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CVS II Pharmacology > Antihypertensive drugs > Flashcards

Antihypertensive drugs Flashcards

(106 cards)

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1
Q

treatment for HTN + angina pectoris

A

BB and/or CCB

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2
Q

HTN + BPH treatment

A

alpha blocker

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3
Q

HTN + DM treatment

A

ACEI or ARB

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4
Q

HTN + heart failure treatment

A

ACEI, ARB, BB, Diuretic

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5
Q

HTN + MI treatment

A

BB and ACEI

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6
Q

HTN + high cholesterol (dyslipidemia) treatment

A

Alpha blocker and CCB
Don’t give thiazide diuretics because they cause increased lipids

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7
Q

what drugs are recommended for stage I HTN

A

One of the following: diuretic, ACEI, ARB or CCB

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8
Q

what are the recommended drugs for stage II HTN

A

2 drug combo:
diuretic + ACEI, ARB, or CCB

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9
Q

In a study of a patient with refractory hypertension, which of the
following antihypertensive combinations will reduce the systolic
BP the most?
A. adding an alpha blocker to a beta blocker
B. adding an ARB to an ACEI
C. Adding K+ sparing diuretic to a thiazide diuretic
D. Adding a dihydropyridine CCB to a non-hydropyridine CCB

A

C. to balance out the ions

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10
Q

hich of the following activities can have the greatest
effect on blood pressure reading?
A. The consumption of three alcoholic drinks 12 h before the
measurement
B. The drinking of a cup of coffee 1h before the measurement
C. The smoking of a cigarette 15 minutes before the measurement
D. The use of a cuff that is one size too small for the patient.

A

C, smoking

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11
Q

what is the site of action or thiazide diuretics

A

DCT

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12
Q

what is the drug of choice for HTN during pregnancy (pre-eclampsia)

A

first choice is Labetalol (beta blocker) otherwise hydralazine, nifedipine, or nitroglycerin

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13
Q

what is the site of action of loop diuretics

A

loop of henle

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14
Q

what is the site of action of osmotic diuretics

A

everywhere but mostly on the proximal convoluted tubule

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15
Q

what is the site of action of carbonic anhydrase
Inhibitors

A

proximal convoluted tubule

These inhibitors work by blocking the enzyme carbonic anhydrase, which is crucial for the reabsorption of bicarbonate. This action leads to increased excretion of bicarbonate, sodium, water, and potassium, and it reduces the reabsorption of these substances in the proximal convoluted tubule.

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16
Q

what is the site of action of K+ sparing diuretics

A

collecting duct/dct

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17
Q

what is the drug(s) of choice for increased SV due to edema or increased renin angiotensin activity

A

Diuretics, ACEI, or ARB

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18
Q

What is the MOA of Thiazide diuretics

A

inhibit Na/Cl cotransport causing increased excretion of Na, K, Cl, Mg and HCO3 and decreasing Ca and uric acid

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19
Q

what is the only thiazide diuretic that does not increase plasma cholestero and TGs

A

indapamide

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20
Q

what type of diuretic is chlorothiazide

A

thiazide diuretic

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21
Q

what type of diuretic is hydrochlorothiazide

A

thiazide

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22
Q

what type of diuretic is indapamide

A

thiazide

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23
Q

what type of diuretic is chlorthalidone

A

thiazide

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24
Q

what type of diuretic is metolazone

A

thiazide

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25
what is the MOA of loop diuretics
inhibit the Na+/K+ dichloride cotransport
26
what type of diuretic would not affect kidney stones
thiazide diuretics
27
what is the major adverse effect of loop diuretics
ototoxicity (when used in conjunction with aminoglycosides)
28
what type of diuretic is furosemide
loop diuretic
29
what type of diuretic is bumetanide
loop diuretic
30
what type of diuretic is torsemide
loop diuretic
31
what type of diuretic is ethacrynic acid
loop diuretic
32
what are the two osmotic diuretics
mannitol and glycerol
33
what is the MOA of osmotic diuretics
increase the osmotic pressure in the PT which leads to inhibition of reabsorption of water and electrolytes
34
what are the indications for mannitol and glycerol (osmotic diuretics)
cerebral edema, acute glaucoma, acute renal failure
35
what are the adverse effects of osmotic diuretics
excessive plasma volume expansion which can lead to heart failure
36
what are the two carbonic anhydrase inhibitors
acetazolamide and Dorzolamide
37
what is the MOA of carbonic anhydrase inhibitors
Increase excretion of Na+, K+ and HCO3
38
what are the indications for carbonic anhydrase inhibitors
high altitude sickness, glaucoma, and overdose of acidic drugs (to alkalinize the urine)
39
what are the adverse effects of CA inhibitors
drowsiness and paresthesia | acetazolamide
40
what is the MOA of spironolactone
K+ sparing diuretic, aldosterone antagonist
41
what is the MOA of Eplerenone
K+ sparing diuretic (less gynecomastia risk)
42
what is the MOA of amiloride
K+ sparing diuretic, black Na+ reabsorption
43
what is the MOA of triamterene
K+ sparing diuretic, block Na+ reabsorption
44
what are the clinical uses of K+ sparing diuretics (Spironolactone, eplerenone, amiloride, and triamterene)
spironolactone + ACEI increased survival in Heart failure and is also used to treat hirsutism due to antiandrogenic effect amiloride is used for nephrogenic Diabetes insipidus caused by lithium
45
what are the adverse effects of K+ sparing diuretics
hyperkalemia, nephrolithiasis, decreased libido and gynecomastia
46
what is the treatment for hyperkalemia
patiromer
47
what is the MOA of conivaptan
V1A and V2 receptor blocker
48
What is the MOA of Tolvaptan
Selective V2 receptor blocker
49
what are the clinical uses of conivaptan and Tolvaptan
Euvolemic and hypervolemic hyponatremia
50
what are the adverse effects of conivaptan and Tolvaptan
Infusion site reaction and hypokalemia
51
Which of the following diuretics causes hyperkalemia: Acetazolamide, Spironolactone, HCTZ, or Furosemide?
spironolactone (also ace inhibitors)
52
what is the suffix for ace inhibitors
"pril" (captopril, enalapril, etc.)
53
what is the MOA of ACE inhibitors
prevent conversion of Angiotensin I to angiotensin II, decrease the release of aldosterone and prevent conversion of bradykinin to its inactive compound (this has a god vasodilatory effect)
54
what is one of the side effects of ACE inhibitors as it relates to its effect on bradykinin
dry cough
55
why are ACEI the drug of choice for patients with HTN + Diabetes
because it slows down renal damage (remember that diabetic patients tend to develop nephropathy)
56
what are the clinical uses of ACEI
heart failure, LV systolic dysfunction (post MI), HTN + Diabetes, and stroke
57
what are the adverse effects of ACEI drugs
hyperkalemia, angioedema, proteinuria, and elevated BUN and creatinine
58
what are the contraindications of ACEI drugs
1. Pregnancy may cause Fetopathy Oligohydramnios, IUGR, Hypocalvaria and renal failure 2. Angioedema 3. Bilateral renal artery stenosis
59
what is the suffix for ARB (angiotensin II receptor blockers)
"Sartan" (losartan, valsartan, etc.)
60
what is the MOA of ARB drugs
they block angiotensin II receptors with NO effect on bradykinin metabolism (unlike ACEI)
61
what are the adverse effects of ARB drugs
hyperkalemia, angioedema
62
what are the contraindications for ARB drugs
pregnancy
63
what is the suffix for beta blockers
"OLOL"
64
what are the three non-selective BB drugs
propranolol, nadolol, and timolol
65
what are the four selective B1 blockers
metoprolol, atenolol, bisoprolol, and betaxolol
66
what type of drug is acebutolol
beta-adrenergic partial agonist
67
what type of drug is nebivolol
B-blocker and NO release
68
what is the MOA of carvedilol and labetalol
non-selective beta and alpha blockers
69
what are the clinical uses of beta blockers
CAD, tachyarrhythmias, migraine headaches, and anxiety
70
what are the adverse effects of beta blockers
Bradycardia Fatigue Sexual disfunction AV Block Abrupt withdrawal can cause rebound hypertension due To upregulation of # of receptors Mask signs of Hypoglycemia
71
what is the most common cause of hypoglycemia
insulin
72
do you need to be cautious when using beta blockers with patients with asthma
yes
73
what is the suffix for calcium channel blockers for vascular tissues (dihydropyridines)
"DIPINE" (amlodipine, nifedipine, felodipine, isradipine, nicardipine, and clevidipine
74
what are the heart (non-hydropyridine) CCB drugs
diltiazem and verapamil (they work directly on the heart)
75
what are the clinical uses of non-hydropyridines
arrhythmias with tachycardia
76
what is the MOA of dihydropyridines
block L-type Ca++ channels causing vasodilation and decrease peripheral resistance
77
what are the adverse effects of dihydropyridines
reflex tachycardia (due to vasodilating of peripheral vessels), ankle edema, and gingival hyperplasia
78
what is the MOA of non-dihydropyridines
decrease heart rate and conduction velocity
79
what are the adverse effects of non-dihydropyridines
AV conduction block and constipation
80
what is the MOA of Clonidine
activates presynaptic alpha 2 receptors (vasodilation)
81
what are the clinical uses of clonidine
mild to moderate HTN
82
what are the adverse effects of clonidine
edema, rebound HTN after withdrawal
83
what alpha 2 agonist is safe for pregnancy
alpha Methyl Dopa
84
What is the MOA of Guanethidine
binds to storage vesicles and inhibits release of NE
85
what neuronal blocking agent is contraindicated in people taking tricyclic antidepressants
guanethidine
86
what is the MOA of reserpine
binds to storage vesicles and destroys them causing depletion of NE, DA, and serotonin (NO LONGER USED due to severe side effects of suicidal thoughts)
87
what is the MOA prazosin, doxazosin and terazosin
Selective antagonists of peripheral alpha 1 receptors
88
what are the clinical uses of selective alpha 1 blockers
HTN, and BPH
89
what are the adverse effects of selective peripheral alpha 1 blockers
first dose syncope (orthostatic hypotension), incontinence in women, retrograde ejaculation
90
what type of necrosis do you see in malignant HTN
fibrinoid
91
what type of necrosis do you see in TB
caseous
92
what are the four direct acting vasodiator drugs
hydralazine, sodium nitroprusside, minoxidil, and fenoldopam
93
what is the MOA of hydralazine
prodrug of NO
94
what is the associated syndrome of hydralazine seen in slow acetylators
SLE like syndrome
95
what is the MOA of sodium nitroprusside
cGMP vasodialtion
96
what is the clinical use of sodium nitroprusside
given for IV HTN crisis (note that is can cause cyanide poisoning if administered too quickl/high dose so you have to start with sodium nitrite then Na thiosulfate of Vit B12
97
what is the common name for the direct acting vasodilator, Minoxidil
rogaine
98
what is the MOA of the direct vasodilator fenoldopam
stimulates D1 and alpha 2 receptor
99
what is the direct renin inhibior drug
aliskiren
100
what is the MOA of the renin inhibitor aliskiren
it blocks conversion of angiotensinogen to AGI
101
what are the adverse effects of aliskiren
hyperkalemia, angioedema also NOT SAFE IN PREGNANCY
102
why are ACEI or ARB the to drugs that are indicated for the combo of HTN and DM
bc ACEI and ARB protect pt. from getting nephropathy which is common in DM
103
what are the antiHTN drugs that can cause rebound HTN
BB and alpha-2 agonists
104
what antiHTN drugs cause hyperkalemia
ACEI, ARB, K+ sparing diuretics, and renin inhibitors
105
what antiHTN drugs are contraindicated in pregnancy
ACEI, ARB, and renin inhibitors
106
what AntiHTN drugs cause reflex tachycardia
CCB's (esp. dihydropyridines) and direct acting vasodilators

CVS II Pharmacology (9 decks)

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