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20 Cards in this Set
- Front
- Back
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Diuretics |
Hydrochlorothiazide
Furosemide Spironolactone |
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Sympatholytic Drugs
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Clonidine
Propranolol - B blocker Metoprolol- B blocker Atenolol- B blocker Prazosin- alpha blocker Terazosin- alpha blocker Doxazosin- alpha blocker Labetolol - mixed Carvediolol- mixed |
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Direct Vasodilators
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Minoxidil- arterial Vasodilator
Hydralazine- arterial Vasodilator Amlodipine- Ca blocker Verapamil- Ca blocker Nifedipine- Ca blocker |
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Inhibitors of Angiotensin System
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Lisinopril- ACE inhibitor
Ramipril- ACE inhibitor Losartan- angiotension blocker Valsartan- angiotension blocker |
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Antihypertensiveagents decrease blood pressure by |
reducing total peripheral resistance or cardiac output or both through neuronal or hormonal mechanism |
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BP= |
CO x TPR |
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CO |
SV X HR |
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Centerally Acting Agent Clonidine |
is an CNS-alpha2-adrenoceptor agonist Lowers sympathetic outflow and increases vagal tone thereby decreasing cardiac output and peripheral resistance
second or third line drug choice for lowering BP and in hypertensive crisis
Side Effects: Compensatory response: water and Na retention |
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B-adrenoceptor blockers
Atenolol (cardioselective) Propranolol (non-cardioselective) |
decrease CO by blocking B1. Used to treat mild to moderate hypertension. Used alone or in combination with other type antihypertensive agents.
With diuretics -- further control blood pressure With a vasodilator to prevent the compensatory response in cardiac and renin release stimulation
Preferred use with patients with other issues
Side Effects: CNS: Fatigue, sedation, sleep disturbance (propranolol) CV: bradycardia and heart block (metoprolol) GI: dry mouth, nausea and vomit, constipation Others: hypoglycemia, hypocalcemia, sexual dysfunction, agranulocytosis
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Alpha-Adrenoceptor Blockers
Prazosin Terazosin Doxazosin |
selectively blocks alpha1-receptors and cause dilation of both arterioles and veins. It may also act in CNS to decrease sympathetic tone.
Used in patients with resistant hypertension Used in patients with prostatic hypertrophy Used in patients with congestive heart failure
Side Effects: CV: orthostatic hypotension, edema, slight tachycardia CNS: headache, dizziness, fatigue, nervousness GI: nausea, abdominal pain Others: Sexual dysfunction |
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Mixed Blockers
Labetalol Carvedilol |
Selective alpha and beta antagonists. Blood pressure is lowered by reduction of systemic vascular resistance and heart rate.
Used in patients with both hypertension and angina Useful drug in treating hypertension of pheochromocytoma and hypertensive emergencies Used in patient with benign prostatic hypertrophy Carvedilol - hypertensive patients w/heart failure
Side effects: Blockade of both types of adrenergic receptors Orthostatic hypotension |
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Direct Vasodilators
Minoxidil Hydralazine |
Directly act on vascular smooth muscles Do not interfere w/ ongoing sympathetic tone significant reflex compensatory response in heart function (Tarycardia), renin release, and water and salt retention used with diuretics or B-blockers to treat refractory hypertensive patients |
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Minoxidil |
metabolite minoxidil sultate which opens up K+ channel on the plasma membrane of smooth muscle cells and stabilizes membrane resting potential
Use of drug: used in patients refractory to other antihypertensive agents and patients with severe renal disease used combined with a beta-blocker to prevent an increase in heart rate and with a diuretic to prevent retention of fluid
Side Effects: salt and water retention, pericardial effusion and tachcardia Hypertrichosis(hair growth) |
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Hydralazine |
Releases nitric oxide which acts on the vascular smooth muscle cells to activate guanylate cyclase and subsequently increase the production of cyclic guanosine monophosphate to relax the vasular smooth muscle
Use of Drug: used in combo w/ diuretic or B-blocker to treat patients with refractory hypertension High first pass effect and low bioavailability
Side effects: Reflex compensatory response CNS: tremor, nausea, headache, palpitations, sweating CV: angina attack and ischemic arrythmias Lupus like symptoms |
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Calcium Channel Blockers
Nifedipine Amlodipine
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Greatest vasodilation effect and less cardiodepression effect
Used to treat some hypertensive emergencies Not used in chronic hypertension: risk of myocardial infarction
Side Effects: Inhibition of heart function Mild salt and water retnetion Others to vasodilation |
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Calcium Channel Blockers
Verapamil |
Greatest cardiodepression effect and moderate vasodilation effect
To treat mild to moderate hypertension Not used in combination with a B-blocker
Side effect: Same of Nifedipine and Amlodipine |
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ACE inhibtors
Lisinopril Ramipirl |
decrease angiotension II production by inhibiting the converting enzyme and decreases peripheral vascular resistance
to treat high blood pressure in cases those involved congestive heart failure, heart attack, and chronic kidney failure
Race: more effective in Caucasian than black people
Side effects: Dry cough, angioedema and hyperkalemia CNS: headache, dizziness, fatigue, nervousness CV: postural hypotension and tachycardia GI: diarrhea, neausea, peptic ulcer reactivation
Contraintradiction |
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Renin-Angiotension System
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Renin --> angiotensinogen --> angiotension I --> Angiotension II -->Aldosterone --> Renal Sodium Retention --> Expends extracellular volume --> Feedback suppression of renin --> angiotensinogen |
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Angiotensin II Receptor Blockers
Losartan Valsartan |
Blockade of angiotension II receptor, decreases vasoconstriction and water and sodium retention
Used: similar to ACE inhibitors; used in patients with left ventricular hypertrophy or with diabetic nephropathy
Side Effects: Similar to those seen in ACE inhibitors, but cough and angioedema are less common
CONTRAINDICATION |
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Contraindications: |
second and third trimesters of pregancy anuria, andrenal failure, sometimes associated with fetal malformations or death |
