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BMS 615 Cardiovascular > Test2: Wk8: 1 Drugs to treat hypertension - Henderson > Flashcards

Test2: Wk8: 1 Drugs to treat hypertension - Henderson Flashcards

1
Q

NonDrug Treatment (4)

A

Sodium restriction

Weight reduction

Exercise (cardio)

Decrease alcohol consumption

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2
Q

Pharmacological (Drug) Treatment

A

Usually diuretics and/or Ξ² blockers for initial therapy

Low dose/combinations to reduce adverse effects

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3
Q

𝑩𝑷=

A

π‘ͺ𝑢𝒙𝑻𝑷𝑹

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4
Q

3 Mechanisms of Antihypertensive Drugs

A
  1. Decrease TPR
  2. Decrease CO
  3. Decrease both
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5
Q

Drugs Used for Treatment of Chronic Essential Hypertension (4)

A

Diuretics

Inhibitors of the Angiotensin System

Sympatholytic Agents

Vasodilators

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6
Q

Diuretics (3)

A

Thiazides and related agents

Loop diuretics

Potassium sparing diuretics

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7
Q

Inhibitors of the Angiotensin System (3)

A

Angiotensin Converting Enzyme Inhibitors (ACEIs)

Angiotensin II Receptor Antagonists

Renin Inhibitors

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8
Q

Sympatholytic Agents (4)

A

Ξ² Blockers

Centrally acting Ξ± 2 agonists

Ξ± 1 Blockers

Adrenergic neuronal blocking agents

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9
Q

Vasodilators (3)

A

Ca 2+ channel blockers

K Channel activators

Guanylate cyclase activators

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10
Q

Thiazide and related diuretics Decrease mortality in

A

Decrease mortality in hypertension

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11
Q

What is Recommended for initial therapy

A

Thiazide and related diuretics

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12
Q

What is Recommended for isolated systolic hypertension in elderly

A

Thiazide and related diuretics

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13
Q

Thiazide and related diuretics: Mechanism Acute

A

Decrease plasma volume ➑ decrease CO ➑ decrease BP

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14
Q

Thiazide and related diuretics: Mechanism Chronic

A

Decrease TPR ➑ decrease BP

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15
Q

Thiazide and related diuretics: Adverse Affects

A

Hypokalemia
Sexual dysfunction
Hyperuricemia
Hyperglycemia

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16
Q

Thiazide and related diuretics: Drug Interactions (4)

A

Digoxin (hypokalemia)
Quinidine (hypokalemia)
NSAIDS (inhibit antihypertensive effect)
Antidiabetics (hyperglycemia)

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17
Q

Loop Diuretics Used as antihypertensive diuretic when GFR β€”

A

<30 ml/min

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18
Q

Loop Diuretics Used to combat

A

massive fluid retention induced by vasodilators

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19
Q

Loop Diuretics More effective than β€” as diuretics

A

thiazides as diuretics

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20
Q

Loop Diuretics Less effective than β€” as antihypertensives

A

thiazides

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21
Q

Potassium sparing Diuretics Used as

A

adjunctive drugs with thiazides and loop diuretics

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22
Q

Potassium sparing Diuretics Reduce/prevent hypokalemia induced by β€” and β€”

A

thiazide and loop diuretics

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23
Q

Potassium sparing Diuretic Adverse effects:

A

hyperkalemia

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24
Q

Potassium sparing Diuretic Spironolactone is a

A

Aldosterone Antagonist

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25
Q

Potassium sparing Spironolactone treats

A

Treat hypertension for primary hyperaldosteronism

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26
Q

Inhibitors of Renin Angiotensin System Mechanism cardiac effects

A

Decrease TPR, CO, and BP

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27
Q

ACE Inhibitors Used for (3)

A

diabetes
CHF
Post MI with systolic dysfuntion

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28
Q

ACE inhibitors drugs

A

Enalapril, lisinopril, benazepril, captopril, fosinopril

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29
Q

ACE Inhibitors Adverse Effects (6)

A 
Renal Failure 
Fetopathic potential ( avoid in pregnancy
Cough
Hyperkalemia 
Rash
Neutropenia
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30
Q

Angiotensin II Receptor Blockers (ARBs) Drugs

A

Losartan, Valsartan, Eprosartan

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31
Q

When to use ARBs

A

Use where ACE inhibitors are indicated but not tolerated

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32
Q

Avoid ARBs in

A

Avoid in pregnancy and renovascular disease

33
Q

ARBs Adverse Effects

A

similar to ACE Inhibitors but less cough

34
Q

Renin Inhibitors drugs

A

Aliskiren

35
Q

Aliskiren MOA

A

Inhibit renin ➑ decreases angiotensin I

36
Q

Aliskiren Effects

A

Similar to ACEIs with less cough

37
Q

Aliskiren uses

A

Hypertension

38
Q

Aliskiren contraindications

A

Similar to ACEIs

39
Q

Beta blockers decrease mortality in

A

hypertension

40
Q

β€” are recommended for initial therapy provided no contraindications exist

A

beta blockers

41
Q

Beta Blockers indications

A

post MI

CHF

42
Q

Beta Blockers Mechanisms

A

Beta1 receptor blockade

43
Q

Beta Blockers effects

A

decrease CO

decrease Renin secretion

44
Q

Beta blocker adverse effects come from actions on β€” receptors

A

Beta2

45
Q

Ξ² Blockers: Adverse Effects (9)

A
  • Bronchospasm
  • Decrease myocardial contractility
  • Decrease AV conduction
  • Decrease HDL, Increase triglycerides
  • insulin induced hypoglycemia
  • Cold extremities
  • Psychic depression
  • Fatigue
  • Sexual dysfunction
46
Q

Cardioselective Ξ² blockers (for diabetes)

A

Atenolol

47
Q

Ξ² blockers with Ξ± 1 blocking activity (for hyperlipidemia)

A

carvedilol and Labetolol

48
Q

Ξ² Blockers: Drug Interactions

A

NSAIDs
Digoxin
Verapamil, diltiazem

49
Q

Centrally acting Ξ± 2 Agonists no recommended for initial therapy except

A

during pregnancy

50
Q

Centrally acting Ξ± 2 Agonists Mechanism

A

Ξ± 2 receptor activation in CNS decreases sympathetic outflow

51
Q

Centrally acting Ξ± 2 Agonists effects

A

Decreases TPR and renin secretion

52
Q

Centrally acting Ξ± 2 Agonists drugs

A

Methyldopa, Clonidine

53
Q

Methyldopa MOA

A

Metabolized intraneuronally to Ξ± methyl NE ( Ξ± 2 agonist)

54
Q

Methyldopa uses

A

Treatment of hypertension during pregnancy

55
Q

Methyldopa adverse effects (6)

A 
Sedation 
Dry mouth 
Positive Coombs test 
Hepatitis 
Rebound hypertension upon withdrawal
Sexual dysfunction
56
Q

Clonidine Adverse effects and toxicities: (4)

A

Sedation
Dry mouth
Rebound hypertension upon withdrawal
Sexual Dysfunction

57
Q

Ξ± 1 Receptor Antagonists

A

Prazosin

58
Q

Prozosin Recommendation

A

not for initial therapy

59
Q

Prazosin is often not

A

effective chronically as monotherapy

60
Q

Prazosin has a favorable effect in

A

hyperlipidemia

61
Q

Prazosin MOA

A

Block alpha 1 receptors in vasculature to decrease TPR

62
Q

Prazosin Adverse effects and toxicities

A

1st dose orthostatic hypotension

sexual dysfunction

63
Q

Adrenergic Neuronal Blocking Agents Reserpine recommendation

A

not for initial therapy

64
Q

Adrenergic Neuronal Blocking Agents Reserpine mechanism and cardiac effects

A

deplete NE from adrenergic nerves

Decrease TPR, HR, CO and BP

65
Q

Reserpine adverse effects and toxicities (3)

A

antiadrenergic effects
psychic depression
GI

66
Q

Vasodilators mechanism

A

arteriodilation - Decrease TPR

venodilation - decrease CO

67
Q

Ca2+ Channel Blockers more effective in β€” than β€” or β€”

A

African Americans than ACEIs and Beta blockers

68
Q

Ca2+ Channel Blockers cardiac effects

A

decrease TPR

varying effects on CO

69
Q

Ca Channel Blockers Adverse Effects (4)

A

increase mortality
hypotension
decreased mycardial contractility
Decreased AV contraction

70
Q

avoid verapamil, diltiazem in CHF with

A

Ca channel blockers

71
Q

K Channel Openers mechanism

A

efflux of K ++β†’ hyperpolarization β†’ relaxation β†’ decrease TPR

72
Q

k Channel Openers - Drugs

A

Minoxidil

73
Q

Minoxidil is used for

A

treatment of severe refractory hypertension

74
Q

K Channel Openers Adverse effects (3)

A

marked fluid retention
tachycardia
hypertrichosis

75
Q

Guanylate Cyclase Activators mechanism cardiac effects

A

decrease TPR and BP

76
Q

Guanylate Cyclase Activators drug

A

Hydralazine

77
Q

Hydralazine used as therapy in

A

pregnancies with preeclampsia

78
Q

Hydralazine adverse effects (3)

A

lupus like syndrome
fluid retention
tachycardia

BMS 615 Cardiovascular (49 decks)

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