Pharmacology - Exam 2A - Antihypertensive Drugs

Front 1

Identify the 6 classes of antihypertensive drugs available for therapy.

Back 1

[DAS-VAC]
Diuretics
Aldosterone antagonists
Sympathetic Agents
Vasodilators
Angiotensin system agents
Ca Channel antagonists

Front 2

What are three types of diuretics used to treat hypertension?

Back 2

Thiazides
Loop of Henle agents
Potassium-sparing agents

Front 3

Which two types of diuretics have NO therapeutic value in the treatment of hypertension?

Back 3

Carbonic anhydrase inhibitors
Osmotic diuretics

Front 4

What are the 6 subclasses sympathetic agents that treat hypertension?

Back 4

alpha-methyl DOPA
Clonidine
Trimethaphan (ganglion blocker)
Adrenergic neuron blockers
Beta-blockers
Alpha1-blockers

Front 5

Guanadrel and Reserpine are a part of what subclass of sympathetic agents?

Back 5

Adrenergic neuron blockers

Front 6

This Beta-blocker is prototypical and non-selective and is used to treat hypertension.

Back 6

Propanolol

Front 7

What subclass of sympathetics do the following drugs belong to?

Which five are long-acting and what property makes them so?

Metoprolol
Atenolol
Acebutolol
Betaxolol
Nadolol
Cartelol
Bisoprolol
Nebivolol

Back 7

Beta-1 selective blockers

Long lasting because its not metabolized by the liver but excreted by the kidney

Atenolol
Betaxolol
Bisoprolol
Nadolol
Cartelol

Front 8

Name the two mixed (a/B) drugs used to treat hypertension.

Back 8

Labetolol
Carvedilol

Front 9

Name the three Alpha-1 blockers (that we learned) used to treat hypertension.

Back 9

Prazosin
Doxazosin
Terazosin

Front 10

Name the 5 vasodilators used to treat hypertension?

Back 10

Hydrazaline
Minoxidil
Sodium nitroprusside
Diazoxide
Fenoldopam

Front 11

Name the five Ca-Channel antagonists used to treat hypertension.

Back 11

Verapamil
Diltazem
Amlodipine
Nifedipine
Bepridil

Front 12

Name the three types of drugs that target the angiotensin system?

Back 12

ACE Inhibitors (the prils)
Angiotensin receptor antagonists (sartans)
Renin inhibitors (Aliskiren)

Front 13

Name the two aldosterone receptor antagonists that are used to treat hypertension.

Back 13

Spironolactone
Eplerenone (best specificity)

Front 14

Give the MOA (mechanism of action) of Thiazides.

Back 14

Sodium excretion (slow acting and long duration)

Front 15

MOA of Loop of Henle diuretics?

Back 15

Sodium excretion (short duration)

Front 16

MOA of potassium-sparing diuretics?

Back 16

Mitigates potassium loss (used with thiazides)

Front 17

MOA of alpha-methyl DOPA?

Back 17

Metabolized to alpha-methyl NE which acts as as alpha2 blocker in the CNS and vasoconstrictor in the PNS.

*doesn't affect CO or HR

Front 18

MOA of Clonidine?

Back 18

CNS α2 adrenergic antagonist that decreases sympathetics

Front 19

MOA of Trimethaphan?

Only given in what types of situations?

Back 19

Ganglion blocker – limited to emergency use

Front 20

MOA of Prazosin, Doxazosin and Terazosin?

Back 20

a1 blockers that
decrease peripheral resistance and venous capacitance
increase heart rate and plasma renin via sympathetics

Front 21

MOA of Hydralazine?

Back 21

decreases intracellular calcium which dilates arterioles without affecting venous capacitance

Front 22

MOA of Minoxidil?

Back 22

Activates ATP-dependent potassium channels => hyperpolarization => relaxation

Front 23

What drug is given to pts having reduced renal function as well as hypertension?

Back 23

Fenoldopam

Front 24

Name the two emergency hypertensive agents

Back 24

Sodium nitroprusside and Diazoxide

Front 25

What is the metabolic/enzymatic function of Renin?

Back 25

converts angiotensin to ANG I

Front 26

What is the metabolic/enzymatic function of ACE aka angiotensin converting enzyme?

Back 26

Cleaves ANG I converting it to ANG II (angiotensin)

Front 27

What is the function of angiotensin?

Back 27

Direct vasoconstrictors leading to increased BP (responds to low BP)

Front 28

What is the function and MOA of Bradykinin?

Back 28

Produces NO and increases prostaglandin production leading to VASODILATION and increased urine flow

Front 29

MOA of ACE Inhibitors on angiotensin and bradykinin?

Back 29

Decreases angiotensin production and increases bradykinin

Front 30

MOA of "sartans"

Back 30

Nonpeptide angiotensin receptor antagonists (competitive irreversible)

Front 31

Which drugs can cause Angina?

Back 31

Vasodilators (Hydralazine and Minoxidil)
Ca-channel blockers

Front 32

Which drugs can cause Bradycardia?

Back 32

Beta blockers and Ca-channel blockers (Verapamil and Diltiazem)

Front 33

Which drugs can cause Bronchospasms/Cough (with asthma or COPD pts)

Back 33

ACE inhibitors (due to increased bradykinins or prostaglandins)

Propanolol (due to blocking β2 adrenoreceptors)

Front 34

Which drugs can cause Cardiac arrhythmias?

Back 34

Diuretics (Due to loss of potassium ion)

Front 35

Which drugs can cause Constipation and Esophageal reflux?

Back 35

Calcium-channel blockers (due to relaxation of GI smooth muscle) ==> Verapamil

Front 36

Which drugs can cause Edema?

Back 36

ACE inhibitors
Vasodilators (due to low renal perfusion, increased renin release) => Hydralazine + Minoxidil
Calcium-channel blockers (caused by arteriolar
dilation and venous constriction)

Front 37

Which drugs can cause Erectile dysfunction?

Back 37

Di(ck)uretics

Front 38

Which drugs can cause Fatigue and sleep disturbances?

Back 38

Beta blockers

Front 39

Which drugs can cause changes in glucose tolerance?

Back 39

Diuretics
Propanolol (due to blocking β2 adrenoreceptors)

Front 40

Which drugs can cause

Back 40

Thiazides
Loop diuretics

*Due to increased plasma uric acid concentration

Front 41

Which drugs can cause Gynecomastia (due to hyperprolactinemia), Hemolytic anemia, Hepatotoxicity, Parkinsonian signs?

Back 41

alpha methyl DOPA

Front 42

Which drugs can cause Headaches?

Back 42

a1-blockers

Front 43

Which drugs can cause Hypotension (orthostatic) – due to venous dilation?

Back 43

Clonidine and alpha1 blockers

Front 44

Which drugs can cause Hypotension (non-orthostatic) – aka “marked” hypotension?

Back 44

α1-blockers
ACE inhibitors (“prils”) – effect seen in CHF patients
Vasodilators

Front 45

Which drugs can cause Hyperkalemia?

Back 45

ACE inhibitors & ARB’s

Front 46

Which drugs can cause Hypertrichosis (excess hair growth)?

Back 46

Minoxidil (vasodilator)

Front 47

Which drugs can cause Impotence/Reduced libido?

Back 47

α-methyl DOPA
Clonidine

Front 48

Which drugs can cause Nervousness and palpitations?

Back 48

α1-blockers

Front 49

Which drugs can cause Placental hypoperfusion (Fetopathy)?

Back 49

ACE inhibitors
ARB’s (ANG II receptor antagonists)
Diuretics

Front 50

Which drugs can cause Sedation and Xerostomia?

Back 50

α-methyl DOPA
Clonidine

Front 51

Contraindications for Diuretics?

Back 51

Don't use NSAID's
with Diuretics, they
inhibit renal
prostaglandin
synthesis

Front 52

Contraindications for clonidine?

Back 52

Not for pts
w/mental
depression

Front 53

Contraindications for Beta blockers?

Back 53

Don't take NSAIDS, decreases prostacyclin synthesis in peripheral vasculature and/or through retention of NA ion by kidney

Front 54

Contraindications for Verapamil?

Back 54

Don't use if SA or
AV nodal problems
present; not used
with B blockers if
SNS important for
cardiac fxn

Front 55

Contraindications for ACE inhibitors?

Back 55

Don't take with
NSAIDs

Front 56

Contraindications for Aliskiren?

Back 56

pregnancy