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Pharmacology > Antihypertensive Agents > Flashcards

Antihypertensive Agents Flashcards

1
Q

preferred drug classes for antihypertensive action

A

diuretics
ACE inhibitors
calcium blockers
beta blockers

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2
Q

thiazides: hydrochlorothiazide, metolazone

A

frontline diuretics for chronic HT.
acts on distal tubule, inhibits water/sodium reabsorption, decrease BP and blood volume.
effective, cheap, no tolerance, and combine well with other drugs.

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3
Q

thiazide adverse effects

A

hypokalemia, hypercalcemia
increased uric acid - gout.
hyperglycemia/glucose intolerance (diabetic caution).
photosensitivity

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4
Q

potassium sparing diuretic

A

spironolactone - aldosterone antagonist
act on distal tubule and collecting duct - inhibit sodium reabsorption and potassium secretion.
for chronic HT

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5
Q

ACE inhibitor actions

A 
decrease angiotensin II production
decrease sympathetic activity
decrease TPR (no change in CO, HR)
decrease aldosterone production (decrease sodium/water retention)
increase bradykinin (dry cough)
less effective in elderly/blacks
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6
Q

ACE inhibitors adverse effects

A

hypotension in hypovolemic patients.
angioedema (mainly around eyes/lips), hyperkalemia.
dry cough (increase bradykinin).
glossitis, oral ulcerations.
birth defects.
bad combination with potassium sparing diuretics.

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7
Q

angiotensin II type I receptor blockers

A

losartan (-sartan)
competitive antagonists.
actions similar to ACE inhibitors, less adverse effects and no cough.

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8
Q

angiotensin II receptors

A

type I - increase aldosterone, ADH, TPR, sympathetic activity.
type II - vasodilation (decrease TPR), increase NO.

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9
Q

renin inhibitor

A

aliskiren
renin inhibition - decrease angiotensin I.
similar action to ACEI (no cough).
used if poor ACEI/ARB tolerance.
less angioedema, glossitis, but similar adverse effects.

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10
Q

calcium channel blockers

A

bind L-type calcium channels in cardiac and vascular smooth muscle.
inhibit calcium influx.
dilate areterioles - decrease TPR, BP

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11
Q

verapamil

A 
significant cardiac depression
decrease HR
constipation
edema
bad combo with beta blockers, HF
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12
Q

nifedipine

A 
arteriole vasodilation
adverse:
constipation
gingival hyperplasia
hypotension, reflex tachycardia, headache, edema
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13
Q

diltiazem

A

similar to verapamil/nifedipine

more cardiac action than vasodilation

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14
Q

beta blockers

A 
delayed hypotensive action
more useful than alpha blockers
rebound HT, fatigue
beta 2 blockers bad for asthma, diabetes.
actions:
1. decrease sympathetic tone
2. decrease renin secretion
3. block cardiac beta 1 receptors (decrease HR, CO, BP)
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15
Q

propranolol

A

non-selective beta blocker

HT, asthma, diabetes

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16
Q

metoprolol

A

beta 1 selective, LA action

HT, HF, arrhythmia

17
Q

atenolol

A

beta 1 selective, no LA action

HT, HF, angina

18
Q

sotalol

A

beta blocker, blocks potassium channels
arrhythmia only
not on exam 2

19
Q

labetalol, carvedilol

A

beta/alpha blocker

HT, HF, hypertensive crisis

20
Q

loop diuretics

A

furosemide
HF, acute HT
acts on loop of henle, decrease plasma calcium

21
Q

phenoxybenzamine

A

irreversible alpha 1 blocker
reflex tachycardia, PHT
pheochromocytoma, HT crisis

22
Q

prazosin

A

selective alpha 1 blocker
benign prostate hypertrophy, HT
no reflex tachycardia, PHT

23
Q

phentolamine

A

non-selective alpha blocker
pheochromocytoma, not HT
reflex tachycardia, PHT

24
Q

hydralazine

A

direct muscle relaxant, dilate arterioles not veins.

reflex tachycardia, palpation, flushing, lupus reaction.

25
Q

minoxidil

A

rogaine
open potassium channels in smooth muscle.
dilate arterioles, chronic HT
hair growth, reflex tachycardia

26
Q

nitroprusside

A 
acute HT, HF
short term, emergency use only
increase NO, cGMP
dilates arteries and veins
reflex tachycardia, cyanide toxicity, methemoglobinemia
27
Q

diazoxide

A

open potassium channels
acute HT crisis
inhibit insulin release

28
Q

clonidine

A

alpha 2 agonist in CNS
HT
rebound HT, xerostomia

29
Q

alpha methyl dopa

A

alpha 2 agonist
HT in pregnancy
rebound HT, xerostomia

30
Q

guanethidine

A

last resort HT drug
decrease release of NE at terminals, decrease effects of TCA, cocaine.
PHT

31
Q

reserpine

A

last resort HT drug

inhibit NE uptake in vesicles

32
Q

lisinopril

A

ACEI
decrease angiotensin II, aldosterone
increase bradykinin
cough, hyperkalemia, glossitis

Pharmacology (5 decks)

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