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PHARM/MHD - Exam #4 > Pharm#8 - Anti Hypertensive Drugs > Flashcards

Pharm#8 - Anti Hypertensive Drugs Flashcards

1
Q

Hydralazine
MOA
Indication

A

vasodilator

RESISTANT HYPERTENSION
- pregnancy induced hypertension

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2
Q

Chlorthalidone

moa
indication

A

thiazide diuretic

1st line drug in uncomplicated HTN

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3
Q

Furesomide

MOA Indication

A

loop diuretic

HTN in severe renal insufficiency

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4
Q

Spironolactone

MOA
Indication

Eplrenenone
-MOA, indication

A

aldosterone receptor antagonist

  • used in combo with other antihypertensives that deplete K+
  1. Aldosterone receptor blocker
    - combo tx. with diuretics to minimize K loss
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5
Q

Triamterene & amiloride

moa
indication

A
  • Enac inhibitors

- combo with diuretics to minimize K loss

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6
Q

Nifedipine

MOA
indication

A

Ca channel antagonist

1st line drug used in uncomplicated HTN

  • used in diabetes and hyperlipidemia
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7
Q

Diltiazem & Verapamil

MOA
indication

A

Ca channel antagonist

1st line in HTN

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8
Q

Clonidine & Guanfacine

MOA
indication

A

alpha 2 agonist

second line HTN

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9
Q

Methyldopa

MOA
indication

A

alpha 2 agonist

HTN in pregnancy

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10
Q

Reserpine

MOA
indication

A

depletes MOA from storage vesicles

resistant HTN

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11
Q

Phenoxybenzamine

MOA
indication

A

alpha blocker (non-selective)

tx for pheochromocytoma before surgery

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12
Q

Prazosin
MOA
indication

A

alpha blocker

2nd line for chronic HTN

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13
Q

Terazosin & Doxazosin

MOA
indication

A

(longer half life than prazosine = better)

alpha 1 blockers (selective)

2nd line for chronic HTN

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14
Q

propranolol

MOA
indication

A

non-selective B blocker

HTN with angina, MI, or arrhythmia
- do not use with asthmatics

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15
Q

Nadolol
MOA
indication

A

selective B blocker

  • long term angina, HTN
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16
Q

Pindolol

MOA
indication

A

partial B agonist

CHRONIC HTN

  • use for patients that are active or sensitive to bradycardia
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17
Q

Metoprolol

MOA
indication

A

B1 antagonist

HTN, long term angina tx

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18
Q

Atenolol

MOA
indication

A

B1 blocker

CHRONIC HTN
- angina, MI, arrhythmia, HF

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19
Q

Labetolol

MOA
indication

A

mixed alpha beta antagonist

  • Chronic HTN
20
Q

Carvedilol

MOA
indication

A

mixed alpha beta receptor antagonist and NO generator

  • Chronic HTN and CHF
21
Q

Hydralazine

MOA
indication

A

vasodilator

resistant HTN, pregnancy induced HTN

22
Q

Minoxidil

MOA
indication

A

vasodilator

resistant HTN

23
Q

Nitroprusside

MOA
indication

A

vasodilator

acute hypertensive crisis

24
Q

Captopril

MOA
indication

A

ACE inhibitor

1st line drug in chronic HTN
- used in HF, MI, and diabetes

25
Q

Enalapril

MOA
indication

A

ACE inhibitor

1st line in chronic HTN, used in HF

26
Q

Lisinipril

MOA
indication

A

ACE inhibitor

1st line in chronic HTN

27
Q

Losartan

MOA
indication

A

Angiotensin receptor inhibitor

1st line drug in chronic HTN

28
Q

What is defined as Stage 1 HTN?

Systolic & diastolic

Stage 2?
Who are treated more vigorously for high BP, old or young?

A

140 -159

90-99

> 160 or >100

  • young

treatment is initiated only at higher pressures in younger patients (

29
Q

What drugs are contraindicated in pregnant patients?

A

ACE inhibitors!

  • as well as Angiotensin receptor inhibitors
30
Q

How does hypokalemia occur with Thiazide use?

A

volume contraction with thiazide diuretics due to loss of Na (pulls water) which stimulates aldosterone & more Enac channels into the membrane

-rebound Na reabsorption
results in K+ leaving due to increased negative charge in lumen

  • also pulls H+ and results in metabolic alkalosis
31
Q

Which drugs (loop or thiazide) should be used for patients with renal insufficiency?

A

LOOP

  • also do not give a new diuretic to a pregnant patient
  • loop diuretics are not THAT effective in a healthy patient, more effective for patients with RENAL INSUFFICIENCY
32
Q

drug interactions for loop diuretics (2)

A

NSAIDS
(loop, thiazide, K+)

Aminoglycosides (increase ototoxicity)

33
Q

Contraindication for K+ sparing drugs

spironolactone, eplrenone, triamterene, amiloride

A

RAS inhibitors

(Ace inhibitors & angiotensin receptor inhibitors)

ACE INHIBITORS EXCACERBATE HYPERKALEMIA!!

34
Q

SE of nifedipine

A

acute tachycardia

peripheral edema

35
Q

SE of verapamil

A

bradycardia

36
Q

Non-dihydropyridines are contraindicated in Pts with what?

state the drugs (2)

A
  • conduction disturbances
  • uncompensated HF (results in cariogenic shock)
  • diltiazem
  • verapamil

Metabolized by liver, caution in patients with liver failure

37
Q

Clonidine main SE?

What should be used instead

A

Rebound HTN when withdraw use

  • Guanfacine has longer half life less chance of rebound
38
Q

alpha 2 agonist that can be used in pregnancy

A

methyldopa

  • do not use in parkinson’s patients on LDOPA since this results in inhibition of action
39
Q

SE for alpha 2 agonists

clonidine, gunfacine, methyldopa

A

BUT MAIN SIDE EFFECT = SEDATION!!! for alpha 2 agonists

40
Q

MOA of B-Blockers (3)

A

decreased cardiac contractility and CO, decreased renin secretion and thus decreased Angiotensin II production

41
Q

What antihypertensive drugs increase TG’s and reduce HDLS

A

B-Blockers

B-blockers block B2 receptors so reduce blood flow to lower limbs which utilize a lot of TG  so there is thus an increase TG in plasma since less flow to the limbs with these drugs

42
Q

Contraindication for BB

A

Cardiogenic Shock
Sinus bradycardia
Asthma
Severe heart failure

43
Q

Hydralazine & nitroprusside only used in ___

A

resistant HTN

  • can induce Lupus like autoimmune when taken for a long time! (resolves when drug is stopped
44
Q

SE of ACEI

A

Problem of ACEI = dry cough related to increased bradykinin production!

45
Q

Which ACEI:
1. short half life* (taken often), requires multiple daily doses, active
metabolites

2.converted to active metabolite enalaprilat,

longer
onset of action, longer half-life, can dose 1-2x per day

  1. ALLOWS ONCE daily dosing
A

CAPTOPRIL

Enalapril
-needs to be converted to active metabolite and thus unpredictable in his onset of action
longer onset & longer half life

Lisinopril

46
Q

What drug mediates vasoconstriction & Na retention but is not associated with dry cough like ACEI?

A

LOSARTAN

  • angiotensin II receptor blocker

PHARM/MHD - Exam #4 (20 decks)

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