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Flashcards in Hypertension Deck (19)
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1

What 2 values are directly proportional to Arterial BP? (And thus most antihypertensive drugs try to lower these)

Cardiac Output & Peripheral Vascular Resistance

2

What 2 control mechanisms of BP are targets of antihypertensive drug therapy?

the Baroreflexes (of sympathetic NS) and the Renin-Aldosterone system

3

In which populations are Thiazide diuretics particularly useful?

elderly and blacks

4

In which population are thiazide diuretics contraindicated in?

Patients with inadequate kidney function, creatine clearance < 50

5

How do thiazide diuretics work?

They increase NA and water excretion --> decrease in blood volume --> decreases CO --> decrease BP

6

True or false, Thiazides can be useful in combination with other antihypertensives?

True. Other agents can cause sodium and water retention which thiazides will counteract. These include ACEs, ARBs, B-blockers, K-sparing

7

What are other side effects of thiazide diuretics?

Hypokalemia, Hypocalcemia, acute gout attacks

8

Which drugs are classified as Thiazide diuretics?

hydrochlorothiazide (HCTZ), chlorothiazide, metolazone

9

Which drug/drug class is most commonly used to treat glaucoma and mountain sickness but also has some mild diuretic effect?

Acetazolamide a carbonic anhydrase inhibitor

10

Where on the nephron do each diuretic class act upon?

Prox tubule --> CA inhibitor (acetazolamide)
Ascending loop --> Loop diurectics
Distal tubule --> thiazides
Collecting tubule --> K-sparing

11

Which drug class is the most efficacious of the diuretics?

Loops, because act at ascending loop. Even in patients with poor renal function

12

What is the most concerning adverse effect of loop diuretics?

ototoxicity, especially when also given with an amino glycoside

13

What are the adverse effects of K-sparing diuretics?

Gastric upset and peptic ulcers, gynecomastia, menstrual irregularity

14

What are severe scenarios in which mannitol is used to maintain urine flow?

increased intracranial pressure, acute renal failure due to shock, drug toxicities, trauma

15

Which drug class do the drugs furosemide and bumetanide belong to?

loop diuretics

16

Mannitol is which type of diuretic?

osmotic

17

Which other drugs are potassium sparing in addition to spironolactone?

triamterene, amiloride hydrochloride

18

What do you monitor with your patients on diuretics?

weight loss and potassium

19

Who are contraindicated to take spironalactone?

Renal dysfunction patients (increased risk of hyperkalemia)