Pharm 11 Antihypertensives

Front 1

secondary causes of hypertension (4)

Back 1

pheochromocytoma, coarctation, renal vascular dz, adrenal cortical tumors

Front 2

tx for mild htn that has minimal compensatory BP responses but can cause hypokalemia, slight hyperlipidemia, hyperuricemia, hyperglycemia, lassitude, weakness and impotence

Back 2

thiazides

Front 3

tx for mod-sev HTN that may cause hypokalemia, hypovolemia, and ototoxicity

Back 3

furosemide (loop diuretics)

Front 4

MOA of clonidine, methyldopa

Back 4

α2 agonists in CNS to decrease SNS outflow, reduces CO and vascular resistance

Front 5

major side effects of α2 agonists?

Back 5

salt/water retention, sedation

clonidine: sudden d/c = rebound HTN

methyldopa: positive Coombs, hemolytic anemia

Front 6

antihypertensive that depletes adrenergic terminal of NE; in low doses has minimal compensatory effect but causes salt/water retention at high dose

Back 6

Reserpine

Front 7

antihypertensive that depletes adrenergic terminal of NE AND blocks its release; may cause orthostatic hypotension and sexual dysfxn

Back 7

guanethidine

Front 8

most serious toxicity of reserpine?

Back 8

behavioral depression

Front 9

a meal high in tyramine may cause a hypertensive crisis in pts on this drug that used to be used for HTN

Back 9

MAO Inhibitors (tyramine causes release of stored NE)

Front 10

type of adrenoceptor blocker that reduces vascular resistance and venous return?

Back 10

α1 blocker (prazosin)

Front 11

why are phentolamine and phenoxybenzamine not useful in tx of HTN?

Back 11

nonselective α-blockers cause excessive compensatory response, esp tachycardia

Front 12

drugs that reduce cardiac output immediately and later also decrease vascular resistance

Back 12

β-blockers

(delayed vasodilation d/t reduction of renin release from kidneys)

Front 13

major side effects of β-blockers

Back 13

sleep disturbance, sedation, impotence, cardiac disturbance, asthma, elevated LDL/trigs

Front 14

drugs that cause release of NO (from endothelium or from drug)

Back 14

nitroprusside, hydralazine

Front 15

drugs that cause hyperpolarization of vascular smooth muscle by opening K+ channels

Back 15

minoxidil, diazoxide

Front 16

antihypertensive associated with lupus-like syndrome?

Back 16

hydralazine

Front 17

vasodilators that are more efficacious on arterioles than veins

Back 17

hydralazine, minoxidil

Front 18

vasodilator reserved for severe HTN?

Back 18

minoxidil

Front 19

toxic effects of minoxidil?

Back 19

severe compensatory responses (salt/water retention and tachycardia), hirsutism, pericardial effusion

Front 20

drugs used for chronic tx of HTN of any severity; fewer compensatory responses than hydralazine and minoxidil

Back 20

nifedipine, verapamil, diltiazem

(calcium channel blockers)

Front 21

adverse effects of nifedipine?

Back 21

constipation, cardiac disturbances, flushing (minor salt/water retention)

Front 22

side effects of short-acting drug for HTN emergencies that releases NO to vascular smooth muscle?

Back 22

excessive hypotension, tachycardia, salt/water retention, cyanide and/or thiocyanate poisoning

Front 23

antidote for most serious nitroprusside side effect?

Back 23

sodium thiocyanate (cyanide poisoning)

Front 24

MOA of diazoxide?

Back 24

Thiazide that lacks diuretic properties; vasodilates by opening K+ channels to hyperpolarize smooth muscle; reduces insulin release

Front 25

antihypertensive drug also used in tx of insulinomas?

Back 25

diazoxide

Front 26

dopamine D1 receptor agonist with short duration vasodilation used for hypertensive emergencies

Back 26

Fenoldopam

Front 27

antihypertensives that increase kinin family vasodilators

Back 27

ACE inhibitors (captopril)

Front 28

antihypertensives that may complicate renal artery stenosis and cause renal failure in fetuses, but are protective for the diabetic kidney?

Back 28

ACE inhibitors

Front 29

drug used when pt develops dry cough 2/2 ACE-I?

Back 29

Losartan, valsartan (angiotensin receptor blockers)

Front 30

drug that inhibits formation of angiotensin I from angiotensinogen

Back 30

aliskiren

Front 31

never take potassium supplements or potassium-sparing diuretics with these antihypertensives

Back 31

angiotensin antagonists (losartan)
renin inhibitors (aliskiren)

(dec angII -> dec aldosterone -> potassium retention)

Front 32

steps of care in pharmacologic tx of HTN?

Back 32

1) lifestyle (salt restriction, wt loss)
2) diuretics
3) sympathoplegics (β blocker or α&β blocker)
4) ACE-Is
5) vasodilators (Ca channel blocker)

Front 33

elderly pts respond better to _____ and ______ than ______

Back 33

β blockers and diuretics than ACE inhibitors

Front 34

pharmacological management of malignant HTN?

Back 34

powerful vasodilator (nitroprusside, fenoldopam or diazoxide) with diuretics (furosemide) and β blockers