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Flashcards in Antihypertensives II Deck (30):
1

drug of choice for pregnancy induced hypertension

methyldopa

2

adverse effects of alpha 2 agonists

rebound hypertension with abrupt cessation
sodium and water retention
hemolytic anemia
hepatitis
orthostatic hypotension

5 H's

3

drugs for pulmonary hypertension (increase in BP in pulmonary artery, vein, or capillaries)

bosentan and epoprostenol

4

how does bosentan work

antagonist at the endothelial receptors of vascular endothelium and SM

usually activation of these receptor is associated with vasoconstriction

5

bosentan is an inducer and metabolized by

CYP 2C9 and CYP 3A4

6

adverse effects of bosentan

HERS

Headache, Edema, Respiratory tract infection Spermatogenesis inhibition

7

contraindication of bosentan

pregnancy - it is a FDA category X drug so it is teratogenic

8

mechanism of epoprostenol

synthetic form of prostacyclin so it is a vasodilator

given IV

9

adverse effects of epoprostenol

CV: tachycardia, flushing, hypotension
CNS: headache, anxiety
GI: nausea and vomiting
neuromuscular and skeletal: arthralgia, jaw pain

10

contraindication for epoprostenol

hypersensitivity
chronic use in pts with heart failure
pts who develop edema after first dose

11

drugs used to treat hypertensive emergencies

parenteral vasodilator: sodium nitroprusside, nitroglycerine, hydralazine
beta blockers: labetolol and esmolol
dopamine receptor agonist: fenoldopam
calcium channel blockers: nicardipine
alpha blockers: phentolamine
potassium channel openers: diazoxide

12

drug of choice for hypertensive emergencies

sodium nitroprusside because it reduces BP in less than two mins

13

uses of nitroprusside

management of hypertensive emergencies, heart failure, controlled hypotension (to reduce bleeding during surgery)

14

what is the mechanism of nitroprusside

activation of guanylyl cyclase from release of NO or direct stimulation by enzyme --> increase in cGMP --> dilation of arterial and venous vessels --> relaxation of smooth muscle

15

adverse effects of nitroprusside

hypotension (toxicity)
reflex tachycardia
cyanide toxicity (if liver or kidney problem and can't get rid of metabolite of nitroprusside)
goose bumps, abdominal cramping, nausea, vomiting, headache, muscle twitching, sweating

16

clinical application of nitroglycerine

same as sodium nitroprusside
management of hypertensive crisis
heart failure
controlled hypotension

17

mechanism of action for nitroglycerine

NO activates guanylyl cyclase --> increased cGMP --> smooth muscle relaxation

18

adverse effects of nitroglycerine

hypotension (toxicity)
methemoglobinemia
headache, allergic reactions, flushing

19

in what type of hypertensive crisis is esmolol usually used for

aortic dissection and postoperative hypertension

20

adverse effects of esmolol

hypotension
nausea, thrombophlebitis, and painful extravasation

21

type of hypertensive crisis is fenoldopam used for

patients with renal failure

22

contraindication to fenoldopam

glaucoma

23

mechanism of antihypertensive emergency drug, nicardipine

calcium channel blocker

24

hypertensive emergency that requires phentolamine

pheochromocytoma, cocaine and amphetamine toxicity, clonidine withdrawal, MAO inhibitor drugs

25

clinical use of diazoxide

management of hypertensive emergency
treatment of hyperglycemia secondary to insulinoma

26

mechanism of diazoxide

open K+ channels and stabilizes membrane potential at resting levels prevent vascular SM contraction

27

adverse effects of diazoxide

hypotension
reflex tachycardia
sodium and water retention
inhibition of insulin release

28

what is a renin inhibitor that is used to treat hypertension

aliskiren

29

adverse effects of aliskiren

hypotension, hyperkalemia, angioedema, acute renal failure (due to lack of vasoconstrictive effect of angiotensin II)

30

contraindications for aliskiren

pregnancy
bilateral renal artery stenosis
hyperkalemia

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