Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
31 Cards in this Set
- Front
- Back
|
methyldopa
|
tx HTN
centrally acting sympathoplegic prodrug, T 1/2 = 2 hrs use in pregnancy lowers BP by acting to decrease sympathetic vasomotor tne, either as central agonists - stimulate medullary receptors, or peripheral antagonists that block receptors at nerve endings interrupt efferent symp pathway at different sites form medullary centers, autonomic ganglia, symp neurons, and adrenergic receptors agonists at presynaptic alpha2 receptors in brainstem, reduces peripheral vascular resistance reduces renin secretion side effects: not recommended for monotherapy b/c --> postural hypotension sodium retention (add a diuretic |
|
|
clonidine
|
orally, clonidine also has a transdermal patch, T 1/2 = 8-12 hrs
lowers BP by acting on adrenergic receptors to decrease symp tone, either as central agonists or peripheral antagonists, interrups efferent symp pathway at different sites from medullary centers, autonomic ganglia, symp neurons and adrenergic receptors agonist on presynaptic alpha2 receptors in brainstem, reduces TPR reduces renin secretion acts directly! side effects: not recommended for monotherapy --> postural hypotension, sodium retention, clonidine, specifically: sedation, dry mouth - dose at bedtime sudden withdrawal of clonidine --> HTN crisis, HA, tremor, abdominal pain, sweating, tachycardia sudden withdrawal of cloniti |
|
|
guanabenz
|
tx HTN
sympathoplegic drugs |
|
|
guanfacine
|
sympathoplegic drugs
|
|
|
propranolol
|
tx HTN
nonselective beta blockers specifically: used in caucasions, young generally: lower BP by blocking beta-adrenergic receptors in heart - reduce CO, kidney - reduce renin, CNS - reduce symp tone, combined with other anti-HTN to counteract reflex tachycardia by vasodilators, increased renin secretion by thiazide and loop diuretics side effects: may worsen sx in pts with reduced myocardial reserve, asthma, peripheral, vascular insufficiency, diabetes usu increased exercise tolerance when used to tx angina, but may decr exercise tolerance in pts with HF by reducing CO may predispose to atherogenesis by increasing atherogenesis by incr plasma triglycerides, decr HDL-cholesterol delayed recovery of normoglycemia significant risk of new-onset diabetes minor: GI, CNS, skeletal muscle tumors |
|
|
nadolol
|
tx HTN
nonselective beta blockers specifically: used in caucasions, young generally: lower BP by blocking beta-adrenergic receptors in heart - reduce CO, kidney - reduce renin, CNS - reduce symp tone, combined with other anti-HTN to counteract reflex tachycardia by vasodilators, increased renin secretion by thiazide and loop diuretics side effects: may worsen sx in pts with reduced myocardial reserve, asthma, peripheral, vascular insufficiency, diabetes usu increased exercise tolerance when used to tx angina, but may decr exercise tolerance in pts with HF by reducing CO may predispose to atherogenesis by increasing atherogenesis by incr plasma triglycerides, decr HDL-cholesterol delayed recovery of normoglycemia significant risk of new-onset diabetes minor: GI, CNS, skeletal muscle tumors |
|
|
penbutolol
|
tx HTN
nonselective beta blockers specifically: used in caucasions, young generally: lower BP by blocking beta-adrenergic receptors in heart - reduce CO, kidney - reduce renin, CNS - reduce symp tone, combined with other anti-HTN to counteract reflex tachycardia by vasodilators, increased renin secretion by thiazide and loop diuretics side effects: may worsen sx in pts with reduced myocardial reserve, asthma, peripheral, vascular insufficiency, diabetes usu increased exercise tolerance when used to tx angina, but may decr exercise tolerance in pts with HF by reducing CO may predispose to atherogenesis by increasing atherogenesis by incr plasma triglycerides, decr HDL-cholesterol delayed recovery of normoglycemia significant risk of new-onset diabetes minor: GI, CNS, skeletal muscle tumors |
|
|
pindolol
|
tx HTN
nonselective beta blockers specifically: used in caucasions, young generally: lower BP by blocking beta-adrenergic receptors in heart - reduce CO, kidney - reduce renin, CNS - reduce symp tone, combined with other anti-HTN to counteract reflex tachycardia by vasodilators, increased renin secretion by thiazide and loop diuretics side effects: may worsen sx in pts with reduced myocardial reserve, asthma, peripheral, vascular insufficiency, diabetes usu increased exercise tolerance when used to tx angina, but may decr exercise tolerance in pts with HF by reducing CO may predispose to atherogenesis by increasing atherogenesis by incr plasma triglycerides, decr HDL-cholesterol delayed recovery of normoglycemia significant risk of new-onset diabetes minor: GI, CNS, skeletal muscle tumors |
|
|
timolol
|
tx HTN
nonselective beta blockers specifically: used in caucasions, young generally: lower BP by blocking beta-adrenergic receptors in heart - reduce CO, kidney - reduce renin, CNS - reduce symp tone, combined with other anti-HTN to counteract reflex tachycardia by vasodilators, increased renin secretion by thiazide and loop diuretics side effects: may worsen sx in pts with reduced myocardial reserve, asthma, peripheral, vascular insufficiency, diabetes usu increased exercise tolerance when used to tx angina, but may decr exercise tolerance in pts with HF by reducing CO may predispose to atherogenesis by increasing atherogenesis by incr plasma triglycerides, decr HDL-cholesterol delayed recovery of normoglycemia significant risk of new-onset diabetes minor: GI, CNS, skeletal muscle tumors |
|
|
acebutolol
|
tx HTN
beta1 selective blocker specifically: preferred for asthmatic or diabetic HTN; generally: Caucasians, young lower BP by blocking beta-adrenergic receptors in heart - reduce CO, kidney - reduce renin, CNS - reduce symp tone, combined with other anti-HTN to counteract reflex tachycardia by vasodilators, increased renin secretion by thiazide and loop diuretics side effects: may worsen sx in pts with reduced myocardial reserve, asthma, peripheral, vascular insufficiency, diabetes usu increased exercise tolerance when used to tx angina, but may decr exercise tolerance in pts with HF by reducing CO may predispose to atherogenesis by increasing atherogenesis by incr plasma triglycerides, decr HDL-cholesterol delayed recovery of normoglycemia significant risk of new-onset diabetes minor: GI, CNS, skeletal muscle tumors |
|
|
atenolol
|
tx HTN
beta1 selective blocker specifically: preferred for asthmatic or diabetic HTN; generally: Caucasians, young lower BP by blocking beta-adrenergic receptors in heart - reduce CO, kidney - reduce renin, CNS - reduce symp tone, combined with other anti-HTN to counteract reflex tachycardia by vasodilators, increased renin secretion by thiazide and loop diuretics side effects: may worsen sx in pts with reduced myocardial reserve, asthma, peripheral, vascular insufficiency, diabetes usu increased exercise tolerance when used to tx angina, but may decr exercise tolerance in pts with HF by reducing CO may predispose to atherogenesis by increasing atherogenesis by incr plasma triglycerides, decr HDL-cholesterol delayed recovery of normoglycemia significant risk of new-onset diabetes minor: GI, CNS, skeletal muscle tumors |
|
|
bisoprolol
|
tx HTN
beta1 selective blocker specifically: preferred for asthmatic or diabetic HTN; generally: Caucasians, young lower BP by blocking beta-adrenergic receptors in heart - reduce CO, kidney - reduce renin, CNS - reduce symp tone, combined with other anti-HTN to counteract reflex tachycardia by vasodilators, increased renin secretion by thiazide and loop diuretics side effects: may worsen sx in pts with reduced myocardial reserve, asthma, peripheral, vascular insufficiency, diabetes usu increased exercise tolerance when used to tx angina, but may decr exercise tolerance in pts with HF by reducing CO may predispose to atherogenesis by increasing atherogenesis by incr plasma triglycerides, decr HDL-cholesterol delayed recovery of normoglycemia significant risk of new-onset diabetes minor: GI, CNS, skeletal muscle tumors |
|
|
esmolol
|
tx HTN
beta1 selective blocker specifically: preferred for asthmatic or diabetic HTN; generally: Caucasians, young lower BP by blocking beta-adrenergic receptors in heart - reduce CO, kidney - reduce renin, CNS - reduce symp tone, combined with other anti-HTN to counteract reflex tachycardia by vasodilators, increased renin secretion by thiazide and loop diuretics side effects: may worsen sx in pts with reduced myocardial reserve, asthma, peripheral, vascular insufficiency, diabetes usu increased exercise tolerance when used to tx angina, but may decr exercise tolerance in pts with HF by reducing CO may predispose to atherogenesis by increasing atherogenesis by incr plasma triglycerides, decr HDL-cholesterol delayed recovery of normoglycemia significant risk of new-onset diabetes minor: GI, CNS, skeletal muscle tumors |
|
|
metoprolol
|
tx HTN
beta1 selective blocker specifically: preferred for asthmatic or diabetic HTN; generally: Caucasians, young lower BP by blocking beta-adrenergic receptors in heart - reduce CO, kidney - reduce renin, CNS - reduce symp tone, combined with other anti-HTN to counteract reflex tachycardia by vasodilators, increased renin secretion by thiazide and loop diuretics side effects: may worsen sx in pts with reduced myocardial reserve, asthma, peripheral, vascular insufficiency, diabetes usu increased exercise tolerance when used to tx angina, but may decr exercise tolerance in pts with HF by reducing CO may predispose to atherogenesis by increasing atherogenesis by incr plasma triglycerides, decr HDL-cholesterol delayed recovery of normoglycemia significant risk of new-onset diabetes minor: GI, CNS, skeletal muscle tumors |
|
|
carteolol
|
tx HTN
mixed beta blcoker also has NO production more effective in caucasian and young |
|
|
carvediol
|
tx HTN
mixed beta blocker + alpha 1 antagonists, blocks Ca entry more effective in caucasian and young mainly used orally for chronic used in hypertensive emergencies, pheochromocytoma side effects: orthostatic hypotension, bronchospasm, hepatotoxicity |
|
|
labetolol
|
Tx HTN
mixed beta blocker + alpha1 antagonist more effective in caucasian and young IV - in ER beta:alpha block ratio of 3:1 for oral labetalol tx: hypertensive emergencies, pheochromocytoma side effects: orthostatic hypotension, bronchospasm, hepatotoxicity |
|
|
betaxolol
|
tx HTN
beta1 specific, blocks Ca entry more effective in caucasian and young |
|
|
nebivolol
|
tx HTN
mixed beta blocker, beta1 specific, NO production more effective in caucasian and young |
|
|
prazosin
terazosin doxazosin |
tx HTN
alpha1 blockers reduces norepi induced vasoconstriction to dilate both arteries and veins BP falls because of decreased peripheral resistance less reflex tachycardia than vasodialtors b/c the alpha2 receptors that inhibit norepi release are unaffected side effects: postural hypotension, may be pronounced with 1st dose mild, infrequent - drowsiness, dizziness, palpitations, HA, easy fatigability |
|
|
hydralazine
|
tx HTN
vasodilators specifically, orally - chronic treatment or IV for eclampsia/preeclampsia acts on vascular SM to cause relaxation and reduce vascular R --> lower Bp hydralazine (and minoxidil and diazoxid) dilate arteries selectively without affecting SM should NOT be used for monotherapy hydralazine (and minoxidil) - combined with diuretics, avoid fluid retention, or combined with beta blockers to diminish renin secretion and reflex tachycardia side effects: antiHTN effects diminish with time b/c relfex tachycardia and increased renin secretion most effective when combined with other drugs hypotension accompanied by reflex tachycardia, increased myocardial contractions, incr renin secretion, fluid retnetion, HA, flushing, palpitations, dizziness in elderly with CAD hydralazine (and minoxidil) - induce angina attacks and MIs hydralazine - causes lupus-like syndrome |
|
|
minoxidil
|
tx HTN
vasodilators, K+ channel opener specifically, orally - chronic treatment acts on vascular SM to cause relaxation and reduce vascular R --> lower BP minoxidil (and hydralazine and diazoxid) dilate arteries selectively without affecting SM should NOT be used for monotherapy minoxidil (and hydralazine) - combined with diuretics, avoid fluid retention, or combined with beta blockers to diminish renin secretion and reflex tachycardia side effects: antiHTN effects diminish with time b/c relfex tachycardia and increased renin secretion most effective when combined with other drugs hypotension accompanied by reflex tachycardia, increased myocardial contractions, incr renin secretion, fluid retnetion, HA, flushing, palpitations, dizziness in elderly with CAD minoxidil (and hydralazine) - induce angina attacks and MIs minoxidil - causes hypertrichosis (topical ointment - Rogaine - tx male baldness) |
|
|
nitroprusside
|
tx HTN
vasodilators specifically, IV - emergencies acts on vascular SM to cause relaxation and reduce vascular R --> lower Bp nitroprusside, spec: non-selective and balanced - dilates both arteries and veins should NOT be used for monotherapy side effects: antiHTN effects diminish with time b/c relfex tachycardia and increased renin secretion most effective when combined with other drugs hypotension accompanied by reflex tachycardia, increased myocardial contractions, incr renin secretion, fluid retnetion, HA, flushing, palpitations, dizziness |
|
|
diazoxide
|
tx HTN
vasodilators, K channel opener IV - emergencies acts on vascular SM to cause relaxation and reduce vascular R --> lower Bp diazoxide (hydralazine, minoxidil) dilate arteries selectively without affecting SM should NOT be used for monotherapy side effects: antiHTN effects diminish with time b/c relfex tachycardia and increased renin secretion most effective when combined with other drugs hypotension accompanied by reflex tachycardia, increased myocardial contractions, incr renin secretion, fluid retnetion, HA, flushing, palpitations, dizziness in elderly with CAD |
|
|
fenoldopam
|
tx HTN
vasodilators specifically, IV - emergencies acts on vascular SM to cause relaxation and reduce vascular R --> lower Bp dilates arteries by acint as a dopamine D1 agonist should NOT be used for monotherapy side effects: antiHTN effects diminish with time b/c reflex tachycardia and increased renin secretion most effective when combined with other drugs hypotension accompanied by reflex tachycardia, increased myocardial contractions, incr renin secretion, fluid retnetion, HA, flushing, palpitations, dizziness in elderly with CAD |
|
|
verapamil
|
tx HTN
calcium channel blocker used in elderly, african americans contraindicated in pts with SA/AV node abnormalities or CHF block slow Ca channels, reduce intracellulra Ca --> relax arteriolar SM --> vasodialtion, lower BP equally effective for monotherapy in mild to mod HTN verapamil - strongest cardiac effects, least vasodilation with diltiazem - doesn't cause reflex tachycardia because depresses the SA and AV node side effects: verapamil (diltiazem) --> myocardial depression, possibly bradycardia with SA node dysfxn contraindicated in pts with SA/AV node abnorms, CHF verpapamil - constipation |
|
|
diltiazem
|
tx HTN
calcium channel blocker used in elderly, african americans contraindicated in pts with SA/AV node abnormalities or CHF block slow Ca channels, reduce intracellulra Ca --> relax arteriolar SM --> vasodialtion, lower BP equally effective for monotherapy in mild to mod HTN in between verapamil and -dipines on cardiac and vasodilation effects diltiazem (and verapamil) - don't cause reflex tachycardia b/c depresses AV/SA node side effects: diltiazem (verapamil) --> myocardial depression, possibly bradycardia w/ SA node dysfxn |
|
|
-dipines
dihydropyridines |
tx HTN
calcium channel blocker used in elderly, african americans contraindicated in pts with SA/AV node abnormalities or CHF block slow Ca channels, reduce intracellulra Ca --> relax arteriolar SM --> vasodilation, lower BP equally effective for monotherapy in mild to mod HTN -dipines: strongest vasodilators, most likely to produce reflex tachycardia side effects: -dipines: reflex tachycardia, HA, flushing, dizziness, peripheral edema |
|
|
alisikrein
|
renin inhibitors
orally active dose dependent reduction of plasma renin dose dependent reduction of BP safety/tolerability - similar to ACE inhibitors |
|
|
-prils
|
tx HTN
ACE inhibitors orally effective for monotherapy captopril - active drug, all others - prodrugs most effective in young, middle aged caucasions 1st choice for pts with diabetes, chronic renal disease, LVH lowers BP by inhibiting ACE BP lowering due to decrease in peripheral vasc resistance vasodilation b/c reduced ang-induced vasoconstriction increased bradykinin --> vasodilation contributes to antiHTN effect lowers BP w/o compromising blood supply to heart, brain, or kidneys don't cause symp activation (or tachycardia) b/c of concurrent baroreceptor resetting or vagal activation lower BP in 50% of pts with mild to mod HTN side effects: bradykinin --> dyr, hacking, nonproductive cough, angioneurotic edema mild, fewer, and w/o lipid changes hyperkalemia b/c inhibited aldosterone secretion anaphylaxis acute renal failure in pts with bilateral renal artery stenosis tast disturbances interfering with nutrition nonallergic, pruritic maculopapular rash |
|
|
-sartans
|
tx HTN
angiotensin receptor antagonists 2 types of ang II receptors - AT1 - receptors in vasc SM --> known actions in ang II all available AT II antagonsists block AT1, no effects on AT2 more specific than ACE inhibitors, do not effect bradykinin metabolism more complete inhibition of angiotensin action b/c other enzymes can generate ang II side effects: do not cause cough or angioneurotic edema (except losartan - uricosuric) otherwise, adverse effects are like ACE inhibitors - hyperkalemia, reduced renal function |
