Pharmacology of Antihypertensives Flashcards
These anti-hypertensive agents are contraindicated in pregnancy.
ACE Inhibitors, ARBs, Aliskiren
What ADRs are associated with dihydropyridine calcium channel blockers?
Reflex tachycardia, pedal edema, gingival hyperplasia
These beta blockers are partial agonists.
Pindolol, acebutolol, penbutolol
What is the MOA of Aliskiren?
Competitive inhibitor of renin
What is the first-line diuretic for treatment of hypertension?
Thiazides - hydrochlorothiazide (Loop diuretics are used when thiazides are ineffective or contraindicated)
This beta blocker has an extremely short half life and is used in hypertensive emergencies and operations.
Esmolol
What are the common alpha blockers?
Doxazosin, prazosin, terazosin (-zosin)
These beta blockers are beta 1 selective.
Metoprolol and atenolol
True/False. Vasodilators may be used as monotherapy.
False - they are always adjunctive. The body has compensatory mechanisms to vasodilation that must be inhibited with other drugs
This vasodilator is a potassium channel opener that hyperpolarizes and relaxes vascular smooth muscle. It is also used topically to treat male baldness.
Minoxidil
What are the non-dihydropyridine calcium channel blockers?
Diltazem, verapamil
What are the common dihydropyridine calcium channel blockers?
Amlodipine, nifedipine
What electrolyte abnormality is associated with thiazides and loop diuretics?
Hypokalemia
What is the MOA of clonidine?
Centrally acting alpha2 agonist - temporarily increases BP until drug enters the CNS and decreases sympathetic signaling
What is the most common ADR associated with beta blockers?
Reduce exercise tolerance due to decreased CO and total peripheral resistance
What is the MOA of methyldopa?
Acts as a false neurotransmitter to stimulate central alpha2 receptors and decrease sympathetic signaling
What is the MOA of propanolol?
Non-selective beta antagonist
True/False. With hypertension, both cardiac output and peripheral vascular resistance are typically increased.
False - generally, only peripheral vascular resistance is increased
What is the MOA of fenoldopam?
Activates vascular D1 receptors to stimulate vasodilation
What drugs can be prescribed to prevent reflex tachycardia caused by anti-hypertensive medications?
Beta blockers
What ADRs are associated with methyldopa?
Sexual dysfunction, somnolence, positive Coombs test (hemolytic anemia)
This vasodilator is used in hypertensive emergencies, but is associated with cyanide toxicity.
Sodium nitroprusside
What is the MOA of losartan?
Angiotensin Receptor Blocker (ARB) - inhibit the effects of angiotensin II
What ADR is most assocaited with alpha blockers?
Postural hypotension
What ADRs are associated with ACE inhibitors?
Hypotension, cough, hyperkalemia, angioedema, rash
What are the MOA of catopril and lisinopril?
Angiotensin Converting Enzyme (ACE) Inhibitors - decrease systemic vascular resistance
Hypertension is defined as a BP over what value?
140/90 mmHg
Calcium channel blockers inhibit calcium influx through voltage-gated channels to relax vascular smooth muscle. How do the dihyropyridine and non-dihydropyridine CCBs differ?
In addition to relaxing vascular smooth muscle, non-dihydropyridine CCBs also decrease HR by slowing AV nodal conduction
What is the MOA of hydralazine?
Releases NO from endothelial cells to cause vasodilation
What are the most common ADRs of clonidine?
Sedation, sexual dysfunction
This beta blocker acts on both alpha and beta receptors.
Labetolol
This long-acting potassium channel opener is used via IV in hypertensive emergencies.
Diazoxide
This beta blocker is beta1 selective and increases nitric oxide.
Nevibulol
