Cardiovascular 2 Anti-hypertensives Flashcards Preview

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Flashcards in Cardiovascular 2 Anti-hypertensives Deck (135):
1

Drug class for Propranolol

sympatholytics: peripheral adrenergic 'r' blockers-beta blockers

2

MoA for Propranolol

adrenergic B1 & B2 receptor inhibitor: reduction in myocardial oxygen demand

3

Indications for Propranolol

angina, HTN, tachyarrhythmias, essential tremor, migraine Px, anxiety

4

SE/ADRs for Propranolol

fatigue, sleep disturbance, depression

5

Contra-indications for Propranolol

hypersensitivity, bradycardia, heart block, uncompensated HF, severe depression, bronchospasm

6

Dx-Dx interactions for Propranolol

ethanol (may increase or decrease conc)

7

Monitoring for Propranolol

BP, chest pain, HR, LFTs

8

What might Propranolol mask?

hypoglycemia

9

Drug class for Metoprolol

sympatholytics: peripheral adrenergic 'r' blocker-beta blocker

10

MoA for Metoprolol

selective B1 adrenergic receptor inhibitor

11

Indications for Metoprolol

angina, HTN, hemodynamically stable post MI

12

SE/ADRs for Metoprolol

fatigue, sleep disturbance, depression, bradycardia, rebound angina/HTN, hypotension

13

Contra-indications for Metoprolol

hypersensitivity, bradycardia, heart block, uncompensated heart failure, severe depression

14

Dx-Dx interactions for Metoprolol

multiple

15

Monitoring for Metoprolol

BP, HR, LFTs

16

Drug class for Atenolol

sympatholytics: peripheral adrenergic 'r' blockers-beta blockers

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MoA for Atenolol

selective B1 adrenergic receptor inhibitor

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Indications for Atenolol

angina, HTN, hemodynamically stable post MI

19

SE/ADRs for Atenolol

fatigue, sleep disturbance, depression, bradycardia, rebound angina, HTN, hypotension

20

Contra-indications for Atenolol

hypersensitivity bradycardia, heart block, uncompensated heart failure, severe depression

21

Dx-Dx interactions for Atenolol

multiple

22

Monitoring for Atenolol

BP, HR, eGFR

23

Drug class for Prazosin

alpha-blocker

24

MoA for Prazosin

selective alpha1 blocker which relaxes smooth muscle in arteries, veins, & prostate

25

Indications for Prazosin

HTN, off-label: PTSD, Raynaud's phenomenon

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SE/ADRs for Prazosin

postural hypotension, nausea, drowsiness, syncope, palpitations, dizziness, 'floppy iris' syndrome

27

Contra-indications for Prazosin

orthostatic hypotension

28

Dx-Dx interactions for Prazosin

PDE-5 blockers (Tadalafil), anti-hypertensive meds

29

Monitoring for Prazosin

BP, BUN, eGFR, syncopal episodes

30

PG category for Prazosin

C but avoid

31

Drug class for Carvedilol

B1, B2, A1 blockers

32

MoA for Carvedilol

mixed alpha, beta receptor inhibitor

33

Indications for Carvedilol

angina (off label), HTN, stable HF, stable post MI

34

SE/ADRs for Carvedilol

fatigue, sleep disturbance, depression, bradycardia, rebound angina/HTN, hypotension

35

Contra-indications for Carvedilol

hypersensitivity, bradycardia, heart block, uncompensated HF, severe depression, bronchospasm, severe liver failure

36

Dx-Dx interactions for Carvedilol

multiple

37

Monitoring for Carvedilol

BP, HR, eGFR, LFTs

38

Drug class for Clonidine

centrally acting A2 agonist

39

MoA for Clonidine

stimulates A2 receptors in brain stem which stimulates inhibitory neuron resulting in reduced sympathetic outflow from CNS which results in reduction in TPR

40

Indications for Clonidine

HTN (immediate release form), ADHD (extended release form), Narcotic addiction

41

SE/ADRs for Clonidine

bradycardia, drowsiness, HA, rash, xerostomia, weakness

42

Contra-indications for Clonidine

pre-existing CNS depression, severe CAD, caution in CKD, recent AMI, stroke

43

Dx-Dx interactions for Clonidine

meds altering AV/SA nodal function, ethanol

44

Monitoring for Clonidine

BP, mental status, HR

45

PG category for Clonidine

C but avoid

46

Drug class for Methyldopa

centrally acting A2 agonist

47

MoA for Methyldopa

central alpha-adrenergic inhibition decrease sympathetic outflow to heart, kidneys, peripheral vasculature

48

Indications for Methyldopa

HTN in PG

49

SE/ADRs for Methyldopa

depression, anxiety, dry mouth, hemolytic anemia, liver disease, edema

50

Contra-indications for Methyldopa

hepatic disease

51

Dx-Dx interactions for Methyldopa

MAO inhibitors

52

Monitoring for Methyldopa

LFT, CrCl, BP, eGFR

53

Drug class for Captopril, Lisinopril, Fosinopril

renin-angiotensin inhibitors: ACEI

54

MoA for Captopril, Lisinopril, Fosinopril

competitive inhibitor of ACE preventing conversion of A1 to A2, decreasing vasoconstriction by A2 & decreases aldosterone secretion

55

Indications for Captopril, Lisinopril, Fosinopril

HTN, HF, LV dysfunction after MI, diabetic nephropathy

56

SE/ADRs for Captopril, Lisinopril, Fosinopril

cough, hyperkalemia, angioedema

57

Contra-indications for Captopril, Lisinopril, Fosinopril

hx angioedema, concurrent use of Aliskerin in diabetic patients, bilateral renal artery stenosis, PG; not w/ ARBs

58

Dx-Dx interactions for Captopril, Lisinopril, Fosinopril

don't use w/ ARBs, Aliskerin

59

Monitoring for Captopril, Lisinopril, Fosinopril

BP, serum, K+, eGFR, BUN, weight, CBC, liver function

60

PG category for Captopril, Lisinopril, Fosinopril

D

61

Drug class for Losartan

angiotensin receptor blockers: ARBs

62

MoA for Losartan

selectively & competitively blocks AT1 & AT2

63

Indications for Losartan

HTN, diabetic nephropathy in T2DM, stroke risk reduction in HTN, LVH

64

SE/ADRs for Losartan

esp in people w/ T2DM: chest pain, fatigue, hypoglycemia, diarrhea, UTI; hyperkalemia

65

Contra-indications for Losartan

not w/ Aliskerin or ACE inhibitors

66

Dx-Dx for Losartan

multiple (see contra-indications)

67

Monitoring for Losartan

BP, K+, eGFR, BUN, CBC, HR, wt

68

PG category for Losartan

do not use

69

What does Losartan increase the excretion of?

uric acid

70

Drug class for Aliskirin

direct renin inhibitor

71

MoA for Aliskirin

direct rening inhibitor that prevents conversion of angiotensinogen to AT1 which reduces conversion to AT2 producing arteriolar vasodilation

72

Indications for Aliskirin

HTN

73

SE/ADRs for Aliskirin

hyperkalemia, hypotension

74

Contra-indications for Aliskirin

don't use w/ ACEI's or ARB's, hereditary or prior angioedema, concomitant use w/ Itraconazole

75

Dx-Dx interactions for Aliskirin

decrease effect of Furosemide, NSAIDs decrease effect of Aliskirin, not w/ grapefruit juice

76

Monitoring for Aliskirin

BP, serum K+, BUN, serum creatinine

77

PG category for Aliskirin

PG D

78

Drug class for Amlodipine

vasodilator: CCB DHP

79

MoA for Amlodipine

vasodilation due to blocking Ca channels in vascular smooth muscle & myocardium

80

Indications for Amlodipine

angina (chronic stable & vasospastic), HTN

81

SE/ADRs for Amlodipine

nausea, palpitations, peripheral edema, elderly-hypotension

82

Contra-indications for Amlodipine

hypersensitivity

83

Dx-Dx interactions for Amlodipine

grapefruit juice

84

Monitoring for Amlodipine

BP, chest pain

85

Drug class for Nifedipine

vasodilator: CCB DHP

86

MoA for Nifedipine

vasodilation due to blocking Ca channels in vascular smooth muscle & myocardium

87

Indications for Nifedipine

angina (chronic stable & vasospastic), HTN

88

SE/ADRs for Nifedipine

nausea, HA, palpitations, peripheral edema, elderly-hypotension

89

Contra-indications for Nifedipine

hypersensitivity

90

Dx-Dx interactions for Nifedipine

grapefruit juice

91

Monitoring for Nifedipine

BP, chest pain

92

Drug class for Diltiazem

vasodilators: CCB NDHP

93

MoA for Diltiazem

dilate coronary arteries & decrease myocardial oxygen demands

94

Indications for Diltiazem

angina, HTN, A fib, A flutter, PSVT

95

SE/ADRs for Diltiazem

edema, HA, dyspepsia

96

Contra-indications for Diltiazem

bradycardia, SSS if no pacer

97

Dx-Dx interactions for Diltiazem

grapefruit juice

98

Monitoring for Diltiazem

BP, chest pain, LFTs

99

Drug class for Verapamil

vasodilators: CCB NDHP

100

MoA for Verapamil

dilate coronary arteries & decrease myocardial oxygen demands

101

Indications for Verapamil

angina, HTN, A fib, A flutter, PSVT

102

SE/ADRs for Verapamil

HA, gingival hyperplasia, constipation, fatigue

103

Contra-indications for Verapamil

bradycardia, SSS if no pacer

104

Dx-Dx interactions for Verapamil

grapefruit juice

105

Monitoring for Verapamil

BP, chest pain, LFTs

106

NDHP CCBs (Diltiazem & Verapamil) should not be used in combo with?

beta blockers

107

Drug class for Hydralazine

vasodilator: direct acting

108

MoA for Hydralazine

direct acting arteriolar vasodilator

109

Indications for Hydralazine

urgent to emergent BP reduction; preclampsia & eclampsia

110

SE/ADRs for Hydralazine

angina, orthostatic hypotension, depression, peripheral neuritis, SLE-like syndrome

111

Contra-indications for Hydralazine

mitral valve rheumatic heart disease, CAD

112

Dx-Dx interactions for Hydralazine

anti-hypertensive meds

113

Monitoring for Hydralazine

BP, HR, CBC, ANA

114

PG category for Hydralazine

PG C but avoid if possible

115

Drug class for HCTZ

diuretics: thiazides

116

MoA for HCTZ

Na-Cl symporter inhibition in DCT increasing Na & Cl excretion max 5% of filtered NaCl

117

Indications for HCTZ

HTN, edema in nephrotic syndrome, lithium induced diabetes insipidus (off label)

118

SE/ADRs for HCTZ

rare vertigo, anorexia, nausea, photosensitivity, QT prolongation, hypokalemia

119

Contra-indications for HCTZ

sulfa sensitivity, hypersensitivity

120

Dx-Dx interactions for HCTZ

beta blockers increase risk of hyperglycemia, may decrease renal excretion Li; NSAIDs

121

Monitoring for HCTZ

serum K+, glucose, BP

122

Drug class for Chlorthalidone

diuretics: 'thiazide-like'

123

MoA for Chlorthalidone

Na-Cl symporter inhibition in DCT increasing Na & Cl excretion max 5% of filtered NaCl

124

Indications for Chlorthalidone

HTN, edema in nephrotic syndrome, lithium induced diabetes insipidus (off label)

125

SE/ADRs for Chlorthalidone

rare vertigo, anorexia, nausea, photosensitivity; QT prolongation, hypokalemia

126

Contra-indications for Chlorthalidone

sulfa sensitivity, hypersensitivity

127

Dx-Dx interactions for Chlorthalidone

beta blockers increase risk of hyperglycemia, may decrease renal excretion Li; NSAIDs

128

Monitoring for Chlorthalidone

serum K+, glucose, BP

129

Drug class for Triamterene

diuretic adjunct: K+ sparing

130

MoA for Triamterene

direct inhibitor of Na influx in DCT & CCT

131

Indications for Triamterene

hypokalemia

132

SE/ADRs for Triamterene

hypotension, edema, constipation, dyspnea, hyperkalemia

133

Contra-indications for Triamterene

hypersensitivity, hyperkalemia

134

Dx-Dx interactions for Triamterene

other K+ retaining drugs

135

Monitoring for Triamterene

serum electrolytes, CrCl, BUN