Antihypertensive therapy Flashcards Preview

Cardiovascular - Pharmacology > Antihypertensive therapy > Flashcards

Flashcards in Antihypertensive therapy Deck (31)
Loading flashcards...
1
Q

What are the two broad categories of CCBs?

A

Dihydropyridnes and non-dihydropyridines.

2
Q

Where do DHPs act?

A

On vascular smooth muscle - peripheral

3
Q

Where do non-DHPs act?

A

On the heart

4
Q

What class of drugs are amlodipine, nifedipine, clevidipine, nicardipine, and nimodipine?

A

DHPs calcium channel blockers.

5
Q

What class of drugs are diltiazem and verapamil?

A

Non-DHPs calcium channel blockers.

6
Q

How do calcium channel blockers work?

A

Block voltage-dependent L-type calcium channels of the heart/smooth muscle. Decrease contractility.

7
Q

What kinds of things can DHPs be used for?

A

HTN, angina (inc Prinzmetal), Raynauds. Not nimodipine

8
Q

What is nimodipine especially used for?

A

Subarachnoid hemorrhage; prevents cerebral vasospasm.

9
Q

What is clevedipine especially used for?

A

hypertensive urgency or emergency

10
Q

What are non-DHPs used for?

A

hypertension, angina, a-fib/flutter

11
Q

What are the toxicities associated with non-DHPs?

A

Cardiac depression, AV block

12
Q

What are the toxicities associated with DHPs?

A

peripheral edema, flushing, dizziness, constipation, gingival hyperplasia

13
Q

What weird toxicity is associated with verapamil?

A

hyperprolactinemia

14
Q

What is the mechanism of hydralazine?

A

Increase cGMP, leads to smooth muscle relaxation.

15
Q

Does hydralizine work preferentially on arterioles or veins?

A

Arterioles –> vasodilation –> decr afterload.

16
Q

What is the clinical use of hydralizine?

A

Severe hypertension (particularly acute). HF (with organic nitrate). Safe to use during pregnancy.

17
Q

What is hydralizine frequently administered with and why?

A

With a beta blocker to prevent reflex tachycardia.

18
Q

What are clevidipine, fenoldopam, labetalol, nicardipine, and nitroprusside all used for?

A

Hypertensive emergency.

19
Q

How does nitroprusside work?

A

Short acting. Increases cGMP via direct release of NO.

20
Q

What is an important side effect of nitroprusside?

A

Cyanide poisoning - releases cyanide.

21
Q

How does fenoldopam work?

A

Dopamine D1 receptor agonist - causes peripheral, renal, and splanchnic vasodilation. Decreases BP, Increases natriuresis.

22
Q

How do nitrates work?

A

Increase NO in vascular smooth muscle, increases cGMP and smooth muscle relaxation. D

23
Q

Do nitrates work on veins or arteries preferentially?

A

Veins. Decrease preload.

24
Q

What is the clinical use for nitrates?

A

Angina, acute coronary syndrome, pulmonary edema.

25
Q

What are toxicities of nitrates?

A

Reflex tachy (give BBlockers), hypotension, flushing, headache

26
Q

What is the “monday disease” effect of nitrates?

A

Monday disease in industrial exposure: Development of tolerance for vasodilating action during the work week and loss of tolerance over the weekend –> tachycardia, dizziness, headache upon reexposure.

27
Q

What are the main treatments for primary (essential) hypertension?

A

Thiazide diuretics, ACEis, ARBs, DHP CCBs

28
Q

What are the main treatments for hypertension with heart failure?

A

Diuretics, ACEis/ARBs, B-blockers (compensated HF), and aldosterone antagonists

29
Q

What are the main treatments for hypertension with diabetes?

A

ACEis/ARBs, CCBs, thiazide diuretics, B-blockers

30
Q

Which hypertensive medication is protective against diabetic nephropathy?

A

ACEis/ARBs

31
Q

Which are main treatments for hypertension in pregnancy?

A

Hydralizine, labetalol, methyldopa, nifedipine