PRELIMS: Cardiovascular Drugs Flashcards
Categories of Hypertension: Elevated BP due to specific abnormalities like chronic kidney disease, renal artery stenosis, certain drugs, catecholamine-producing tumors, endocrine disorders, or cerebral damage. Less than 10% of patients with hypertension.
Secondary Hypertension
Categories of Hypertension: No clear, discernible cause of elevated BP. Accounts for 90% of hypertensive individuals.
Primary hypertension
Mechanisms of Essential Hypertension
Various mechanisms might contribute to essential hypertension, including genetic factors, lifestyle factors, and possible abnormalities in blood vessel function or kidney regulation.
Categories of Antihypertensive Agents
Diuretics: Increase urine formation and excretion, reduce fluid volume in the vascular system.
Beta-Blockers: Decrease heart rate and cardiac output.
ACE Inhibitors: Block the conversion of angiotensin I to angiotensin II, reducing vasoconstriction.
Angiotensin II Receptor Blockers (ARBs): Block the effects of angiotensin II at its receptor.
Calcium Channel Blockers: Prevent calcium entry into cells, reducing vascular resistance.
Thiazide Diuretics - Mechanism of Action
Act primarily on the early portion of the distal tubule, inhibiting sodium reabsorption. Increased sodium and water retention in the nephron leads to diuretic effect.
Loop Diuretics - Mechanism of Action
Act on the ascending limb of the loop of Henle, inhibiting sodium and chloride reabsorption, preventing the reabsorption of water.
Potassium-Sparing Diuretics - Mechanism of Action
Prevent potassium secretion into the distal tubule. Interfere with the sodium-potassium exchange, leading to sodium excretion while reducing potassium loss.
Side Effects of Diuretics
Fluid depletion and electrolyte imbalances
Thiazides: Hyponatremia, hypokalemia, hyperlipidemia, increased uric acid
Loop Diuretics: Hypomagnesemia, ototoxicity, gout
Potassium-Sparing Diuretics: Hyperkalemia, gynecomastia (Spironolactone)
Common Effects: Weakness, fatigue, orthostatic hypotension, GI disturbances, mood changes, confusion
Thiazide Diuretics - Examples
Hydrochlorothiazide
Chlorthalidone
Indapamide
Metolazone
: Loop Diuretics - Examples
Furosemide
Bumetanide
Torsemide
Ethacrynic acid
Thiazide Diuretics - Common Uses
Essential hypertension
Mild to moderate heart failure
Edema associated with various conditions (e.g., liver cirrhosis)
Potassium-Sparing Diuretics - Examples
Spironolactone
Eplerenone
Triamterene
Amiloride
Loop Diuretics - Common Uses
Severe heart failure
Pulmonary edema
Edema associated with renal or hepatic disease
Potassium-Sparing Diuretics - Common Uses
Hypertension (often in combination with other diuretics)
Heart failure (to reduce aldosterone effects)
Conditions causing hypokalemia (e.g., when combined with thiazides)
CATEGORIES OF ANTIHYPERTENSIVE AGENTS
DIURETICS
Agents that BLOCK PRODUCTION OR ACTION OF ANGIOTENSIN
DIRECT VASODILATORS
SYMPATHOPLEGIC AGENTS
Increase the formation and excretion of urine
increase the renal excretion of water and sodium, thus decreasing the volume of fluid within the vascular system
DIURETICS
lower BP by depleting the body of sodium and reducing blood volume
Diuretics
lower BP by reducing PVR
inhibiting cardiac function, and increasing venous pooling in capacitance vessels reduce CO
sites of action in the sympathetic reflex arc
SYMPATHOPLEGIC AGENTS
