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52 Cards in this Set

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Beta-1 blockers
"BEAM"
Atenolol
Metoprolol
(nebivolol)
Beta non-selective blockers
Propranolol
Timolol
Pindolol
Nadolol
Non-selective beta blockers & alpha-1 blockers
Labetalol (also some beta-2 agonist effect)
Carvedilol
MOA beta-blockers
Decrease CO (anti-HTN)
Decrease workload of heart (chronic/stable CHF)
Minimize s/s hyperthyroidism
Decrease renin production
SE beta-blockers
Fatigue
Insomnia
Impotence
Decreased HDL
Increased TG
Who are non-selective beta-blockers contraindicated in?
COPD
Asthma
MOA thiazide diuretic (most commonly used)
Block Na uptake at DCT --> more Na excretion in urine

(Hydrochlorothiazide)
SE thiazides
Hypokalemia
Hypercalcemia
Hyperuricemia
(possible - hypersensitivity in sulfa-allergic pt)
CCB names and main effect
Diltiazem - heart (little - vasculature)
Nifedipine - vasculature
Verapamil - heart & vasculature
SE CCB
Constipation
Vertigo
HA
Fatigue
Hypotension
ACE inhibitors
(-prils)
Captopril
Lisinopril
Enalapril
MOA ACE inhibitors
Inhibit ACE (enzyme that converts Ang I to Ang II)
--> VD & decreased water & Na retention
Increased bradykinin (ACE degrades it)
SE ACE inhibitors
Dry cough
Rash
Fever
Altered taste
Hypotension
Hyperkalemia
Angioedema
1st dose syncopy
Can you use ACE inhibitors in pregnancy
NO
(Fetotoxic)
Alpha-blockers
Prazosin
Terazosin
MOA alpha-blockers
Arteriolar VD --> decreased total PVR
SE alpha-blockers
Reflex tachycardia
1st dose syncopy
ARBs (angiotensin II R blockers)
(-sartans)
Losartan
Candesartan
Valsartan
Difference in ARBs and ACE Inhibitors
ACE Inhibitors increase bradykinin

ARBs have no effect on ACE, so no effect on bradykinin
(AND NO ANGIOEDEMA)
MOA Clonidine
Central alpha-2 agonist
(depress SNS outflow)
MOA hydralazine
Smooth m. relaxant
MOA Nitroprusside, SE
VD
(poisonious if given PO b/c hydrolyzed to cyanide)
1st line tx for ALL PT to prevent HTN
Lifestyle modification
optimal wt, healthy diet, cessation of smoking, exercise, restriction of Na, moderation in alcohol consumption
Target BP & 1st line tx for all pts
< 140/90
Thiazides

(stage 2 HTN - 2 drugs - thiazides being 1 of the 2)
What is stage II HTN
SBP > 160 or DBP > 100
Target BP & 1st line tx for high risk CAD pt
< 130/80
Most - thiazide
Chronic renal or DM pt - ACE inhibitor or ARB
What makes someone high risk for CAD in a/w HTN control
DM
Chronic renal disease
CAD (asymptomatic)
Target BP and 1st line tx for pt w/ hx stable angina, unstable angina, MI
< 130/80
Bb + (ACEI or ARB)

If unsuccessful - ADD CCB or thiazide
If Bb not tolerated - Verapamil or Diltiazem
Target BP & 1st line tx for pt w/ CHF
< 120/80
Bb + (ACEI or ARB) + (loop or thiazide)
**if severe CHF - add aldosterone antagonist
What HTN drugs are contraindicated in CHF pt
Verapamil
Diltiazem
Clonidine
Alpha blocker
What drug must be d/c if acute exacerbation of CHF
Beta-blocker (until CO restored)
DOC for HF
Digoxin
What is HTN emergency
SBP > 210 & DBP > 150

(if pre-existing condition - DBP > 130)
Drugs used during HTN emergency
Nitroprusside
Diazoxide
Labetalol
MOA Nitroprusside
VD - arteries & veins
(decreases pre-load)
Nitroprusside is metabolized into?
Cyanide
(not a huge issue if IV, mostly if PO)

Give Thiosulfate if problem
MOA Diazoxide
Direct arteriolar VD
MOA Labetalol
Bb & alpha blocker

(prevents reflex tachycardia a/w most alpha blockers)
MOA Spironolactone
"potassium-sparing diuretic"
Aldosterone antagonist at late DCT & CD
SE spironolactone
Hyperkalemia
Metabolic acidosis
H-related SE (similar to sex H)
MOA ergot alkaloids
Block 5-HT2 R --> VC
Ergotamine use
moderate to severe migraines
(best if used during prodrome)
Ergotamine is contraindicated for
Pregnancy
PVD
CAD
Methysergide use
Prevent migraine (only prophylactic)
MOA Triptans
5-HT 1 agonist --> VD

(more powerful than ergots)
Use of triptans
Prevent migraines
Tx ongoing migraine
Who should triptans be avoided in
Prinzmetal's angina
PVD
Uncontrolled HTN
Taking SSRI, SNRI, MAOIs (promote serotonin syndrome)
MOA Cyproheptadine
Blocks 5-HT 2 R --> VC
Use cyproheptadine
Prevent migraines
More so for cluster HA

(not really used as much as others)
-setron drugs, MOA, use
Ondansetron, Granisetron, Dolasetron, Palonosetron
5-HT 3 blocker
Anti-emetic (CNS-driven vomiting)
Metoclopramide, MOA, use
5-HT 4 agonist --> increase GI motility
Anti-emetic
Buspirone, MOA, use
5-HT 1 agonist
Anxiolysis