Secondary HTN Drugs Flashcards
What are the 4 loops diuretics (K+ losing)?
Furosemide
Torsdemide
Bumetanide
Ethacrynic acid
Where do the Loops Diuretics work at?
Thick ascending limb of the loop of henle
MOA for Loops diuretics?
(-) Na, K, 2Cl cotransporter
Unlike Thiazide diuretics, Loop diuretics are effective in patients with?
LOW GFR
What toxicity can occur when taking Loop diuretics like Furosemide?
Ototoxicity
What electrolyte changes are seen/allergy with Loop Diuretics?
Hypo-electrolytes
Sulfonamide allergy patients should not take
There are 2 types of K+ sparing Diuretics. What are they?
Aldosterone Antagonists
ENaC blockers
There are 2 types of K+ sparing Diuretics. What are they?
Aldosterone Antagonists
ENaC blockers
What are the Aldosterone Antagonists?
Spironolactone
Eplerenone
What are the ENaC blockers?
Amiloride
Triamterene
What are the ENaC blockers?
Amiloride
Triamterene
Where do K+ sparing Diuretics, (ENaC blockers and Aldosterone Antagonists) work?
Collecting duct
Where do K+ sparing Diuretics (ENaC blockers and Aldosterone Antagonists) work?
Collecting duct
MOA for ENaC blockers?
(-) Na+ channels at collecting duct
What electrolyte change can K+ sparing Diuretics result in?
Hyperkalemia
What are 4 K+ sparing Diuretics?
Amiloride
Triamterene
Spironolactone
Eplerenone
What is a direct Renin inhibitor?
Aliskiren
MOA for Aliskiren?
(-) Renin from converting Angiotensinogen to Angiotensin 1
Are they any benefits for taking Aliskiren (Renin (-))?
NO - evidence of increased risk of adverse effects
What is a nonselective Beta Blocker?
Propranolol
What are 3 Beta1 blockers?
Metoprolol
Bisoprolol
Atenolol
What are 3 Beta1 blockers?
Metoprolol
Bisoprolol
Atenolol
Abrupt stoppage of ____ and ____ will cause an increase in SNS tone = tachycardia, rebound HTN, MI or death
alpha 2 agonists and beta blockers
Alpha 1 receptor job
Vasoconstriction
Alpha 2 receptor job
Inhibitory feedback mechanisms in brain to decrease sympathetic tone
Beta1 receptor job
Increase HR, contractility and renin secretion
Beta2 receptor job
Skeletal muscle vasodilation
What are 3 alpha1 blockers?
Prazosin
Doxazosin
Terazosin
What are 3 alpha1 blockers?
Prazosin
Doxazosin
Terazosin
Adverse effects of Alpha1 blockers like Prazosin?
Orthostatic hypotension
Retrograde ejaculation
What else can Alpha1 blockers like Doxazosin and Terazosin treat?
BPH and kidney stones
Where do Alpha2 Agonists target?
Brainstem
What are 2 Alpha2 Agonists?
Clonidine
Methyldopa
What are 2 Alpha2 Agonists?
Clonidine
Methyldopa
What are the adverse effects of Clonidine and what is its drug class?
Alpha2 Agonist
– Rebound HTN if dose missed, xerostomia, drowsy
When is Methyldopa used and what is its drug class?
Alpha2 Agonist
= Used for gestational HTN (during pregnancy)
What are the adverse effects seen with Methyldopa use and what is its drug class?
Alpha2 Agonist
- (+) coombs test
- SLE like syndrome
What are 3 direct vasodilators?
Hydralazine
Nitroprusside
Minoxidil
What are 3 direct vasodilators?
Hydralazine
Nitroprusside
Minoxidil
3 vasodilators, what they dilate and when/if they are used?
- Hydralazine (artery dilation) – used in HTN emergency of pregnant women
- Nitroprusside (artery and vein dilation)
- Minoxidil (artery dilation)
