Flashcards in Hypertension Deck (19)
What 2 values are directly proportional to Arterial BP? (And thus most antihypertensive drugs try to lower these)
Cardiac Output & Peripheral Vascular Resistance
What 2 control mechanisms of BP are targets of antihypertensive drug therapy?
the Baroreflexes (of sympathetic NS) and the Renin-Aldosterone system
In which populations are Thiazide diuretics particularly useful?
elderly and blacks
In which population are thiazide diuretics contraindicated in?
Patients with inadequate kidney function, creatine clearance < 50
How do thiazide diuretics work?
They increase NA and water excretion --> decrease in blood volume --> decreases CO --> decrease BP
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
What are other side effects of thiazide diuretics?
Hypokalemia, Hypocalcemia, acute gout attacks
Which drugs are classified as Thiazide diuretics?
hydrochlorothiazide (HCTZ), chlorothiazide, metolazone
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
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
Which drug class is the most efficacious of the diuretics?
Loops, because act at ascending loop. Even in patients with poor renal function
What is the most concerning adverse effect of loop diuretics?
ototoxicity, especially when also given with an amino glycoside
What are the adverse effects of K-sparing diuretics?
Gastric upset and peptic ulcers, gynecomastia, menstrual irregularity
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
Which drug class do the drugs furosemide and bumetanide belong to?
Mannitol is which type of diuretic?
Which other drugs are potassium sparing in addition to spironolactone?
triamterene, amiloride hydrochloride
What do you monitor with your patients on diuretics?
weight loss and potassium