Antihypertensives Dr. Bateson

Front 1

Initial hypotensive effects of diuretics are:

Back 1

-reduction in plasma volume
-reduction in CO

Front 2

Continual use of diuretics as antihypertensives leads to vasodilation due to?

Back 2

-Na depletion causing decreased intracellular Ca
-renal prostaglandin biosynthesis
-K channel opening

Front 3

Thiazides main use is?
(name 2 drugs)

Back 3

-1st choice antihypertensive drugs for patients with NORMAL renal function
(Hydrochlorothiazide + Indapamide)

Front 4

Loop diuretics main use is?
(name 2 drugs)

Back 4

-preferable to thiazides when pt has malignant HTN or chronic renal dz
(Furosemide + ethacrynic acid)

Front 5

Potassium sparing diuretics are mostly used in?
(name 2 drugs)

Back 5

-only used in combo with thiazides to counteract hypokalemia
(Triamterene, amiloride)

Front 6

Spironolactone's main use is?

Back 6

-Potassium sparing antihypertensive drug when HTN is due to hyperaldosteronism

Front 7

Clonidine
class?
MOA?
Toxicity?

Back 7

-Sympatholytic- alpha2 agonist
-activates alpha 2 receptors (decreases central adrenergic tone)- 2nd choice!!
-decreased REM, contra w depression, ~50% xerostomia, can cause HTN crisis with rapid withdrawal, transdermal skin eruption, sexual dysfunction,

Front 8

Methyldopa
class?
MOA?
toxicity?

Back 8

-sympatholytic indirect adrenergic (alpha2 agonist) & imidazoline receptor agonist
-"false neurotransmitter"; preferred for preggos
-CNS, bradycardia, AV block, sexual dysfunction, can cause + Coomb's test, hyperprolactinemia

Front 9

Prazosin
class?
MOA?
uses?
Adverse?

Back 9

-sympatholytic- alpha1 blocker
-selectively blocks, dilates resistance and capacitance vessels
-2nd choice drug (often in combo)
-prominent postural hypotension, nasal stuffiness, peripheral edema, CNA, urinary freq/incontinence, sexual dysfunction

Front 10

Propanolol
class?
MOA?
uses?

Back 10

-sympatholytic- beta blocker
-dec CO, renin, NE, and reduces central adrenergic tone
-young age, hyperkinetic primary HTN, exertional angina, post MI, supraventricular arrhythmia
-

Front 11

Labetalol
class?
MOA?
uses?

Back 11

-sympatholytic- alpha/beta blocker
-decreases CO, venous tone and peripheral vascular resistance, has evident postural hypotension, and HIGH antihypertensive efficacy
-same as all beta blockers

Front 12

Nitroprusside
class/MOA?
adverse?
Contra?
uses?

Back 12

-vasodilator, converted to NO by smooth muscle cells
-excessive vasodilation, rebound HTN, palpitations, N/V, cyanide accumulation
-impaired cerebral circulation, compensatory HTN, congenital optic neuropathy
-HTN emergencies, acute dissecting aortic aneurysm, severe heart failure, during surgery

Front 13

Hydralazine
class?
MOA?
uses?
adverse/contra?

Back 13

-vasodilation
-IP3>Ca>NO>K channel opening
-HTN (2nd choice), heart failure in blacks (combined w isosorbide)

Front 14

Minoxidil
class?
MOA?
uses?
adverse?

Back 14

-vasodilator
-[PRODRUG] opens K channels, less Ca release so less contraction (only acts on arterioles)
-severe HTN (that doesn't respond to other drugs), topical for baldness
-edema, pericardial effusion, tachycardia, hypertrichosis, allergies

Front 15

Diazoxide
class?
MOA?
uses?
adverse?

Back 15

--vasodilator (thiazide like; not diuretic)
-opens K channels, less Ca release so less contraction (only acts on arterioles)
-HTN emergencies, tx hypoglycemia (secondary to insulinoma)
-edema, hyperglycemia, excessive hypotension, hypertrichosis (CONTRA in coronary dz, DM, sulfa allergy and impaired cerebral circulation)

Front 16

Fenoldopam
class?
MOA?
uses?
adverse?
contra?

Back 16

-Vasodilator- D1 dopamine receptor agonist
-activates peripheral receptors most in renal and mesenteric arteries, increases natriuresis
-reflex tachycardia, dose dependent extra-ocular pressure, decreases K
-angina, glaucoma, hypoK states

Front 17

Verapamil
Diltiazem
class?
uses?

Back 17

-Ca channel blockers that decrease BP
-1st choice HTN (really effective in blacks)

Front 18

Nifedipine
class?
uses?

Back 18

-Ca channel blockers that lower BP
-HTN emergencies (has a mortality risk though...)

Front 19

Aliskerin
class?
MOA?
uses?
Adverse?

Back 19

-RAS- renin inhibitor
-competitive inhibition
-2nd choice anti-HTN
-diarrhea, hyperK, severe HTN [Contra= preggos]

Front 20

Captopril
class?
MOA?
adverse?
uses?

Back 20

-ACE inhibitor
-(inhibits synth of ang II), increases bradykinin causing vascular smooth muscle dilation
-postural hypotension, diabetic glomerulopathy, dry/disturbing cough, artery stenosis, dysgeusia, prenatal effects
-1st choice anti-HTN, MI, chronic congestive heart failure, primary or secondary hyperaldosteronism

Front 21

Enalapril
class?
MOA?
uses?
contra?

Back 21

-ACE inhibitors
-PRODRUG > converted into enalaprilat (only given through IV)
-HTN emergencies (when given through IV)
-artery stenosis, advanced renal insufficiency, coronary artery dz, hypovolemia, hyperK, preggos

Front 22

Losartan
class?
MOA?
uses?
Adverse?
contra?

Back 22

-Ang II antagonist
-competitive antagonism at AT1 receptors; no effects on bradykinin & leukotrienes
-1st choice HTN
-hypotension, hyperK
-renal/abdominal artery stenosis, Preggos