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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
Potassium sparing Spironolactone treats
Treat hypertension for primary hyperaldosteronism
26
Inhibitors of Renin Angiotensin System Mechanism cardiac effects
Decrease TPR, CO, and BP
27
ACE Inhibitors Used for (3)
diabetes CHF Post MI with systolic dysfuntion
28
ACE inhibitors drugs
Enalapril, lisinopril, benazepril, captopril, fosinopril
29
ACE Inhibitors Adverse Effects (6)
``` Renal Failure Fetopathic potential ( avoid in pregnancy Cough Hyperkalemia Rash Neutropenia ```
30
Angiotensin II Receptor Blockers (ARBs) Drugs
Losartan, Valsartan, Eprosartan
31
When to use ARBs
Use where ACE inhibitors are indicated but not tolerated
32
Avoid ARBs in
Avoid in pregnancy and renovascular disease
33
ARBs Adverse Effects
similar to ACE Inhibitors but less cough
34
Renin Inhibitors drugs
Aliskiren
35
Aliskiren MOA
Inhibit renin ➑ decreases angiotensin I
36
Aliskiren Effects
Similar to ACEIs with less cough
37
Aliskiren uses
Hypertension
38
Aliskiren contraindications
Similar to ACEIs
39
Beta blockers decrease mortality in
hypertension
40
--- are recommended for initial therapy provided no contraindications exist
beta blockers
41
Beta Blockers indications
post MI | CHF
42
Beta Blockers Mechanisms
Beta1 receptor blockade
43
Beta Blockers effects
decrease CO decrease Renin secretion
44
Beta blocker adverse effects come from actions on --- receptors
Beta2
45
Ξ² Blockers: Adverse Effects (9)
- Bronchospasm - Decrease myocardial contractility - Decrease AV conduction - Decrease HDL, Increase triglycerides - insulin induced hypoglycemia - Cold extremities - Psychic depression - Fatigue - Sexual dysfunction
46
Cardioselective Ξ² blockers (for diabetes)
Atenolol
47
Ξ² blockers with Ξ± 1 blocking activity (for hyperlipidemia)
carvedilol and Labetolol
48
Ξ² Blockers: Drug Interactions
NSAIDs Digoxin Verapamil, diltiazem
49
Centrally acting Ξ± 2 Agonists no recommended for initial therapy except
during pregnancy
50
Centrally acting Ξ± 2 Agonists Mechanism
Ξ± 2 receptor activation in CNS decreases sympathetic outflow
51
Centrally acting Ξ± 2 Agonists effects
Decreases TPR and renin secretion
52
Centrally acting Ξ± 2 Agonists drugs
Methyldopa, Clonidine
53
Methyldopa MOA
Metabolized intraneuronally to Ξ± methyl NE ( Ξ± 2 agonist)
54
Methyldopa uses
Treatment of hypertension during pregnancy
55
Methyldopa adverse effects (6)
``` Sedation Dry mouth Positive Coombs test Hepatitis Rebound hypertension upon withdrawal Sexual dysfunction ```
56
Clonidine Adverse effects and toxicities: (4)
Sedation Dry mouth Rebound hypertension upon withdrawal Sexual Dysfunction
57
Ξ± 1 Receptor Antagonists
Prazosin
58
Prozosin Recommendation
not for initial therapy
59
Prazosin is often not
effective chronically as monotherapy
60
Prazosin has a favorable effect in
hyperlipidemia
61
Prazosin MOA
Block alpha 1 receptors in vasculature to decrease TPR
62
Prazosin Adverse effects and toxicities
1st dose orthostatic hypotension | sexual dysfunction
63
Adrenergic Neuronal Blocking Agents Reserpine recommendation
not for initial therapy
64
Adrenergic Neuronal Blocking Agents Reserpine mechanism and cardiac effects
deplete NE from adrenergic nerves | Decrease TPR, HR, CO and BP
65
Reserpine adverse effects and toxicities (3)
antiadrenergic effects psychic depression GI
66
Vasodilators mechanism
arteriodilation - Decrease TPR venodilation - decrease CO
67
Ca2+ Channel Blockers more effective in --- than --- or ---
African Americans than ACEIs and Beta blockers
68
Ca2+ Channel Blockers cardiac effects
decrease TPR | varying effects on CO
69
Ca Channel Blockers Adverse Effects (4)
increase mortality hypotension decreased mycardial contractility Decreased AV contraction
70
avoid verapamil, diltiazem in CHF with
Ca channel blockers
71
K Channel Openers mechanism
efflux of K ++β†’ hyperpolarization β†’ relaxation β†’ decrease TPR
72
k Channel Openers - Drugs
Minoxidil
73
Minoxidil is used for
treatment of severe refractory hypertension
74
K Channel Openers Adverse effects (3)
marked fluid retention tachycardia hypertrichosis
75
Guanylate Cyclase Activators mechanism cardiac effects
decrease TPR and BP
76
Guanylate Cyclase Activators drug
Hydralazine
77
Hydralazine used as therapy in
pregnancies with preeclampsia
78
Hydralazine adverse effects (3)
lupus like syndrome fluid retention tachycardia

BMS 615 Cardiovascular (49 decks)

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