antihypertensives Flashcards
(22 cards)
hypertension medications
beta blockers: to stop tachycardia from compensatory increased sympathetic outflow
diuretics, ACE inhibitors: block salt and water retention from compensatory increased renin secretion
diuretics
hydrochlorothiazide
chlorthalidone
furosemide
hydrochlorothiazide
chlorthalidone
block Na/Cl transport in distal convoluted tubule
-treatment: HTN, mild edema
oral
dur. 8-12 hours
side effects: hypokalemia, hyperglycemia, hyperuricemia, hyperlipidemia
furosemide
block Na/K/2CL transporter in thick ascending limb
- treat: HTN, heart failure, edema, hypercalcemia
- oral
dur. 2-3 hours - hypokalemia, hypovolemia, ototoxicity
sympathoplegics: centrally acting: Clonidine
-Agonist at α2 receptors, in CNS this results in decreased SANS outflow
-treats HTN
-oral
dur 2-3 days
-SE: Sedation, danger of severe rebound hypertension if suddenly stopped
sympathoplegics: centrally acting: methyldopa
-Prodrug converted to methylnorepinephrine in CNS, with result like clonidine
-SE: Sedation, induces hemolytic antibodies
treats HTN
oral, dur. 12-24 hours
postganglionic neuron blockers: reserpine
-Blocks vesicular pump (VMAT) in adrenergic neurons
-HTN, huntington’s
oral
dur 5 days
SE: sedation, depression
Alpha blockers
Prazosin -Selective α1 blocker: • reduces peripheral vascular resistance • prostatic smooth muscle tone Treat: Mild hypertension, benign prostatic hyperplasia oral dur 6-8 hrs first dose: ortho
beta blockers
propranolol -Prototype nonselective β blocker: • reduces cardiac output • possible secondary reduction in renin release treat HTN oral dur 6-8 SE: Bronchospasm in asthmatics • excessive cardiac depression, sexual dysfunction, sedation, sleep disturbances
Vasodilators: calcium channel blockers
Verapamil, diltiazem
-Prototype L-type calcium channel blockers
• combine moderate vascular effect with strong cardiac effect
-Treat: Hypertension, angina, arrhythmias
oral
dur 6-8 hours
SE: Excessive cardiac depression • constipation
better vasodilators than cardiodepressants
Nifedipine, other dihydropyridines
older oral vasodilators
Hydralazine
Minoxidil
Hydralazine
-Probably causes release of nitric acid (NO) by endothelial cells
• causes arteriolar dilation
-treat: HTN
Oral
dur 6-8 hours
SE: Tachycardia, salt and water retention, lupus-like syndrome
Minoxidil
-Prodrug, sulfate metabolite opens K+ channels, causes arteriolar smooth muscle hyperpolarization and vasodilation
-treat: severe HTN, male pattern baldness
-oral, dur 6-8hrs
SE: Marked tachycardia, salt and water retention
• hirsutism
IV vasodilators
Nitroprusside
Diazoxide
Fenoldopam
Nitroprusside
-Releases NO from drug molecule
-treats: Hypertensive emergencies • cardiac decompensation
-IV
-requires constant infusion, minutes
-SE: Excessive hypotension
• prolonged infusion may cause thiocyanate and cyanide toxicity
Diazoxide
-K+ channel opener in smooth muscle, secretory cells
-treat: Hypertensive emergencies
• hypoglycemia due to insulin-secreting tumors
-SE: Hyperglycemia
• edema, excessive hypotension
Fenoldopam
-D1 agonist • causes arteriolar dilation -treat: Hypertensive emergencies ver short duration SE: excessive hypotension
renin antagonist:
Aliskiren renin inhibitor -reduces angio I synthesis treats HTN oral dur 12 hrs SE: angioedema, renal impairment
ACE inhibitors
Captopril -ACE inhibitor • reduces angiotensin II synthesis -treats: HTN, diabetic renal disease, heart failure oral h-l: 2.2 but dur. of 12 hrs SE: Hyperkalemia • teratogen • cough
other ACE inhibitors
Benazepril, enalapril, lisinopril,
ARB
Losartan -Blocks AT1 receptor -treats HTN oral dur. 6-8 hr hyperkalemia -teratogen
