Blood Pressure Lowering Drugs Flashcards
(39 cards)
RAAS antagonist
class: ACE inhibitors
MOA
- Inhibition of ACE reduces the synthesis of angiotensin II and prevents bradykinin breakdown.
- The bradykinin»>angiotensin II leads to vasodilation
RAAS antagonist
class: ACE inhibitors
Adverse Effects
- Dry cough (due to bradykinin), hyperkalemia, ARF, angioedema
- Contraindicated in pregnancy and in pts w/ bilateral renal artery stenosis
RAAS antagonist
class: Angiotensin-II receptor blockers (ARBs)
MOA
- ARBs block type 1 angiotensin II receptors on blood vessels and other tissues, like heart
- leads to preventing angiotensin induced vasoconstriction
RAAS antagonist
class: Angiotensin-II receptor blockers (ARBs)
Adverse Effects
-hyperkalemia, ARF
no increase in bradykinin, so no dry cough or angioedema
-Contraindicated in pregnancy and in pts w/ bilateral renal artery stenosis
RAAS antagonist
class: Neprilysin Inhibitor plus angiotensin-II receptor blocker
MOA
- Neprilysin is a enzyme that degrades bradykinin and other peptides, inhibition of this enzyme increases bradykinin leading to vasodilation
- Used only in combo w/ ARBs
RAAS antagonist
class: Neprilysin Inhibitor plus angiotensin-II receptor blocker
Adverse Effects
- Hyperkalemia, angioedema, renal function deterioration, hypotension
- Overlap or use w/in 36hrs of ACE inhibitors can increase risk of angioedema=contraindicated
- Contraindicated in pregnancy and in pts w/ bilateral renal artery stenosis
RAAS antagonist
class: Aldosterone Antagonists
MOA
Block the aldosterone receptor in the renal collecting tubule, increasing the Na+ and water excretion while conserving the K+ and H+
RAAS antagonist
class: Aldosterone Antagonists
Adverse Effects
- Hyperkalemia, renal function deterioration, gynecomastia
- Risk of hyperkalemia is increased w/ declining renal function and w/ the concurrent use of ARBs or ACE
RAAS antagonist
class: Direct Renin Inhibitor
MOA
Produce vasodilation by inhibiting the activity of renin, which is responsible for stimulating angiotensin II formation
RAAS antagonist
class: Direct Renin Inhibitor
Adverse Effects
Diarrhea, hyperkalemia, angioedema
Contraindicated in pregnancy
Sympatholytics
class: Alpha-1 blockers
MOA
Drugs block the binding of Epi and NE to alpha-1 adrenoreceptors in the vascular smooth muscle causing vasodilation
Sympatholytics
class: Alpha-1 blockers
Adverse Effects
headache and dizziness orthostatic hypotension nasal congestion reflex tachycardia fluid retention
Sympatholytics
class: Beta-1 selective blocker
MOA
Bind and block Epi and NE on beta-1 predominately in the heart and kidney
Causes decrease in HR, CO, BP, and renin release
Sympatholytics
class: Nonselective beta blocker
MOA
Block beta 1 and 2 equally
Beta-1: decrease in HR,CO, BP, and renin release
Beta-2: bronchospasm and vasoconstriction
Sympatholytics
class: Vasodilating beta blockers
MOA
Have additional vasodilating properties via the alpha-1 blockade on top of the beta inhibition
Sympatholytics
class: Beta Blockers
Adverse Effects
Exaggeration of decrease in HR, CO, BP Smooth muscle spasm CNS penetration-insomnia, depression Shitty quality of life Adverse metabolic effects Withdrawal phenomenon
Sympatholytics
class: Central alpha-2 agonists
MOA
Suppress NE release by binding to and activating alpha 2 adrenoreceptors causing:
- reduced sympathetic outflow of the heart=decrease CO,HR, and contractility
- reduced sympathetic output of vasculature=vasodilation, reduced SVR, decreased art pressure
Sympatholytics
class: Central alpha-2 agonists
Adverse Effects
- sedation, dry mouth, nasal mucosa, bradycardia, orthostatic hypotension, and impotence
- contipation, nausea, GI upset
- sudden stop can lead to rebound HTN from the excessive sympathetic activity
Vasodilators
class: Non-Dihyropyridine CCB
MOA
Bind and block L-type Ca+ channels located on the vascular smooth muscle, cardiac myocytes, and cardiac nodal tissue( SA and AV nodes)
Vasodilators
class: Non-Dihyropyridine CCB
Effects
- vascular smooth muscle relaxation=vasodilation
- decreased myocardial force generation=neg inotropy
- decreased HR, particularly at the AV node
Vasodilators
class: Non-Dihyropyridine CCB
Adverse Effects
- flushing, headache, peripheral edema, excessive hypotension and bradycardia, impaired electrical conduction( AV node block), depressed contractility
- Contraindicated: current bradycardia, heart conduction defects, and heart failure by systolic dysfunction
Vasodilators
class: Dihydropyridine CCB
MOA
- prevent the flow of Ca+ through L-type Ca+ channels specifically on the vascular smooth muscle
- results in vasodilation, reduced SVR and BP
Vasodilators
class: Dihydropyridine CCB
Adverse Effects
Peripheral edema, flushing, headache, excessive hypotension, reflex tachycardia
Direct Vasodilators
MOA
- Directly relaxing the arteriolar smooth muscle
- little effect on veins=decreasing SVR
- lowers after load= great for HF
