B1/B2 Blocker
Propanolol
Indication for Propanolol
Angina, HTN, Essential tremor, migraine Px, anxiety
Contraindications for Propanolol
Bradycardia Heart block Uncompensated HF Severe depression Bronchospams
Propanolol caution in elderly
2x the potency
Selective B1 Blocker
Metropolol
Atenolol
Indication for Metropolol
Angina
HTN
Stable post MI
Contraindications for Metropolol
Bradycardia
Heart block
Uncompensated HF
Severe depression
What do high doses of Metrolpolol and Atenolol do
Lose selectivity
Alpha 1 blocker
Prazosin
Prazosin MOA
Selective A1 blocker relaxes vascular smooth muscle
Indications for Prazosin
HTN
PTDS, Reynauds
Side effects of Prazosin
Postural HOTN
Syncope
Contraindications for Prazosin
Orthostatic HOTN
Prazosin Dx-Dx interaction
PDE-5 inhibitors
Other anti-HTNs
Centrally acting Alpha 2 AGONIST
Clonidine
Methyldopa
What is Methyldopa indicated for?
Hypertensive crisis in pregnancy
Indications for Clonidine
HTN
ADHD
Narc, ETOH w/d
Clonidine side effect
Xerostoma
Contraindications for Clonidine
CNS depression
Severe CAD
Clonidine Dx-Dx interaction
ETOH, SA/AVN altering drugs
B1/B2/A1 blocker
Carvedolol
Indications for Carvedolol
HTN
Stable post MI
(Angina)
Carvedolol side effects
Rebound HTN/angina
Contraindications for Carvedolol
Bradycardia Heart block Uncompensated HF Severe depression Broncospasm Liver Dz
Name the Bet Blockers
Metropolol
Atenolol
Propanolol
Carvedolol
Name the Alpha2 agonists
Clonidine
Methyldopa
ACEIs
Lisinopril
Captopril
Fosinopril
ACEI MOA
Inhibits conversion of AT1 into AT, decreasing vasoconstriction and aldosterone secretion
Indication for ACEI
HTN
HF
LVD post MI
Side effects of ACEI
Cough
Angioedema
Contraindications for ACEI
Hx of angioedema
pregnancy
bilateral renal artery stenosis
What drugs don;t we mix with ACEIs?
ARBs
Aliskerin
When do we modify the dose of ACEI?
Renal Dz
What do we watch for with the first dose of an ACEI?
HOTN
Angiotensin Receptor Blocker (ARB)
Losartan
What does Losartan primarily bind to?
AT1
What don;t we use in combo with ARBs?
ACEIs
Aliskerin
Direct Renin Inhibitor
Aliskerin
Aliskerin MOA
Direct renin inhibitor vasodilates
Indication for Aliskerin
HTN
What drugs do we avoid when on Aliskerin?
ACEIs
ARBs
What else do we avoid on Aliskerin?
Grapefruit juice
Two DHP Calcium Channel Blockers
Amplodipine
Nifedipine
Indications for DHP CCBs
HTN
Chronic stable or vasospastic angina
Side effect of Amlodipine
Dependent edema
Side effect of Nifedipine
HOTN, esp in elderly
What do we avoid when on DHP CCBs?
Grapefruit juuice
Two NDHP Calcium Chanel Blockers
Diltiazem
Verapamil
NDHP CCB MOA
Dilates coronary arteries and decreased MVO2
Indications for NDHP CCBs
Angina
HTN
A-fib/flutter
Side effect of Diltiazem
Dyspepsia
Side effect of Verapamil
Gingival hyperplasia
Contraindications for NDHP CCBs
Bradycardia
Sick sinus syndrome without a pacer
What do we avoid with NHDP CCBs?
Grapefruit juice
Direct-acting Vasodilator
Hydralazine
What does Hydralazine dilate?
Arterioles
Indications for Hydralazine
Hypertensive crisis
(pre) eclampsia
What condition does Hydralazine CAUSE?
Lupus
Contraindications for Hydralazine
CAD
Mitral Valve rheumatic heart dz
Thiazide diuretic
HCTZ
Where does HCTZ inhibit Na+/Cl- symporters?
Distal convoluted tubule
Indications for HCTZ
HTN
Edema of nephrotic syndrome
(Lithium-induced diabetic insipidus)
Side effects of HCTZ
Hypokalemia
Long QT
Contraindication of HCTZ
Sulfa allgery
HCTZ Dx-Dx interactions
Beta blockers, Lithium, NSAIDs
Chlorthalodone class
Thiazide-like diuretic
How much more potent is Clorthalodoe than HCTZ?
2X
K+ sparing diuretic
Triamterene
Triamterene indication
Hypokalemia
Contraindication of Triamterene
Sulfa allergy
Triamterene Dx-Dx interactions
Other K+ sparing drugs
What do we usually combine Triamtere with?
Thiazide diuretics