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21 Cards in this Set
- Front
- Back
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Which beta blockers are selective for the beta one receptors?
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Atenolol
Nebivolol Metoprolol |
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Which beta blockers also act at the alpha 1 receptor?
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Labetalol
Carvedilol |
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Which beta blockers are non-selective?
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Propranolol
Timolol Pindolol Nadolol |
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Where does a thiazide diuretic work and what is its action?
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Works at the DCT to block reabsorption of Na+ resulting in increased Na+ and water excretion
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What two anti-HTN meds cause first dose syncope?
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ACEIs
Alpha blockers (ex: terazosin) |
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What are the ADRs to thiazides?
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Hypokalemia
Hypercalcemia Hyperuricemia |
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How do CCBs work? What are some examples of this class of drug?
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Block the Ca++ channels in the heart and vasculature thus decreasing contraction force and causing vasodilation, respectively
Verapamil Diltiazem Nifedipine |
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How do ACEIs work?
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They block ACE and thus conversion of angiotensin I to angiotensin II (vasodilation); also results in decreased aldosterone (decreased blood volume d/t increased Na+ and H2O excretion) and increased bradykinin (since ACE degrades bradykinin; causes significant vasodilation).
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What are the ADRs of ACEIs and why might a patient require an ARB instead of an ACEI?
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ADRS: dry cough, 1st dose syncope, rash, fever, altered taste, hypotension, HYPERkalemia (b/c aldosterone is blocked and K+ can't be excreted), angioedema, fetotoxic
Some pts can't tolerate the dry cough associated with the increased bradykinin in ACEIs so an ARB would be more acceptable since it doesn't decrease degradation of bradykinin (just blocks angiotensin II receptors and decreases aldosterone production) |
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How do alpha-blockers lower BP?
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Cause arteriolar vasodilation via blockade of alpha receptors.
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What are the ADRs of alpha blockers?
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Reflex tachycardia
1st dose syncope |
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What are some examples of ARBs?
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Losartan
Candesartan Valsartan |
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Why is nitroprusside only given IV?
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Oral admin can result in its metabolism to cyanide - if this becomes a problem with IV admin the pt is given Na+ thiosulfate
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What is the 1st line tx for pts with essential HTN >140/90?
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Thiazides
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How many meds should a pt with Stage II HTN be taking to lower their BP?
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At least 2: thiazide + 1 other anti-HTN
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What is the 1st line tx for HTN in pts with DM or chronic renal failure?
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ACEI or ARB
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What is the target BP for pts w/ hx of angina or MI? How should they be treated?
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<130/80
Beta blocker + ACEI/ARB +/- CCB or thiazide if not controlled with the first two meds Verapamil or diltiazem can be substituted for the beta blocker if for some reason it is CI/not tolerated |
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What is the target BP for CHF and how is it managed?
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<120/80
Beta blocker + ACEI/ARB + Loop or thiazide diuretic (if severe CHF add aldosterone antagonist such as spironolactone) |
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What drugs are CI in CHF patients?
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Verapamil
Diltiazem Clonidine (CNS alpha 2 agonist) Alpha blockers (ex: terazosin) |
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Why does hyperkalemia occur when using drugs that block aldosterone?
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Na+ isn't reabsorbed at the level of the kidney and so K+ cannot be exchanged for it resulting in retention of K+
Spironolactone is considered a K+ sparing diuretic |
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Why do thiazides cause hypokalemia?
*this answer might be wrong... |
Even though thiazides block reabsorption of Na+ in the DCT, they do not affect aldosterone and thus the Na+/K+ exchange is able to occur in the collecting duct.
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