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Pharm II > Anti-HTN > Flashcards

Anti-HTN Flashcards

(102 cards)

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1
Q

What anti-HTN drugs are included in the Diuretics class?

A

Thiazide: Indapamide
Loop
Potassium sparing

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2
Q

What anti-HTN drugs are included in the Sympathetic Nervous System Drugs - 𝛼2 agonist class?

A

Clonidine, Methyldopa

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3
Q

What anti-HTN drugs are included in the Sympathetic Nervous System Drugs - 𝛼1 blocker class?

A

Prazosin

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4
Q

What anti-HTN drugs are included in the Sympathetic Nervous System Drugs - Β-blockers class?

A

Propranolol, Nebivolol (-olol)

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5
Q

What anti-HTN drugs are included in the Sympathetic Nervous System Drugs - Combined 𝛼1-β blockers class?

A

Carvedilol, Labetalol

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6
Q

What anti-HTN drugs are included in the Vasodilators - Drugs acting though NO class?

A

Hydralazine, Sodium Nitroprusside

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7
Q

What anti-HTN drugs are included in the Vasodilators - D1 agonist class?

A

Fenoldopam

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8
Q

What anti-HTN drugs are included in the Vasodilators - Calcium channel blockers class?

A

Nifedipine, Amlodipine (-dipine), Diltiazam, Verapamil

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9
Q

What anti-HTN drugs are included in the Inhibitors of RAS - ACE-I class?

A

Enalapril, Lisinopril

-pril

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10
Q

What anti-HTN drugs are included in the Inhibitors of RAS - ARBs class?

A

Losartan, Valsartan

-artan

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11
Q

What condition leads to an increased incidence of renal failure, coronary disease, HF, and stroke?

A

HTN

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12
Q

If a pt is considered stage 1 HTN (SBP 130-139 or DBP 80-89), how many drugs should be used?

A

1

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13
Q

If a pt is considered stage 2 HTN (SBP ≥ 140 or DBP ≥ 90), how many drugs should be used?

A

2

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14
Q

What is considered first line of HTN treatment?

A

Lifestyle modifications

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15
Q

What is the most common cause of failure of antihypertensive treatment?

A

Non-compliance

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16
Q

How much does the efficacy in decreased BP differ between anti-HTN drugs?

A

Very little

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17
Q

Should BP lowering be gradual or abrupt?

A

Gradual without compromising vital organs

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18
Q

What is the effect of combining drugs from different groups for treatment of HTN?

A

Increases efficacy and may decrease toxicity

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19
Q

Thiazide diuretics (Indapamide) is a direct vasodilator used in the treatment of mild to moderate HTN and lowers BP by how much?

A

10-15 mmHg

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20
Q

What are notable SE’s of diuretics with respect to HTN tx?

A

Reduced glucose tolerance
Increased plasma lipid concentration
avoided w lower doses

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21
Q

What is one of the initial recommended drugs for HTN treatment that acts by counteracting Na+ and H2O retention?

A

Thiazides

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22
Q

What populations are thiazide diuretics more effective in?

A

African Americans, elderly

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23
Q

What drug class has the following MOAs?

  • ↓ BP by reducing sympathetic vasomotor tone
  • Adrenergic receptor action
  • Interruption of efferent sympathetic pathway
  • Activate baroreflexes to cause Na+ and H2O retention
  • Best when combined w diuretic
A

Sympatholytics

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24
Q

The following is the MOA for what drugs?

Stimulation of medullary alpha2 adrenergic receptors leading to decreased peripheral sympathetic nerve activity

A

Clonidine, Methyldopa

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25
What drug used to treat HTN is safe in pregnancy?
Methyldopa
26
What drugs have the following therapeutic effects? | - ↓ sympathetic outflow/ renin secretion leading to ↓ BP
Clonidine, Methyldopa
27
Does Clonidine or Methyldopa decrease HR and CO more?
Clonidine
28
What are the adverse effects of centrally acting sympatholytics? (4)
Sedation/ CNS effects Xerostomia ED Hemolytic anemia/ + Coombs test (Methyldopa)
29
Why are centrally acting sympatholytics not recommended for monotherapy?
CNS effects (only if refractory pts)
30
What can be caused by sudden withdrawal of clonidine?
Hypertensive crisis
31
What is the MOA of Prazosin?
Specifically blocks alpha1 adrenergic receptors
32
What drug has the following indications/ therapeutic effects? Reduce NE vasoconstriction to dilate arteries/ veins ↓ peripheral resistance = ↓ BP Do not adversely affect plasma lipids Beneficial in BPH
Prazosin
33
With what class of drugs is the "first dose phenomenon" evident? (postural hypotension)
Alpha1- adrenergic antagonists
34
Besides postural hypotension, what other adverse effects are seen with alpha1- adrenergic antagonists?
Na+ and water retention | Reflex tachycardia
35
What drug class decreases BP by blocking beta-adrenergic receptors in the heart to reduce CO, in the kidneys to reduce renin secretion, and in the CNS to reduce sympathetic vasomotor tone?
Beta-blockers (propranolol)
36
What drug class is combined with other drugs to counteract reflex tachycardia and increase renin secretion?
Beta-blockers (propranolol)
37
What drug class is no longer recommended for monotherapy of HTN?
Beta blockers
38
What is the preferred drug for pts with angina, post MI, migraine, and HF?
Beta blockers
39
What is the least preferred drug for pts with high physical activity, African heritage, asthma, DM, hypercholesterolemia, and PVD?
Beta blockers
40
What beta blocker leads to increase NO = direct vasodilation = decreased ED?
Nebivolol
41
What are the main c/i's for Beta blockers? (4)
DM Severe (end stage) HF Heart block Asthma
42
Sudden withdrawal of Beta blockers may lead to what?
Undesirable CV outcomes
43
Beta specific drugs fall into what category? | *study tip*
A-N
44
Beta non-specific drugs fall into what category? | *study tip*
N-Z
45
In what pt population should you avoid use of combined alpha and beta blocker?
Asthmatics (bronchoconstriction)
46
What adverse effect does Labetalol have?
Hepatotoxicity (EM use only)
47
Sodium nitroprusside relaxes what in addition to arterial smooth muscle?
Veins
48
Which vasodilators are used IV for emergencies?
Nitroprusside, fenoldopam, some CCBs
49
What class of drugs works best in combo w other drugs to oppose compensatory responses and have diminished effects with time?
Vasodilators
50
Which vasodilators are used for chronic oral treatment?
Hydralazine
51
The following sxs may accompany what primary sx with vasodilators? - Reflex tachycardia and ↑ myocardial contraction - ↑ renin secretion - Fluid retention - HAs, flushing - Palpitations, dizziness
Hypotension
52
What is the drug of last choice for the treatment HTN?
Hydralazine
53
What drug dilates arterioles but not veins, is used in chronic therapy of severe HTN, combined with other agents only?
Hydralazine
54
What drug is used in severe HTN or hypertensive emergencies in pregnancy (compelling indication)?
Hydralazine
55
What is the primary adverse effect seen w Hydralazine?
SLE in slow acetylators
56
What is the primary adverse effect seen w Hydralazine?
SLE in slow acetylators
57
What drug rapidly lowers BP and is used for emergency hypertensive situations?
Sodium nitroprusside
58
What drug is metabolized by the liver rapidly to thiocyanate and is given by IV infusion only?
Sodium nitroprusside
59
What is the primary adverse effect of Sodium nitroprusside?
Cyanide accumulation
60
What is the indication for Fenoldopam?
Emergency hypertensive situations
61
How is Fenoldopam given?
``` IV administration (also has short half life) ```
62
What do all CCBs end with? (name wise)
"-dipine"
63
What class of drugs are orally active and bind to L-type channels in the myocardium and vascular smooth muscle?
CCBs
64
What tissue is most sensitive to CCBs although it will exert effects on all tissues that depend on calcium for normal resting tone and contraction?
Vascular smooth muscle
65
What class of drugs is one of the first choices for hypertensive therapy?
CCBs
66
``` The following are major cardiac effects for what class of drugs? ↓ contractility = neg inotropic ↓ impulse generation in the SA node = neg chronotropic ↓ AV node conduction = neg dromotropic ```
CCBs
67
Which CCB has the greatest effects on vascular smooth muscle?
Verapamil < Diltiazem < Nifedipine
68
Which CCB has the greatest effects on cardiac muscle?
Verapamil > Diltiazem > Nifedipine
69
Due to the differences in tissue selectivity of CCBs, the drugs have opposite effects on HR. Which increases HR? Which decreases HR?
Nifedipine ↑ HR | Verapamil ↓ HR
70
Which CCB is recommended for HTN in pregnancy?
Nifedipine
71
How are CCBs excreted?
Renal
72
Which CCB is most likely to produce reflex tachycardia?
Nifedipine | highest vasodilation = marked hypotension = reflex tachycardia
73
Which CCB has the greatest effects on vasodilation and reflex tachycardia?
Verapamil < Diltiazem < Nifedipine
74
Which CCB has the greatest effects on depressed SA and AV node function?
Verapamil > Diltiazem > Nifedipine
75
Verapamil and diltiazem are c/i'd and dihydropyridines used cautiously in pts with what?
HF
76
Which CCBs cause the most vascular SEs? | reflex tachycardia, HA, flushing, dizziness, peripheral edema
Dihydropyridines
77
What is the most common SE of Verapamil?
Constipation
78
Which anti hypertensive drugs lower BP without compromising the heart, brain, or kidneys?
ACE Inhibitors
79
What drug class is one of the first choices for hypertensive mono therapy (mild-mod HTN) and definitive DOC for treatment of hypertensives with: DM, CKD, HF?
ACE Inhibitors
80
Which drug class for anti hypertensives enhance antihypertensive efficacy of diuretic drugs and balance the adverse effects of diuretics?
ACE Inhibitors
81
ACE inhibitors are DOC for what specific condition (even without HTN)?
CKD + particularly indicated for diabetic nephropathy
82
What drug class used to treat HTN has the following adverse effects? - Orthostatic hypotension and dizziness (severe if hypovolemic) - Dry, hacking, non-productive cough - Angioneurotic edema - Acute renal failure if bilateral renal artery stenosis
ACE Inhibitors
83
What are the 2 most important c/i's with ACE inhibitor treatment?
Pregnancy | Combo w NSAIDS
84
Which drug class to treat HTN block AT1 receptors selectively without affecting AT2 receptors?
ARBs
85
All effects (good and bad) of ARBs are similar to ACE inhibitors except what?
Cough and angioedema
86
What are the most preferred drugs in pregnancy? (HTN)
Methyldopa, labetalol, nifedipine
87
What are the least preferred drugs in pregnancy? (HTN)
ACE inhibitors, ARB
88
What are the most preferred drugs in pts with angina pectoris? (HTN)
BB, CCB
89
What are the least preferred drugs in pts with angina pectoris? (HTN)
Hydralazine, minoxidil
90
What are the most preferred drugs in pts post MI/ w clinical CAD? (HTN)
ACE inhibitors/ ARB, BB
91
What are the most preferred drugs in HF? (HTN)
ACEI/ ARB + BB + diuretic + aldosterone antagonist
92
What are the least preferred drugs in HF? (HTN)
CCB
93
What are the most preferred drugs in pts for recurrent stroke prevention? (HTN)
Diuretic, ACEI, ARB
94
What are the most preferred drugs in pts w CKD? (HTN)
ACEI/ ARB
95
What are the most preferred drugs in pts w T2DM? (HTN)
ACEI/ ARB, CCB
96
What are the least preferred drugs in pts w T2DM? (HTN)
Diuretic, BB
97
What are the most preferred drugs in pts w asthma? (HTN)
CCB, ACEI
98
What are the least preferred drugs in pts w asthma? (HTN)
BB
99
What are the most preferred drugs in pts w BPH? (HTN)
alpha-blocker
100
What are the most preferred drugs in pts with migraine HA? (HTN)
BB, CCB
101
What are the most preferred drugs in pts w osteoporosis? (HTN)
Diuretic
102
Gingival hyperplasia is an adverse effect of which CCB class?
"-dipines"

Pharm II (13 decks)

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