HTN drugs Flashcards Preview

Pharmacology 2 > HTN drugs > Flashcards

Flashcards in HTN drugs Deck (13):
1

Captopril, Lisinopril, Fosinopril (ACEI)

MoA

- Blocks Angiotension-Converting enzyme

--> results in decrease effects of Angiotensin II

--> builds up bradykinin

A image thumb
2

captopril, lisinopril, fosinopril

application

- First-line or add-on therapy for uncomplicated HTN

- First-line therapy for compelling indications of

--> diabetes

--> chronic kidney disease

--> coronary artery disease

--> left ventricular dysfunction

--> previous ischemic stroke

- enahnce the efficacy of diruertic drugs --> good combo

3

Describe ACEI pharm

- cleared mostly by the kidney --> reduce dose in kidney failure

- elevated plasma renin activity causes hyperresponsive to ACEIs --> reduce doses in pts with HIGH PLASMA RENIN LEVELS (HF, Na+ depleted patients)

4

describe various situtations of ACEI

AVOID: PREGNANCY, bilateral renal artery stenosis, history of angioedema

- POTENTIALL FAVORABLE SITuTATIONS FOR EFFECTS

--> low-normal potassium, PREDIABETES, Albuminuria

- Situations with potentially UNFABORABLE EFFECTS

--> HYPERKALEMIA

--> VOLUME DEPLETION

--> high-noraml K+

5

describe adverse effects of ACEI

ADVERSE:

--> hypotension

--> COUGHING (5-20%) - consider ARB when severe

--> angioedema

--> increased plasma K+

--> acute renal failure

--> fetopathic potential

6

Losartan, valsartan, candesartan (-ARTAN)

(MoA)

ANGIOTENSIN RECEPTOR 1 BLOCKER

A image thumb
7

EFFECTS OF losartan, valsartan, candesartan

Inhibit Ang II-induced

- contraction of vascular smooth muscle

- Thirst

- Vasopressin release

- aldosterone secretion

- release of adrenal catecholamines

- enhancement of noradrenergic NT

- increases in sympathetic tone

- changes in renal function

- cellular hypertrophy and hyperplasia

8

ROle of losartan, valsartan, candesartan role in antihypertensive therapy

- first-line or add-on therapy for compliated hypertension (as effective as ACEIs)

- first-line therapy for compelling indications of diabetes, chronic kidney disease, coronary artery disease, left ventricular dysfunction

- commonly used as an alternative for patients with intolerance to ACE inhibitors

9

describe various situations to use or not use angiotension receptors blockers (ARB)

- avoid use: PREGNANCY, bilateral renal artery stenosis

- Situations with potentially favorable effects

--> low-normal potassium

--> prediabetes

- situations with potentially ufnaorable effects

--> high-normal K+

--> hyperkalemia

--> volume depletion

10

Nifedipine, amlodipine, felodipine

MoA = DIHYDROPYRIDINE Calcium channel blocker

- Role in antihypertensive therapy:

--> FIrst-line or add-on therapy for uncomplicated hypertension

--> add-on therapy for: Diabetes, coronary artery disease

- Avoid: Left ventricular dysfunction

- Situations with potentially FAVORABLE effects

--> elderly patients with isolated sytolic hypertension

- situations with potentially UNFAVORABLE effects

--> high-normal heart rate or tachycardia or PERIPHERAL EDEMA

11

Verapamil, Diltiazem

NON-DIHYDROPYRIDINE calcium channel blocker

- ROLE in antihypertensive therapy

--> first line or add-on therapy for uncomplicated HTN

--> alternative to Beta-blockers in coronary artery disease

- AVOID: LEFT VENTRICULAR DYSFUNTION

- FAVORABLE: MIGRNAE HEADACHE, ARRHYTHMIAS, HIGH-normal heart rate or tachycardia

- UNFAVORABLE: LOW-normal heart rate

12

describe Thiazide diuretics for HTN

- Role of antihypertensive therapy

--> first line or add-on for uncomplicated HTN

--> first-line therapy in pts with LEFT VENTRICULAR DYSFUNCTION or PREVIOUS ISCHEMIC STROKE

- AVOID USE if pts: allergic rxn to sulfa-type drugs, GOUT, HYPOnatremia, HYPOkalemia

- FAVORABLE: osteoporosis or high-normal K+

- UNFAVORABLE: gout, prediabetes, low-normal K+, elevated fasting glucose

13

Propranolol, Metoprolol, Pindolol, Labetalol

Propranolol (non-selective), Metoprolol (cardio-selective),

Pindolol (ISA), Labetalol (mixed alpha/beta)

- TX: First-line therapy for pts with CORONARY ARTERY DISEASE or LEFT VENTRICULAR DYSFUNCTION

- FAVORABLE: Migraine headache, tachyarrhythmia, normal heart rate or tachycardia, hyperthyroidism