Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Unit 4-Antihypertensives > Flashcards

Unit 4-Antihypertensives Flashcards

1
Q

Furosemide

Drug class

A

Loop diuretic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Furosemide

Mechanism

A

Inhibits Cl portion of Na-K-2Cl cotransporter in luminal membrane at medullary and cortical (proximal) talH –> decreased Ca++ and Na+ (and water) reabsorption, resultant K+ loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Furosemide

Uses

A

Crisis edema (pulmonary, CHF, cirrhosis), hypercalcemia, drug toxicity/OD; severe hypertension in setting of CHF or cirrhosis;

useful in patients with renal insufficiency (GFR < 30-40)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Furosemide

Side effects

A

Hypokalemia/hypomagnesemia, hypercalcinuria, nephrocalcinosis, ototoxicity (esp. w/aminoglycoside)

Hyper -glycemia, -lipidemia, -uricemia; hypo -magnesia, -natremia; gout, photosensitivity, drug interactions; erectile dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Hydrochlorothiazide

Drug class

A

Thiazide diuretic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Hydrochlorothiazide

Mechanism

A

Inhibits the Cl portion of the Na-Cl cotransporter in the luminal membrane at the early distal tubule –> decreased Na+ (and water) reabsorption, increased Ca++ reabsorption, resultant K+ loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hydrochlorothiazide

Uses

A

HTN (intravascular contraction), chronic edema (cardiac insufficiency), idiopathic hypercalciuria (stones), nephrogenic diabetes insipidus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hydrochlorothiazide

Side effects

A

Hypokalemia/hypomagnesemia, contraction alkalosis, increased BUN & creatinine

Hyper -glycemia, -lipidemia, -uricemia, -calcemia; hypo -magnesia, -natremia; gout, photosensitivity, impotence, drug interactions

avoid NSAIDs, bile sequestrants; ineffective if GFR <30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Chlorthalidone

Drug class

A

Thiazide-like diuretic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Chlorthalidone

Mechanism

A

Inhibits the Cl portion of the Na-Cl cotransporter in the luminal membrane at the early distal tubule –> decreased Na+ (and water) reabsorption, increased Ca++ reabsorption, resultant K+ loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Chlorthalidone

Uses

A

Reduce stroke risk, CHF events; HTN (intravascular contraction), chronic edema (cardiac insufficiency), idiopathic hypercalciuria (stones), nephrogenic diabetes insipidus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Chlorthalidone

Side effects

A

Hypokalemia/hypomagnesemia, contraction alkalosis, increased BUN & creatinine

Hyper -glycemia, -lipidemia, -uricemia, -calcemia; hypo -magnesia, -natremia; gout, photosensitivity, impotence, drug interactions

avoid NSAIDs, bile sequestrants; ineffective if GFR <30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Metolazone

Drug class

A

Thiazide-like diuretic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Metolazone

Mechanism

A

Inhibits the Cl portion of the Na-Cl cotransporter in the luminal membrane at the early distal tubule –> decreased Na+ (and water) reabsorption, increased Ca++ reabsorption, resultant K+ loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Metolazone

Uses

A

HTN (intravascular contraction), chronic edema (cardiac insufficiency), idiopathic hypercalciuria (stones), nephrogenic diabetes insipidus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Metolazone

Side effects

A

Hypokalemia/hypomagnesemia, contraction alkalosis, increased BUN & creatinine

Hyper -glycemia, -lipidemia, -uricemia, -calcemia; hypo -magnesia, -natremia; gout, photosensitivity, impotence, drug interactions

avoid NSAIDs, bile sequestrants; ineffective if GFR <30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Amiloride

Drug class

A

Renal ENaC inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Amiloride

Mechanism

A

Blocks Na channel and Na/H antiporter in lumenal membrane at the late distal tubule and collecting duct –> decreased K+ secretion and distal tubule acid secretion, increased Ca++ absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Amiloride

Uses

A

Combination with other diuretics to prevent hypokalemia; edema, idiopathic hypercalciuria (stones); lithium-induced polyuria & toxicity, Liddle syndrome, mucocilliary clearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Amiloride

Side effects

A

Hyperkalemia in patients with renal failure or on ACE inhibitors

Contraindicated in patients with renal failure (hyperkalemia), ACEi/ARB use; FeNa = 2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Spironolactone

Drug class

A

Aldosterone receptor antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Spironolactone

Mechanism

A

Competes for aldosterone receptor, inhibiting mRNA transcription and translation –> decreased Na and K channels, decreased number and activity of Na-K-ATPase pumps in the late distal tubule and collecting duct –> decreased K+ secretion, distal tubule acid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Spironolactone

Uses

A

Reduction in CHF mortality (30% in NYHA class III and IV); combination with other diuretics to prevent hypokalemia; edema; primary and secondary aldosteronism; hypertension; anti-testosterone agent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Spironolactone

Side effects

A

Hyperkalemia in patients with renal failure or on ACE inhibitors; male patients may have gynecomastia, erectile dysfunction, and loss of libido; female patients may have amenorrhea, breast soreness, and oligomenorrhea

Contraindicated in patients with renal failure (hyperkalemia); FeNa = 2%; requires a salt-restricted diet; only drug not requiring tubular lumen access

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Eplerenone

Drug class

A

Potassium-sparing diuretic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Eplerenone

Mechanism

A

Block alodesterone; inhibits sodium reabsorption in distal tubule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Eplerenone

Uses

A

Reduction in CHF mortality (30% in NYHA class III and IV); combination with other diuretics to prevent hypokalemia; edema; primary and secondary aldosteronism; hypertension; anti-testosterone agent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Eplerenone

Side effects

A

Hyperkalemia; much lower incidence of gynecomastia and mennorhagia

Caution in renal failure, ACEi or ARB use, and in diabetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Captopril

Drug class

A

short-acting ACE-I (vasodilators)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Captopril

Mechanism

A

Blocks endothelial ACE from converting angiotensin I to angiotensin II (potent vasoconstrictor); as a side effect, also prevents breakdown of bradykinin (potent vasodilator)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Captopril

Uses

A

CHF, left ventricular hypertrophy, post-MI (prevents left ventricular remodeling)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Captopril

Side effects

A

Dry cough, angioedema, inhibits renal autoregulation, hypotension

Short-acting; contraindicated in pregnancy, renal artery stenosis, hyperkalemia, and prior angioedema (no ARB allowed, either); caution in renal failure; reduces incidence of future CAD events, may reduce risk of diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Lisinopril (Prinivil); Benazepril (Lotensin); Quinapril (Accupril); Ramipril (Altace)

Drug class

A

long-acting ACE-I (vasodilators)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Lisinopril (Prinivil); Benazepril (Lotensin); Quinapril (Accupril); Ramipril (Altace)

Mechanism

A

Blocks endothelial ACE from converting angiotensin I to angiotensin II (potent vasoconstrictor); as a side effect, also prevents breakdown of bradykinin (potent vasodilator)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Lisinopril (Prinivil); Benazepril (Lotensin); Quinapril (Accupril); Ramipril (Altace)

Uses

A

CHF, left ventricular hypertrophy, post-MI (prevents left ventricular remodeling)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Lisinopril (Prinivil); Benazepril (Lotensin); Quinapril (Accupril); Ramipril (Altace)

Side effects

A

Dry cough, angioedema, decreased renal function, hypotension

Long-acting; contraindicated in pregnancy, renal artery stenosis, hyperkalemia, and prior angioedema (no ARB allowed, either); caution in renal failure; reduces incidence of future CAD events; may reduce risk of diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Enalapril

Drug class

A

ACE-I (vasodilators)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Enalapril

Mechanism

A

Metabolized to active form enalaprat

Blocks endothelial ACE from converting angiotensin I to angiotensin II (potent vasoconstrictor); as a side effect, also prevents breakdown of bradykinin (potent vasodilator)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Enalapril

Uses

A

CHF, left ventricular hypertrophy, post-MI (prevents left ventricular remodeling)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Enalapril

Side effects

A

Dry cough, angioedema, decreased renal function, hypotension

contraindicated in pregnancy, renal artery stenosis, hyperkalemia, and prior angioedema (no ARB allowed, either); caution in renal failure; reduces incidence of future CAD events; may reduce risk of diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Losartan (Cozaar); Valsartan (Diovan); Irbesartan (Avapro)

Drug class

A

Angiotensin II Recepter Blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Losartan (Cozaar); Valsartan (Diovan); Irbesartan (Avapro)

Mechanism

A

Competitive inhibition of angiotensin II in vascular endothelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Losartan (Cozaar); Valsartan (Diovan); Irbesartan (Avapro)

Uses

A

Fall in peripheral vascular resistance, w/little change in HR or CO; same uses as ACE-I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Losartan (Cozaar); Valsartan (Diovan); Irbesartan (Avapro)

Side effects

A

Angioedema, decreased renal function, hypotension; dry cough less frequent than with ACE-I

Contraindicated in pregnancy, renal artery stenosis, hyperkalemia, and prior angioedema (no ARB allowed, either); caution in renal failure

45
Q

Aliskiren

Drug class

A

Renin inhibitor

46
Q

Aliskiren

Uses

A

Not very effective

47
Q

Diltiazem

Drug class

A

Non-dihydropyridine Calcium channel blockers

48
Q

Diltiazem

Mechanism

A

Interact with L-type voltage gated plasma membrane Ca channel –> decreased calcium entry into vascular smooth muscle cell, preventing contraction; causes decreased contractility, firing rate of aberrant pacemaker sites, and conduction velocity; prolongs repolarization in SA node and AV node (–> decreases HR); less vasodilation

49
Q

Diltiazem

Uses

A

Hypertension, anti-anginal (chronotropic effects –> decreased myocardial oxygen demand), SVT (class IV anti-arrhythymic)

50
Q

Diltiazem

Side effects

A

Leg edema, bradycardia, AV nodal blockade, hypotension, worsening heart failure

Constipation (most common), headache, flushing

Contraindicated in overt decompensated heart failure, bradycardia, sinus node dysfunction, high-degree AV block

51
Q

Verapamil

Drug class

A

Non-dihydropyridine Calcium channel blockers

52
Q

Verapamil

Mechanism

A

Interact with L-type voltage gated plasma membrane Ca channel –> decreased calcium entry into vascular smooth muscle cell, preventing contraction; causes decreased contractility, firing rate of aberrant pacemaker sites, and conduction velocity; prolongs repolarization in SA node and AV node (–> decreases HR); less vasodilation

53
Q

Verapamil

Uses

A

Hypertension, anti-anginal (chronotropic effects –> decreased myocardial oxygen demand), SVT (class IV anti-arrhythymic)

54
Q

Verapamil

Side effects

A

Leg edema, bradycardia, AV nodal blockade, hypotension, worsening heart failure

Constipation (most common), headache, flushing

Contraindicated in overt decompensated heart failure, bradycardia, sinus node dysfunction, high-degree AV block

55
Q

Amlodipine

Drug class

A

Dihydropyridine Calcium channel blockers

56
Q

Amlodipine

Mechanism

A

Interact with L-type voltage gated plasma membrane Ca channel –> decreased calcium entry into vascular smooth muscle cell, preventing contraction; causes dilation of epicardial coronary arteries, arteriolar resistance arteries; less heart-specific activity

57
Q

Amlodipine

Uses

A

Hypertension, Raynauds, angina (3rd choice drug)

58
Q

Amlodipine

Side effects

A

Leg edema (less than 1st generation), heart failure, AV nodal blockade, reflex tachycardia (lipophilic agents gain entry to brain and depress vasomotor center, rapidly dropping BP; this causes more reflex sympathetic activation (leading to adverse CV effects); long-acting agents are less lipophilic, and will cause less sympathetic activation and initial fall in BP)

Constipation (most common), headache, flushing

Contraindicated in overt decompensated heart failure, bradycardia, sinus node dysfunction, high-degree AV block

59
Q

Nifedipine

Drug class

A

Dihydropyridine Calcium channel blockers

60
Q

Nifedipine

Mechanism

A

Interact with L-type voltage gated plasma membrane Ca channel –> decreased calcium entry into vascular smooth muscle cell, preventing contraction; causes dilation of epicardial coronary arteries, arteriolar resistance arteries; less heart-specific activity

61
Q

Nifedipine

Uses

A

Hypertension, Raynauds, angina (3rd choice drug)

62
Q

Nifedipine

Side effects

A

Leg edema (less than 1st generation), heart failure, AV nodal blockade, reflex tachycardia (lipophilic agents gain entry to brain and depress vasomotor center, rapidly dropping BP; this causes more reflex sympathetic activation (leading to adverse CV effects); long-acting agents are less lipophilic, and will cause less sympathetic activation and initial fall in BP)

Constipation (most common), headache, flushing

Contraindicated in overt decompensated heart failure, bradycardia, sinus node dysfunction, high-degree AV block

63
Q

Propranolol

Drug class

A

Nonselective β-blocker

64
Q

Propranolol

Mechanism

A

Nonselective β-blocker; primarily reduces cardiac output

65
Q

Propranolol

Side effects

A

Bronchospasm, bradycardia (negative chronotrope), CHF (negative ionotrope), masking of hypoglycemia symptoms

Decreased exercise capacity, depression (crosses BBB), worsening symptoms of peripheral vascular disease

66
Q

Metoprolol

Drug class

A

β1-selective blocker

67
Q

Metroprolol

Mechanism

A

Moderately selective β1 blockade

68
Q

Metoprolol

Side effects

A

Less likely to have bronchospasm, hypoglycemic awareness, and depression

69
Q

Atenolol

Drug class

A

β1-selective blocker

70
Q

Atenolol

Mechanism

A

Moderately selective β1 blockade

71
Q

Atenolol

Side effects

A

Less likely to have bronchospasm, hypoglycemic awareness, and depression

72
Q

Bisoprolol

Drug class

A

β1-selective blocker

73
Q

Bisoprolol

Mechanism

A

Moderately selective β1 blockade

74
Q

Bisoprolol

Side effects

A

Less likely to have bronchospasm, hypoglycemic awareness, and depression

Longer-acting than other beta-blockers

75
Q

Nadolol

Drug class

A

β1-selective blocker

76
Q

Nadolol

Mechanism

A

Moderately selective β1 blockade

77
Q

Nadolol

Side effects

A

Less likely to have bronchospasm, hypoglycemic awareness, and depression

Longer-acting than other beta-blockers

78
Q

Labetolol

Drug class

A

Combined αβ blocker

79
Q

Labetolol

Mechanism

A

β1 blockade with vasodilatory effects

80
Q

Labetolol

Uses

A

Hypertensive urgency

81
Q

Carvedilol

Drug class

A

Combined αβ blocker

82
Q

Carvedilol

Mechanism

A

β1 blockade with vasodilatory effects

83
Q

Carvedilol

Uses

A

Acute coronary syndrome, CHF

84
Q

Esmolol

Drug class

A

β1-selective blocker

85
Q

Esmolol

Uses

A

AV nodal blockade in unstable patients

Short half-life

86
Q

Terazosin (Hytrin); Doxazosin (Cardura)

Drug class

A

α1-adrenergic receptor antagonist

87
Q

Terazosin (Hytrin); Doxazosin (Cardura)

Mechanism

A

Blocks post-synaptic α1-adrenergic receptor antagonist on vascular smooth muscle

88
Q

Terazosin (Hytrin); Doxazosin (Cardura)

Uses

A

BPH; second-tier meds (use when other condition around, not for isolated hypertension)

89
Q

Terazosin (Hytrin); Doxazosin (Cardura)

Side effects

A

Orthostatic hypotension, fluid retention, worsening angina (secondary to reflex tachycardia)

90
Q

Clonidine

Drug class

A

Central α2-agonist

91
Q

Clonidine

Mechanism

A

Stimulation of central α2a adrenergic receptors –> reduction in sympathetic outflow from vasomotor systems in brainstem; inhibition of renin release (secondary to decreased sympathetic tone)

92
Q

Clonidine

Side effects

A

Rebound HTN if abruptly stopped; moderate orthostatic hypotension

Sedation, dry mouth, fatigue, depression

93
Q

α-methyldopa (Aldomet)

Drug class

A

Central α2-agonist

94
Q

α-methyldopa (Aldomet)

Mechanism

A

Stimulation of central α2a adrenergic receptors –> reduction in sympathetic outflow from vasomotor systems in brainstem; inhibition of renin release (secondary to decreased sympathetic tone)

95
Q

α-methyldopa (Aldomet)

Uses

A

Hypertension of pregnancy (only)

96
Q

α-methyldopa (Aldomet)

A

Rebound HTN if abruptly stopped; moderate orthostatic hypotension

Sedation, dry mouth, fatigue, depression

Takes place of dopa, so less NE (also, methyl-NE activates α2)

97
Q

Reserpine

Drug class

A

Ganglion blocking agent (adrenergic neuron blocking agent)

98
Q

Reserpine

Mechanism

A

Blocks transport of NE, DA, and 5HIAA into storage granules in PNS and CNS –> less neurotransmitter available when nerves are stimulated

99
Q

Reserpine

Uses

A

Decrease cardiac output and systemic vascular resistance

100
Q

Reserpine

Side effects

A

Sedation, mental depression, Parkinsonism symptoms

101
Q

Hydralazine

Drug class

A

Direct (vasodilators)

102
Q

Hydralazine

Mechanism

A

Relax smooth muscle of peripheral arterioles

Serves as an antioxidant, preventing oxidation of NO

103
Q

Hydralazine

Uses

A

Hypertensive urgency; patients with BOTH advanced CHF and hypertension

104
Q

Hydralazine

Side effects

A

Drug-induced lupus

reflex tachycardia

105
Q

Minoxidil

Drug class

A

Direct (vasodilators)

106
Q

Minoxidil

Mechanism

A

Relax smooth muscle of peripheral arterioles

Smooth muscle relaxation by opening cardiovascular ATP-sensitive potassium channels

107
Q

Minoxidil

Uses

A

Refractory hypertension; hair loss

108
Q

Minoxidil

Side effects

A

Pericardial effusion; hirsutism

reflex tachycardia

Pharmacology (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions