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Flashcards in Antihypertensives Deck (23)
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1
Q

What are 4 criteria for antihypertensive drug selection?

A

1-Underlying medical condition
2-Race (avoid ACE-I in black)
3-Severity
4-Combinations

2
Q

Which type of antihypertensive depletes sodium to reduce blood volume?

A

Diuretics

3
Q

Which type of antihypertensive reduces peripheral vascular resistance?

A

Sympathoplegics

4
Q

Which type of antihypertensive relaxes vascular smooth muscles thus dilating resistance vessels and increasing capacitance?

A

Direct vasodilators

5
Q

Which type of antihypertensive inhibit action/production of angiotensin and thus reduce peripheral vascular resistance?

A

Anti-angiotensin agents

6
Q

What are the 5 categories of diuretics?

A

1-Acetazolamide/canagliflozin (Proximal tubule)
2-Osmotic agents (Descending thin)
3-Loop agents (Thick ascending loop)
4-Thiazides (Distal convoluted tubule)
5-Aldosterone antagonists (Collecting tubule)

7
Q

Which drug is not reabsorbed and results in water retention, is not used for hypertension but for increased intracranial pressure after head trauma?

A

Mannitol

*Osmotic

8
Q

Which drug was discovered because it was related to bacteriostatic sulfonamides and is a carbonic anhydrase inhibitor?

A

Acetazolamide

*Not used for hypertension but as a diuretic. Results in more NA in the lumen

9
Q

Which 2 diuretics are very efficacious by inhibiting luminal Na/K/CL transporter in the thick ascending limb of loop of henle and cause caused Hypokalemia?

A

Loop diuretics:
1-Furosemide
2-Bumetanide

*inhibited by NSAIDs under certain conditions

10
Q

Which diuretics inhibit NaCl reabsorption from the luminal side of epithelial cells in the distal convoluted tubule by blocking Na/Cl transporter?

A

Thiazides:
1-Hydrochlorothiazide
2-Chlorthalindone

*also causes hypokalemia and is inhibited by NSAIDs under certain conditions

11
Q

Which diuretics prevent K secretion by antagonizing effects of aldosterone in collecting tubules or Na influx through ion channels?

A

Potassium sparing diuretics:
1-K blocker=Spironolactone (aldactone)
2-Na influx=amiloride

*often used in combination to offset hypokalemia

12
Q

Which drugs inhibit the converting enzyme peptide dipeptidase that hydrolyzes angiotensin I to II and can cause a dry cough?

A

ACE inhibitors (captopril)

*increases bradykinin to vasodilate

13
Q

Which drugs decrease peripheral vascular resistance without causing a dry cough because they do not act on bradykinin metabolism?

A

Angiotensin II inhibitors

Losartan (Cozaar)

*Side effects same as ACE-I *hyperkalemia)

14
Q

What are 3 groups of direct vasodilators that are primarily used for resistant cases?

A

1-Hydralazine (release of NO)
2-Verapamil, Diltiazem, Nifedipine (Reduce Ca influx)
3-Minoxidil (hyperpolarize smooth muscle by opening K channel)

15
Q

Which drug acts on central a2 receptors in the medulla and reduces sympathetic tone to decrease blood pressure?

A

Clonidine

*Dry mouth and sedation side effects

16
Q

Which drugs are competitively blocking nicotinic cholinoceptors on postganglionic neurons in both simp and parasymp ganglia?

A

Ganglionic blocking agents

*Mecamylamine (rarely used)

17
Q

Which drugs inhibit release of norepinephrine from sympathetic nerve endings?

A

Adrenergic blocking agents- Guanethidine (ismelin)

*orthostatic hypotension

18
Q

Which two beta blockers are cardioselective (B1 in heart)?

A

1-Atenolol (tenormin)

2-Metoprolol (metoprolol)

19
Q

Which beta blockers are non-cardioselective (B1 and B2?

A

1-Propranolol (inderal)

2-Nadolol (corgard)

20
Q

Which beta blockers are beta and alpha 1 blockers?

A

1-Labetalol (trandate)

2-Carvedilol (coreg)

21
Q

Which alpha-blockers are cardioselective?

A

1-Prazosin (minipress)

2-Terazosin (hytrin)

22
Q

Which alpha blockers are non-cardioselective (a1 and a2)?

A

1-Phetolamine (regitine)

2-Phenoxybenzamine (dibenzyline)

23
Q

Which drugs cause vasodilation and thus decrease TPR and BP and are used for hypertension as well as benign prostatic hypertrophy?

A

a1 antagonists (prazosin, terazosin)

*Orthostatic hypotension and nasal congestion