Drugs To Treat Hypertension

Front 1

At what blood pressure should you start HTN treatment?

Back 1

140/90

(150/90 if over 60 years old)

Front 2

What are the Primary drugs for HTN

Back 2

*Drugs that decrease CVD risk*

Thiazides, ACE Inhibitors, ARBs, CCBs

Front 3

What are the Secondary drugs for HTN

Back 3

*less evidence that supports decrease in CVD risk*

Alpha blockers, Beta-blockers, Renin Inhibitors, Clonidine (alpha2-CNS-symp. blocker)

Front 4

Main thiazide used for HTN

Back 4

Hydrochlorthiazide (all end in "azide")

Front 5

Non-selective Beta-blocker (Blocks B1 and B2 receptors) used for HTN

Back 5

Propranolol

Front 6

Cardioselective Beta-blocker (blocks B1 only) for HTN

Back 6

Atenolol

Front 7

Mixed receptor (blocks B1, B2, alpha1) vasodilator beta-blocker for HTN

Back 7

Carvedilol

Front 8

Best drug choice for a pt w/ both HTN and angina/MI/CHF

Back 8

Beta-blocker (propranolol, carvedilol, atenolol)

Front 9

Non-selective alpha-blocker (blocks a1 and a2) that prevents vasoconstriction and is used to treat Pheochromocytoma

Back 9

Phentoloamine

Front 10

Selective alpha-blocker (blocks a1 only) that prevents vasoconstriction and is used as an adjunct w/ other HTN drugs

Back 10

Prazosin (all end in "osin")

Front 11

ACE Inhibitors

Back 11

Lisinopril & Enalapril (prodrug)

*all end in "prill"*

Front 12

Angiotensin Receptor Blockers (ARBs)

Back 12

Losartan (competitive) and Valsartan (non-competitive)

*end in "sartan"*

Front 13

Renin Inhibitor that is used in combo with non-renin anti-HTNs

Back 13

Aliskiren

Front 14

Ca2+ Channel Blocker that blocks L-type Cav channels in vascular smooth mm only

Back 14

Amlodopine

Front 15

Ca2+ Channel Blocker that blocks L-type Cav channels in vascular smooth mm and heart and thus also serve as Class IV antiarrhythmics

Back 15

Diltiazem and Verapamil

Front 16

Direct Vasodilator that inhibits Ca2+ release and stimulates the NO pathway to relax smooth mm on arteries

Back 16

Hydralazine

Front 17

Drugs only used for refractory HTN

Back 17

Hydralazine and Minoxidil (direct vasodilators)

Front 18

IV drug that produces NO and is used to treat hypertensive emergencies

Back 18

Nitroprusside

Front 19

Drugs of choice to treat hypertension in African Americans

Back 19

Calcium-channels blockers (Amlodopine, Ditilizem, Verapamil)

Front 20

Last resort HTN drug that depletes nor-epi in sympathetic nerves to act as a sympathetic blocker

Back 20

Reserpine

Front 21

Stimulates a2 on inhibitory neuron in the brainstem to decrease symp outflow and cause decreased heart rate and vasodilation

Back 21

Clonidine (A2-CNS-Symp Blocker)

Front 22

Inhibits the rate-limiting step in Ang II production

Back 22

Aliskiren (renin inhibitor)

Front 23

Blocks Ang II from increasing BP w/out Bradykinin side effects.

Also prevents cardiac remodelling

Back 23

ARBs (Losartan & Valsartan)

Front 24

Inhibits the conversion of Ang I to Ang II to prevent vasoconstriction, heart remodeling, Na+ retention, and aldosterone release.

Also inhibits bradykinin breakdown to cause vasodilation and increase vasc. permeability

Back 24

ACE Inhibitors (Lisinopril & Enalapril)

Front 25

Block sympathetics to decrease cardiac output, decrease renin release from the kidney, and prevent vasoconstriction of vasculature

Back 25

Beta-blockers (Propranolol, Atenolol, Carvedilol)

Front 26

Blocks Na/Cl transporter in the distal convoluted tubule to decrease Na+ reabsorption and thus decrease plasma volume

Back 26

Hydrocholorthiazide (thiazide diruetic)

Front 27

K+ Sparing Diuretic used in combo with Hydrochlorothiazide to prevent hypokalemia

Back 27

Triameterene

Front 28

Main SE is hypokalemia which increases mortality

Back 28

Hydrochorothiazide (thiazide diuretics)

Front 29

SE = Brady, Angina upon w/drawl, transient increase in glucose and lipids, bronchospasm in asthmatics and COPD, worsening of acute CHF, CNS effects

Back 29

Beta-Blockers (Propranolol, Atenolol, Carvedilol)

Front 30

SE = first dose phenomenon (postural hypotension w/ first dose), Reflex Tachy, Water retension

Back 30

Alpha-Blockers (Phentoloamine & Prazosin)

Front 31

SE = excessive hypotension, Teratogen, Renal failure (especially if pt is diabetic)

Back 31

All drugs effecting Renin-Aldosterone System including ACE-Inhibs (Lisinopril & Enalapril), ARBs (Losartan & Valsartan), Renin Inhib (Aliskiren)

Front 32

Additional Bradykinin side effects of angioedema and dry cough

Back 32

ACE-Inhibitors (Lisinopril & Enalapril)

Front 33

SE = Excessive Hypotension that causes flushing, edema, reflex tachy

Back 33

CCBs (Amlodopine) - but no relfex tachy w/ Verapamil or Ditilazem

Front 34

SE = varying bioavailability based genetics (fast acetylators need larger doses), excessive hypotension w/ reflex tachy and edema, SLE-like syndrome

Back 34

Hydralazine

Front 35

SE = marked hypotension and hypertrichosis

Back 35

Minoxidil