WEEK 2 ANTIHYPERTENSIVES & DIURETICS Flashcards
Describe the action of ACE inhibitors
Blocks angiotensin-converting enzyme from converting angiotensin I to angiotensin II
What are 2 therapeutic effects of ACE inhibitors?
- Prevent vasoconstrictive effect of angiotensin II
- Prevent the release of aldosterone
Name 1 example of an ACE inhibitor
Ramipril (Altace)
Name 3 side effects associated with ACE inhibitors
- Dry cough
- Hypotension
- Renal dysfunction/hyperkalemia
Which ethnic group do ACE inhibitors have a higher chance of causing adverse effects in?
African americans (angioedema)
What are 2 medications that interact negatively with ACE inhibitors?
- Potassium (inc. risk for hyperkalemia)
- NSAIDs (decrease effectiveness, harder on kidneys)
Describe the action of angiotensin receptor blockers (ARBs)
Blocks angiotensin II receptors at various sites, to prevent vasoconstriction and aldosterone release
Name 2 therapeutic effects of ARBs
- Prevent the vasoconstrictive effect of angiotensin II
- Prevent the release of aldosterone thereby preventing fluid retention
Name 1 example of an ARB
Losartan
Name 3 side effects of ARBs
- Hypotension
- Hyperkalemia
- Diarrhea
Name 2 medications that interact negatively with ARBs
- Potassium (inc. risk for hyperkalemia)
- NSAIDs (decrease effectiveness, harder on kidneys)
Describe the action of calcium channel blockers (CCBs)
Blocks entry of calcium into myocardial and vascular smooth muscle cells to inhibit contraction
Name 2 therapeutic effects of CCBs
- Reduces blood pressure by decreasing heart rate and contractility, and inhibiting vasoconstriction
- Prevents angina by decreasing the heart’s demand for oxygen by decreasing heart rate and contractility
Name 1 example of a CCB
Amlodipine
Name 3 side effects of CCBs
- Hypotension (dizziness and headache)
- Peripheral edema
- Constipation
What 2 comorbid conditions should CCBs be used with caution in?
- Hepatic impairment
- Severe CHF
Describe the action of beta blockers
Blocks stimulation of myocardial beta-1 adrenergic receptors
Name 3 therapeutic effects of beta blockers
- Decreases blood pressure by decreasing heart rate
- Prevents angina by reducing the oxygen demand of the heart
- Slows the progression of heart failure by decreasing afterload
Name 1 example of a beta blocker
Metoprolol
Name 3 side effects of beta blockers
- Erectile dysfunction
- Fatigue/weakness
- Hypotension/dizziness
What are 2 reasons beta blockers would be held?
- Bradycardia
- Pulmonary edema
What 2 comorbid conditions should beta blockers be used with caution in?
- Diabetes (may mask hypoglycemia)
- Asthma/COPD (bronchospasm)
Why should beta blockers not be abruptly discontinued?
May cause rebound hypertension
When should diuretics be held?
Anuria
Which drug class may inhibit the effects of some diuretics?
NSAIDs
Describe the action of thiazide diuretics
Inhibits sodium reabsorption in the distal tubule to increase excretion of water, sodium, and other electrolytes
Name 1 example of a thiazide diuretic
Hydrochlorothiazide
Name a contraindication unique to thiazide diuretics
Sulfa allergy
Name a side effect unique to thiazide diuretics
Hyperglycemia
Describe the action of loop diuretics
Inhibits reabsorption of sodium and chloride from the loop of Henle to increase excretion of water and electrolytes
Name 1 example of a loop diuretic
Furosemide
What are 2 side effects of both loop and thiazide diuretics?
- Hypokalemia
- Hypotension
Which drugs may cause ototoxicity when taken with loop diuretics?
Aminoglycosides
Describe the action of potassium-sparing diuretics
Antagonizes aldosterone to cause sodium bicarbonate and calcium loss while saving potassium and hydrogen ions
What are 2 therapeutic effects of loop, thiazide, and potassium-sparing diuretics?
- Lowers BP by decreasing blood volume
- Promotes diuresis in patients with edema
Name 1 example of a potassium-sparing diuretic
Spironolactone
Name 2 side effects of potassium-sparing diuretics
- Hyperkalemia
- Hypotension
Name a contraindication unique to potassium-sparing diuretics
Severe renal impairment (CrCl <30)