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26 Cards in this Set
- Front
- Back
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What drug do you use to treat pre HTN?
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NONE
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What drug is usually used to treat stage one HTN?
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usually start with a thiazide diuretic and
commonly had an ACE (either separately or fixed- dose combinations |
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Angiotensin-‐converting enzyme inhibitors-
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”The Prils”
– Lisinopril (Prinivil or Zestril) – Enalapril (Vasotec) – Captopril (Capoten) – Ramipril (Altace) – Quinapril (Accupril) |
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which Angiotensin-‐converting enzyme inhibitors- can be used in ppl with liver dysfunction?
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Lisinopril and Captopril
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What are other used for Angiotensin-‐converting enzyme inhibitors?
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• Decrease the risk of MI’s in high risk patients b/c of anti‐inflammatory effects
• Stroke prevention • Nephro (renal) protective for pt’s with DM • Reduce the incidence of Type 2 diabetes • Prevention of diabetic retinopathy in Type 1 DM |
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side effects of Angiotensin-‐converting enzyme inhibitors-
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• Hypotension (First-‐dose hypotensive effect may occur)
• Dizziness, HA, fatigue, mood changes, impaired taste • Hyperkalemia • Hypoglycemia (especially in pt’s already taking hypoglycemic drugs) • Dry, nonproduc)ve cough • Angioedema |
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ARB’s-‐Angiotensin Receptor Blockers
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losartan (Cozaar, Hyzaar) valsartan (Diovan)
irbesartan (Avapro) Candesartan (Atacand) |
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Allow angiotensin I to be converted to angiotensin II, but block the receptors that receive or ‘pick up’ angiotensin II
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ARB’s-‐Angiotensin Receptor Blockers
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Block vasoconstriction and release of aldosterone
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ARB’s-‐Angiotensin Receptor Blockers
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side effects of ARB’s-‐Angiotensin Receptor Blockers
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• Hypotension
• Hyperkalemia less likely • Does not cause cough and angioedema rare • May cause insomnia, diarrhea, nasal congestion, URI’s, fatigue |
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• Effect the RAAS by:
– Directly blocking the beginning of RAAS...Renin blocker – Approved in 2008-‐Aliskiren (tekturna) – Aliskerin + hydrocholorthiazide=Tekturna HCT |
Direct Renin Inhibitors
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ACE’s, ARB’s and DRI’s contraindicated in ______
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pregnancy
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side effects of Direct Renin Inhibitors
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Diarrhea, cough, flu like symptoms & rash
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Action: inhibits the movement of calcium ions across the cell membrane resulting in relaxation of vascular smooth muscle producing vasodilation and thus ↓BP
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Calcium Channel Blockers-‐CCB’s
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work as anti-hypertensives, anti-anginals, anti-arrhythmics
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Calcium Channel Blockers-‐CCB’s
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• Amlodipine-‐(Norvasc)-‐most commonly used
• Nifedipine (Procardia) • Diltiazem (Cardizem) |
Calcium Channel Blockers-‐CCB's
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Calcium Channel Blockers-‐CCB's side effects
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Cardiovascular
– Hypotension, palpitations, reflex tachycardia • Gastrointestinal – Constipation, nausea • Other – Rash, flushing, peripheral edema, dermatitis – May increase serum level of digoxin |
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The Beta Blockers:
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“Olols, alols, ilols”
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Non Selective Beta Blockers
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– *Carvedilol (Coreg)
– *Propranolol (Inderal) – *Nadolol (Corgard) |
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Only Beta Blocker safe during pregancy
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Labetalol (Trandate or Normodyne)
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– Reduce BP by reducing heart rate through beta1-‐blockade
– Cause reduced secretion of renin – Long-‐term use causes reduced peripheral vascular resistance – Result: decreased blood pressure |
Beta-‐blockers-‐Peripherally acting Beta adrenergics
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the BB’s that are cardio-‐”selective” will be those that act directly on the B1 receptors on the heart muscle blocking the effects of epinephrine...the key won’t work. so.....
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decrease in HR and contractility thus decrease in CO,BP and workload on the heart
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These work on both the B1 & B2 receptors and can wreak havoc in certain populations
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Non-‐Selective BB’s
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Centrally acting alpha2-‐receptor agonists
• clonidine (Catapres) po/transdermal methyldopa (Aldomet) Can be used for hypertension in pregnancy |
HTN that has not responded to newer, safer antihypertensives
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Peripherally acting dual alpha1-‐ and beta-‐receptor blockers
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carvedilol (coreg)
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Peripherally acting alpha1-‐receptor agonists
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– Treatment of hypertension; doxazosin (Cardura)
– Used to relieve symptoms of BPH • tamsulosin (Flomax) |
