(THER) Antihypertensives I and II Flashcards
Hydralazine MOA and Indication
Arteriole vasodilator
Ind: Resistant hypertension; pregnancy induced hypertension
Spironolactone should not be used in combination with which drugs?
Drugs that inhibit the RAA system (ACE Inhibitors, ARBs, or BBs)
Thiazides are not as useful in patients with…
Renal insufficiency
What is the effect of Calcium Channel Blockers?
Relax peripheral arterial vascular smooth muscle and decrease total peripheral resistance.
What effect do calcium channel blockers have on cardiac output/contractility?
Decrease calcium-induced calcium release from myocyte SR and can reduce CO
Nifedipine MOA and Side effects
Relatively selective vasodilator
AEs: Acute tachycardia; peripheral edema
Diltiazem Effects and Adverse Effects
Effects: Reduces both CO and peripheral resistance
AEs: bradycardia
Patients taking short-acting nifedipine, diltiazem or verapamil were 1.6 times more likely to… as compared to patients on other hypertensives.
Have an MI than patients on other antihypertensives.
MOA and Effect for Sympatholytic Drugs
What does it mean that they are centrallyy acting agents?
Reduce sympathetic drive to heart/blood vessels
They reduce this sympathetic output from vasopressor centers in the brainstem.
Clonidine MOA and AEs (3)
Drug interaction?
Alpha-2 agonist: decreases sympathetic outflow from CNS
AE: sedation, dry mouth, contact dermatitis
May interact with other CNS depressants, potentiating their action
In what way should you withdraw patients off of Clonidine and why?
Withdraw slowly to prevent rebound hypertension
How does Guanfacine differ from Clonidine?
It has similar effects but a longer half-life
Methyldopa MOA (2)
- Agonist at a-2 adrenergic receptor (decreases sympathetic tone, dropping BP)
- Competes for DOPA decarboxylase preventing production of dopamine and subsequent NE/Epi
Methyldopa AEs and key interaction
AE: sedation
Interaction: reduces L-dopa therapeutic effects
Which drug is probably the most extensively used hypotensive agent in management of hypertension in pregnant women?
Methyldopa
Reserpine MOA
Disrupts NE vesicular storage, leading to the eventual digestion of NE by MAO. Overall drop in sympathetic stimulation.