Pharm#8 - Anti Hypertensive Drugs Flashcards Preview

PHARM/MHD - Exam #4 > Pharm#8 - Anti Hypertensive Drugs > Flashcards

Flashcards in Pharm#8 - Anti Hypertensive Drugs Deck (46):
1

Hydralazine
MOA
Indication

vasodilator

RESISTANT HYPERTENSION
- pregnancy induced hypertension

2

Chlorthalidone

moa
indication

thiazide diuretic

1st line drug in uncomplicated HTN

3

Furesomide
MOA Indication

loop diuretic

HTN in severe renal insufficiency

4

Spironolactone

MOA
Indication

Eplrenenone
-MOA, indication

aldosterone receptor antagonist


- used in combo with other antihypertensives that deplete K+

2. Aldosterone receptor blocker
- combo tx. with diuretics to minimize K loss

5

Triamterene & amiloride

moa
indication

- Enac inhibitors

- combo with diuretics to minimize K loss

6

Nifedipine

MOA
indication

Ca channel antagonist

1st line drug used in uncomplicated HTN

- used in diabetes and hyperlipidemia

7

Diltiazem & Verapamil

MOA
indication

Ca channel antagonist

1st line in HTN

8

Clonidine & Guanfacine

MOA
indication

alpha 2 agonist

second line HTN

9

Methyldopa

MOA
indication

alpha 2 agonist

HTN in pregnancy

10

Reserpine

MOA
indication

depletes MOA from storage vesicles

resistant HTN

11

Phenoxybenzamine

MOA
indication

alpha blocker (non-selective)

tx for pheochromocytoma before surgery

12

Prazosin
MOA
indication

alpha blocker

2nd line for chronic HTN

13

Terazosin & Doxazosin

MOA
indication

(longer half life than prazosine = better)

alpha 1 blockers (selective)

2nd line for chronic HTN

14

propranolol

MOA
indication

non-selective B blocker

HTN with angina, MI, or arrhythmia
- do not use with asthmatics

15

Nadolol
MOA
indication

selective B blocker

- long term angina, HTN

16

Pindolol

MOA
indication

partial B agonist

CHRONIC HTN

- use for patients that are active or sensitive to bradycardia

17

Metoprolol

MOA
indication

B1 antagonist

HTN, long term angina tx

18

Atenolol

MOA
indication

B1 blocker

CHRONIC HTN
- angina, MI, arrhythmia, HF

19

Labetolol

MOA
indication

mixed alpha beta antagonist

- Chronic HTN

20

Carvedilol

MOA
indication

mixed alpha beta receptor antagonist and NO generator

- Chronic HTN and CHF

21

Hydralazine

MOA
indication

vasodilator

resistant HTN, pregnancy induced HTN

22

Minoxidil

MOA
indication

vasodilator

resistant HTN

23

Nitroprusside

MOA
indication

vasodilator

acute hypertensive crisis

24

Captopril

MOA
indication

ACE inhibitor

1st line drug in chronic HTN
- used in HF, MI, and diabetes

25

Enalapril

MOA
indication

ACE inhibitor

1st line in chronic HTN, used in HF

26

Lisinipril

MOA
indication

ACE inhibitor

1st line in chronic HTN

27

Losartan

MOA
indication

Angiotensin receptor inhibitor

1st line drug in chronic HTN

28

What is defined as Stage 1 HTN?

Systolic & diastolic

Stage 2?
Who are treated more vigorously for high BP, old or young?

140 -159

90-99

>160 or >100

- young

treatment is initiated only at higher pressures in younger patients (

29

What drugs are contraindicated in pregnant patients?

ACE inhibitors!

- as well as Angiotensin receptor inhibitors

30

How does hypokalemia occur with Thiazide use?

volume contraction with thiazide diuretics due to loss of Na (pulls water) which stimulates aldosterone & more Enac channels into the membrane

-rebound Na reabsorption
results in K+ leaving due to increased negative charge in lumen

- also pulls H+ and results in metabolic alkalosis

31

Which drugs (loop or thiazide) should be used for patients with renal insufficiency?

LOOP

- also do not give a new diuretic to a pregnant patient

-loop diuretics are not THAT effective in a healthy patient, more effective for patients with RENAL INSUFFICIENCY

32

drug interactions for loop diuretics (2)

NSAIDS
(loop, thiazide, K+)

Aminoglycosides (increase ototoxicity)

33

Contraindication for K+ sparing drugs

(spironolactone, eplrenone, triamterene, amiloride)

RAS inhibitors

(Ace inhibitors & angiotensin receptor inhibitors)

ACE INHIBITORS EXCACERBATE HYPERKALEMIA!!

34

SE of nifedipine

acute tachycardia

peripheral edema

35

SE of verapamil

bradycardia

36

Non-dihydropyridines are contraindicated in Pts with what?

state the drugs (2)

- conduction disturbances

- uncompensated HF (results in cariogenic shock)


- diltiazem
-verapamil

Metabolized by liver, caution in patients with liver failure

37

Clonidine main SE?

What should be used instead

Rebound HTN when withdraw use

- Guanfacine has longer half life less chance of rebound

38

alpha 2 agonist that can be used in pregnancy

methyldopa

- do not use in parkinson's patients on LDOPA since this results in inhibition of action

39

SE for alpha 2 agonists

(clonidine, gunfacine, methyldopa)

BUT MAIN SIDE EFFECT = SEDATION!!! for alpha 2 agonists

40

MOA of B-Blockers (3)

decreased cardiac contractility and CO, decreased renin secretion and thus decreased Angiotensin II production

41

What antihypertensive drugs increase TG's and reduce HDLS

B-Blockers

B-blockers block B2 receptors so reduce blood flow to lower limbs which utilize a lot of TG  so there is thus an increase TG in plasma since less flow to the limbs with these drugs

42

Contraindication for BB

Cardiogenic Shock
Sinus bradycardia
Asthma
Severe heart failure

43

Hydralazine & nitroprusside only used in ___

resistant HTN

- can induce Lupus like autoimmune when taken for a long time! (resolves when drug is stopped

44

SE of ACEI

Problem of ACEI = dry cough related to increased bradykinin production!

45

Which ACEI:
1. short half life* (taken often), requires multiple daily doses, active
metabolites

2.converted to active metabolite enalaprilat,

longer
onset of action, longer half-life, can dose 1-2x per day

3. ALLOWS ONCE daily dosing

CAPTOPRIL

Enalapril
-needs to be converted to active metabolite and thus unpredictable in his onset of action
longer onset & longer half life

Lisinopril

46

What drug mediates vasoconstriction & Na retention but is not associated with dry cough like ACEI?

LOSARTAN

- angiotensin II receptor blocker