists common drug interactions
- cardiac depression increased by diltiazem and verapamil
- hypotensive effect decreased by NSAIDs
Guanfacine common adverse effects
- dry mouth
- fatigue
- rebound hypertension
- sedation
Guanfacine common drug interactions
- hypotensive effect decreased by tricyclic antidepressants
- sedative effect increased by CNS depressants
Methyldopa common adverse effects
- autoimmune hemolytic anemia
- hepatitis
- lupus-like syndrome
- dry mouth
- fatigue
- rebound hypertension
- sedation
Methyldopa common drug interactions
- hypotensive effect increased by levodopa
- hypotensive effect decreased by tricyclic antidepressants
- sedative effect increased by CNS depressants
ACE inhibitors common adverse effects
- acute renal failure
- angioedema
- cough
- hyperkalemia
- metallic taste
- neutropenia
- rash
ACE inhibitors common drug interactions
- increase serum levels of lithium
- hyperkalemic effect increased by potassium-sparing diuretics and potassium supplements
- hypotensive effect decreased by NSAIDs
Angiotensin receptor antagonists common adverse effects
hyperkalemia
Angiotensin receptor antagonists common drug interactions
serum levels of drug increased by cimetidine and decreased by phenobarbital
Aliskiren common adverse effects
hyperkalemia
Aliskiren common drug interactions
- aliskiren reduces serum levels of furosemide
- cyclosporine increases levels of aliskiren
Dihydropyridine common adverse effects
- dizziness
- edema
- gingival hyperplasia
- headache
- tachycardia
Dihydropyridine common drug interactions
serum levels of drug increased by azole antifungal agents, cimetidine, and grapefruit juice
Diltiazem common adverse effects
- atrioventricular block
- bradycardia
- constipation
- dizziness
- edema
- gingival hyperplasia
- headache
- heart failure
Diltiazem common drug interactions
- increases serum levels of carbamazepine, digoxin, and theophylline
- decreases serum levels of lithium
Verapamil common adverse effects
- atrioventricular block
- bradycardia
- constipation
- dizziness
- edema
- gingival hyperplasia
- headache
- heart failure
Verapamil common drug interactions
- increases serum levels of carbamazepine, digoxin, and theophylline
- decreases serum levels of lithium
Hydralazine common adverse effects
- angina
- dizziness
- fluid retention
- headache
- lupus-like syndrome
- tachycardia
Hydralazine common drug interactions
hypotensive effect decreased by NSAIDs
Minoxidil common adverse effects
- angina
- dizziness
- fluid retention
- headache
- hypertrichosis
- pericardial effusion
- tachycardia
Minoxidil common drug interactions
hypotensive effect decreased by NSAIDs
Nitroprusside common adverse effects
- dizziness
- headache
- increased intracranial pressure
- methemoglobinemia
- thiocyanate
- cyanide toxicity
Nitroprusside common drug interactions
none
Fenoldopam common adverse effects
- headache
- nausea
Fenoldopam common drug interactions
none
Age 65+ most preferred drugs
ARB, ACEI, CCB, thiazide diuretic
Age 65+ least preferred drugs
clonidine, B-blocker
African heritage most preferred drugs
thiazide diuretic, CCB
African heritage least preferred drugs
B-blocker
Pregnant most preferred drugs
methyldopa, labetalol
Pregnant least preferred drugs
ACEI, ARB, aliskiren
Angina Pectoris most preferred drugs
B-blocker, CCB
Angina Pectoris least preferred drugs
hydralazine, minoxidil
Myocardial infarction most preferred drugs
ACEI, ARB, B-blocker, aldosterone antagonist
Myocardial infarction least preferred drugs
hydralazine, minoxidil
Congestive heart failure most preferred drugs
ACEI, ARB, B-blocker, thiazide or loop diuretics
Congestive heart failure least preferred drugs
verapamil
Stroke prevention most preferred drugs
ARB, ACEI, CCB, thiazide diuretic
Kidney disease most preferred drugs
ACEI or ARB
Diabetes most preferred drugs
ACEI, ARC, CCB, thiazide diuretic
Asthma most preferred drugs
ACEI, ARC, CCB, thiazide diuretic
Benign prostatic hyperplasia most preferred drugs
a-blocker
Migraine headache most preferred drugs
B-blocker, CCB
Osteoporosis most preferred drugs
thiazide diuretic
Organic Nitrites and Nitrates meds
amyl nitrate
isosorbide dinitrate
isosorbide mononitrate
nitroglycerin
Calcium Channel Blockers meds
amlodipine
nifedipine
diltiazem
verapamil
B-Adrenoceptor Antagonists meds
atenolol
metoprolol
nadolol
propranolol
Other Agents meds
ranolazine
ivabradine
trimetazidine
Amlodipine oral bioavailability
75%
Amlodipine excreted unchanged in urine
10%
Amlodipine elimination half life
40 hours
Felodipine oral bioavailability
20%
Felodipine excreted unchanged in urine
1%
Felodipine elimination half life
14 hours