Antihypertensives Flashcards Preview

Pharm Midterm 1 > Antihypertensives > Flashcards

Flashcards in Antihypertensives Deck (104):
1

Stage 1/First line Anti-HTN

Ca channel blockers
Thiazides
ACEIs
ARBs

2

ACE inhibitors

Captopril
Enalapril
Lisinopril

3

ARBs

Lorsatan
Valsartan

4

Renin inhibitor

Aliskiren

5

Ca channel blockers

Verapamil
Diltiazem
Nifedipine
Amlodipine

6

Thiazides

Chlorthalidone
Hydrochlorothiazide
Metolazone

7

Loop Diuretics

Ethacrynic Acid
Furosemide
Torsemide

8

K sparing diuretics

Amiloride
Triamterene
Spironolactone
Eplerenone

9

What are the 2nd line Anti-HTNs

Beta blockers
Aldosterone antagonists

10

Beta blockers

Atenolol
Metoprolol
Propranolol
Pindolol

11

Alpha blockers

Doxazosin
Prazosin
Terazosin

12

Mixed alpha/beta blockers

Labetalol

13

Central alpha 2 agonists

Clonidine
Methyldopa

14

What are the 3rd line Anti-HTNs

Direct Vasodilators

15

Direct vasodilators

Hydralazine
Minoxidil

16

Non-selective endothelin receptor blocker

Bosentan

17

Synthetic PGI2

Epoprostenol

18

What do ACEIs do

Decrease PVR, BP
Decrease diabetic nephropathy
Decrease albuminuria

19

DOC pts post MI

ACEI/ARB (but beta blocker first)

20

Elevated creatinine in pts with bilateral renal stenosis

ACEI

21

Major AE is Hyperkalemia

ACEI

22

No effect on bradykinin

ARBs

23

Least selective Ca channel blocker

Verapamil

24

Can cause reflex tachycardia

Ca channel blockers
Alpha blockers (short term)
Direct vasodilators

25

Contraindicated in CHF due to negative inotropic effects

Verapamil

26

Great for HTN but not arrhythmias

Dihydropyridines

27

What are the Dihydropyridines

Nifedipine
Amlodipine

28

What are the Nondihydropyridines

Verapamil
Diltiazem

29

Major AE is Hypokalemia

Thiazides

30

1st line in pts with HTN and severe LV dysfunction

Spironolactone
Eplerenone

31

Pregnancy beta blocker

Pindolol

32

Decrease NE and renin via beta 1

Beta blockers

33

DOC only for CAD or LV dysfunction and HTN

Beta blockers

34

Minimal change in CO RBF, GFR

Alpha blockers

35

Tx in HTN with BPH

Alpha blockers

36

Alpha or Beta blockers safe in pregnancy

Labetalol
Pindolol

37

Does not affect CO

Methyldopa

38

DOC in pregnancy induced HTN

Methyldopa

39

Contraindications for methyldopa

Hemolytic anemia
Hepatitis
Can cause +ve coombs test

40

DOC eclampsia emergency in pregnancy

Hydralazine

41

Coadminister with diuretic and beta blocker

Minoxidil

42

Pregnancy category X

Bosetan

43

Lowers pulmonary, peripheral and coronary resistance

Epoprostenol

44

Requires continuous IV infusion

Epoprostenol
Bosentan

45

Can cause Lupus-like syndrome (NAT)

Direct vasodilators

46

How do ACEIs lower BP

Decrease Na and H2O retention
Increase renin

47

When do you give ACEIs

Young whites
CHF

48

What do you have to add to ACEIs for blacks and old

Diuretic

49

Can cause angioedema

ACEIs
ARBs (much lower risk)

50

Contraindications for ACEIs

Pregnancy

51

What do ARBs block

ATII receptor

52

Do ARBs have nephrotoxicity

Low

53

When do you give ARBs

Young whites
CHF
Post-MI

54

Contraindications for ARBs

Pregnancy
Bilateral renal artery stenosis

55

How does Aliskiren act

Inhibits ATII and aldosterone

56

What Ca channel blocker has cardiac and vascular SM effects

Verapamil

57

Why use Diltiazem over Verapamil

More selective
Better side effect profile

58

How do Ca channel blockers work

Bind L-type (heart and muscle)
Relax muscle
-ve inotropism and/or vasodilation

59

How are Dihydropyridines different from Nondyhydropyridines

Greater affinity for vasculature
Don't cause decrease in CO

60

Works with blacks and whites

Ca channel blockers

61

Why don't you need to add a diuretic with a Ca channel blocker

Intrinsic natriuretic effect

62

Which Ca channel blockers do you give to angina, migraine or SVT

Nondihydropyridines

63

What is the difference between 1st and 2nd gen dihydropyridines

Longer half life

64

AE of Verapamil

Constipation

65

AE of Dihydropyridines

Hypotension
Peripheral edema
Bradychardia
Heart block

66

DOC Black and old with normal kidney, heart

Thiazides

67

Effect of Thiazides

Increase Na and water excretion
Decrease ECF, CO, RBF

68

What can be used to counteract Na and water retention by other Anti-HTN drugs

Thiazides

69

Contraindication of Thiazides

Diabetes

70

DOC poor renal fn or unresponsive to other diuretics

Loop

71

Loop diuretic effect on HTN

Decrease Renal vascular resistance
Increase RBF

72

What decreases K lost due to thiazide/loop

Amiloride
Triamterene

73

Aldosterone antagonists to inhibit vasoconstriction

Spironolactone
Eplerenone

74

Risk of hyperkalemia

K sparing diuretics

75

Most widely used beta blockers

Beta 1

76

Beta 1 selective

Atenolol
Metoprolol

77

Nonselective beta 1 and 2

Propranolol
Pindolol

78

Mechanism of beta blockers

Decrease CO, contractility, HR, sympathetics, NE, renin, ATII, aldosterone

79

Who are beta blockers more effective in

Young white

80

Contraindication of Propranolol

Asthma
COPD

81

What Sx do beta blockers mask

Hypoglycemia

82

What can abrupt beta blocker withdrawal cause

Angina/MI in heart disease pts

83

What should you give with an alpha blocker for HTN

Propranolol
Diuretic

84

What is the action of alpha blockers

Decrease PVR and MAP
Relax arterial and venous SM

85

What causes orthostatic hypotention

Doxazosin
Prazosin
Terazosin
Labetalol

86

Ameliorate AE of alpha blockers

Give beta blocker

87

Increases rate of CHF

Doxazosin

88

Does not cause reflex tachy or increased CO

Labetalol

89

When to use Labetalol

Long term tx
Emergency (IV)

90

Contraindication for Labetalol

Pheochromocytoma

91

Doesn't decrease RBF or GFR

Central alpha 2 agonists

92

Effect of Clonidine

Decrease PVR and CO

93

When do you give Clonidine

2nd line when no response with 2+ drugs

94

What do you administer alpha 2 agonists with

Diuretic

95

Common AE for alpha 2 agonists

Sedation
Xerostomia
Dizziness
HA
Sexual dysfunction

96

What can happen with abrupt withdrawal of alpha 2 agonists

Rebound HTN

97

What is never 1st line

Direct vasodilators

98

How do direct vasodilators act

Open K channels
Arteriolar dilation (ONLY)

99

When do you give Minoxidil

Severe malignant HTN
Male pattern baldness

100

What do you give with a direct vasodilator

Loop
Beta blocker

101

What is used for pulmonary HTN

Bosentan
Epoprostenol

102

Pt with ischemic stroke

ACEI
ARB
Thiazide

103

Pt with acute or chronic CAD

Beta blocker
ACEI
ARB

104

Pt with LV dysfunction

Beta blocker
Thiazide/Loop
ACEI
ARB
Hydralazine and Isosorbide dinitrate (if black)