Antihypertensives Flashcards
(104 cards)
1
Q
Stage 1/First line Anti-HTN
A
Ca channel blockers
Thiazides
ACEIs
ARBs
2
Q
ACE inhibitors
A
Captopril
Enalapril
Lisinopril
3
Q
ARBs
A
Lorsatan
Valsartan
4
Q
Renin inhibitor
A
Aliskiren
5
Q
Ca channel blockers
A
Verapamil
Diltiazem
Nifedipine
Amlodipine
6
Q
Thiazides
A
Chlorthalidone
Hydrochlorothiazide
Metolazone
7
Q
Loop Diuretics
A
Ethacrynic Acid
Furosemide
Torsemide
8
Q
K sparing diuretics
A
Amiloride
Triamterene
Spironolactone
Eplerenone
9
Q
What are the 2nd line Anti-HTNs
A
Beta blockers
Aldosterone antagonists
10
Q
Beta blockers
A
Atenolol
Metoprolol
Propranolol
Pindolol
11
Q
Alpha blockers
A
Doxazosin
Prazosin
Terazosin
12
Q
Mixed alpha/beta blockers
A
Labetalol
13
Q
Central alpha 2 agonists
A
Clonidine
Methyldopa
14
Q
What are the 3rd line Anti-HTNs
A
Direct Vasodilators
15
Q
Direct vasodilators
A
Hydralazine
Minoxidil
16
Q
Non-selective endothelin receptor blocker
A
Bosentan
17
Q
Synthetic PGI2
A
Epoprostenol
18
Q
What do ACEIs do
A
Decrease PVR, BP
Decrease diabetic nephropathy
Decrease albuminuria
19
Q
DOC pts post MI
A
ACEI/ARB (but beta blocker first)
20
Q
Elevated creatinine in pts with bilateral renal stenosis
A
ACEI
21
Q
Major AE is Hyperkalemia
A
ACEI
22
Q
No effect on bradykinin
A
ARBs
23
Q
Least selective Ca channel blocker
A
Verapamil
24
Q
Can cause reflex tachycardia
A
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)
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