Pharm: Antihypertensive drugs Flashcards Preview

MHD/Pharm Block 4 > Pharm: Antihypertensive drugs > Flashcards

Flashcards in Pharm: Antihypertensive drugs Deck (52):
1

What are the first line drugs of choice for treating hypertension?

Diuretics
Calcium channel blockers
ACE inhibitors
Angiotensin receptor blockers

2

Which anti-hypertensive drugs are not used as first line drugs of choice?

Centrally acting agonists
Alpha adrenergic blockers
Beta blockers
Vasodilators

3

What are the anatomic sites of blood pressure control?

1) Arterioles
2) Veinous capacitance
3) Heart
4) Kidneys: RAA system

4

What class of anti-hypertensive is the best choice for uncomplicated hypertension therapy?

Diuretics

5

What are the major thiazide diuretics?

Hydrochlorothiazide
Chlorthalidone

6

What are the side effects of the thiazide diuretics?

Hyponatremia
Hyperglycemia
Increased LDL/HDL
Hypokalemia

7

What is the mechanism for diuretics causing hypokalemia and metabolic alkalosis?

The Na+ concentration in the lumen of the collecting duct is increased.
A net negative lumenal charge drives K+ and H+ out of cells into lumen to be excreted.

8

What are the drug interactions for thiazides?

NSAIDs and beta blockers

9

What are the contraindications for thiazides?

Hypokalemia

10

What are the side effects of the loop diuretics?

Dehydration/hyponatremia
Hypokalemia
Impaired diabetes control
Increased LDL/HDL
Ototoxicity

11

What drug interactions are associated with loop diuretics?

NSAIDs
Aminoglycosides

12

What are the potassium sparing diuretics?

Aldosterone receptor blocker: Spironolactone, Eplerenone
ENaC blocker: Triamterene, Amiloride

13

What are the side effects of potassium sparing diuretics?

Hyperkalemia
Gynecomastia

14

What are the drug interactions for potassium sparing diuretics?

NSAIDs
ACE inhibitors with ARBs

15

What are contraindications for potassium sparing diuretic treatment?

RAS inhibitors

16

What are the two types of calcium channel blockers and how do they differ?

Dihydropyridines: selective for smooth muscle
Non-dihydropyridines: smooth muscle and cardiac pacemakers

17

What are the major calcium channel blockers and which class do they fall in?

Nifedipine: dihydropyridine
Diltiazem: nondihydropyridine
Verapamil: nondihydropyridine

18

Side effects of nifedipine

Acute tachycardia
Peripheral edema

19

Major side effect of diltiazem

Bradycardia

20

Side effects of verapamil

Constipation
Bradycardia

21

CCBs should not be given to patients with what condition?

Contraindicated for patients with conduction disturbances, heart failure

22

What class of drugs may interact with CCBs?

Beta blockers
Use together with caution

23

What CCBs shouldnt be used to treat chronic hypertension?

Short acting CCBs put chronic HTN patients at high risk for MI

24

What are the sympatholytic drugs used to treat hypertension?

Clonidine and Guanfacine
Methyldopa
*Both are alpha 2 agonists

25

What are the side effects of clonidine?

Sedation
Dry mouth
Dermatitis
Rebound hypertension

26

What is the difference between clonidine and guanfacine?

Guanfacine has a longer half life, less chance for rebound hypertension

27

When is methyldopa most often prescribed?

Pregnancy with hypertension

28

What is the mechanism of action for reserpine?

Blocks VMAT, preventing NE concentration in vesicles

29

What side effects are associated with reserpine?

Depression/suicidal ideations
Nasal congestion

30

What is phenoxybenzamine used for?

Treating HTN in patients with Pheochromocytoma

31

What is the mechanism of action of Prazosin?

Selective alpha 1 antagonist

32

What is the difference between prazosin, terazosin, and doxazosin?

Terazosin and doxazosin have longer half lives than prazosin

33

What is the mechanism of action of the beta blockers?

Decreased
1) cardiac contractility
2) Cardiac Output
3) renin secretion

34

What are the most commonly used beta blockers?

Metoprolol
Atenolol

35

What is the major difference between metoprolol and atenolol?

Metoprolol crosses the BBB, atenolol does not

36

What are the side effects of all beta blockers?

Bradycardia
Impotence
Increased TGs
Decreased HDLs
Hyperglycemia
Impaired exercise tolerance

37

What are the side effects of the non-selective beta blockers?

Increased airway resistance

38

What are the side effects of the lipophilic beta blockers?

Insomnia
Chronic fatigue

39

What additional risk must be considered for diabetic patients taking beta blockers

Masked hypoglycemia
Epinephrine is released when glucose is low, but its effect is blocked so the typical hypoglycemic symptoms may not present

40

What drugs are vasodilators used for treating HTN?

Hydralazine
Minoxidil
Nitroprusside

41

When are vasodilators used for?

Used in combo for patients not responding to first line treatment for HTN

42

Side effects of hyralazine

Tachycardia
Angina aggrevation
Fluid retention
NSAIDs can reduce effectiveness

43

What is a unique side effect of nitroprusside?

Cyanide poisoning

44

What are the ACE inhibitor drugs?

Captopril
Enalapril
Lisinopril

45

What advantages does lisinopril have over enalopril?

Easily absorbed
Not metabolized, excreted unchanged by kidney

46

Side effects of ACE inhibitors

Hyperkalemia
Dry cough
Angioedema

47

Contraindications of ACE inhibitors

Pregnancy
Bilateral renal stenosis

48

How do ACE inhibitors affect renal function in diabetics?

Preserve renal function

49

Mechanism of action for Losartan

Angiotensin II receptor blocker
Mediates vasoconstriction and sodium retention

50

What is the major contraindication for losartan treatment?

Pregnancy
Causes fetal renal failure

51

What are the "good combinations" of drugs used to treat hypertension?

Thiazide/Loop diuretic + K+ sparing diuretic
Thiazide with beta blockers
CCBs with ACEi's

52

What are the "bad combinations" of drugs used to treat hypertension?

ACEi's with K+ sparing diuretics
ACEi's with ARBs have no advantage in diabetics