Flashcards in Pharm: Antihypertensive drugs Deck (52):
What are the first line drugs of choice for treating hypertension?
Calcium channel blockers
Angiotensin receptor blockers
Which anti-hypertensive drugs are not used as first line drugs of choice?
Centrally acting agonists
Alpha adrenergic blockers
What are the anatomic sites of blood pressure control?
2) Veinous capacitance
4) Kidneys: RAA system
What class of anti-hypertensive is the best choice for uncomplicated hypertension therapy?
What are the major thiazide diuretics?
What are the side effects of the thiazide diuretics?
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.
What are the drug interactions for thiazides?
NSAIDs and beta blockers
What are the contraindications for thiazides?
What are the side effects of the loop diuretics?
Impaired diabetes control
What drug interactions are associated with loop diuretics?
What are the potassium sparing diuretics?
Aldosterone receptor blocker: Spironolactone, Eplerenone
ENaC blocker: Triamterene, Amiloride
What are the side effects of potassium sparing diuretics?
What are the drug interactions for potassium sparing diuretics?
ACE inhibitors with ARBs
What are contraindications for potassium sparing diuretic treatment?
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
What are the major calcium channel blockers and which class do they fall in?
Side effects of nifedipine
Major side effect of diltiazem
Side effects of verapamil
CCBs should not be given to patients with what condition?
Contraindicated for patients with conduction disturbances, heart failure
What class of drugs may interact with CCBs?
Use together with caution
What CCBs shouldnt be used to treat chronic hypertension?
Short acting CCBs put chronic HTN patients at high risk for MI
What are the sympatholytic drugs used to treat hypertension?
Clonidine and Guanfacine
*Both are alpha 2 agonists
What are the side effects of clonidine?
What is the difference between clonidine and guanfacine?
Guanfacine has a longer half life, less chance for rebound hypertension
When is methyldopa most often prescribed?
Pregnancy with hypertension
What is the mechanism of action for reserpine?
Blocks VMAT, preventing NE concentration in vesicles
What side effects are associated with reserpine?
What is phenoxybenzamine used for?
Treating HTN in patients with Pheochromocytoma
What is the mechanism of action of Prazosin?
Selective alpha 1 antagonist
What is the difference between prazosin, terazosin, and doxazosin?
Terazosin and doxazosin have longer half lives than prazosin
What is the mechanism of action of the beta blockers?
1) cardiac contractility
2) Cardiac Output
3) renin secretion
What are the most commonly used beta blockers?
What is the major difference between metoprolol and atenolol?
Metoprolol crosses the BBB, atenolol does not
What are the side effects of all beta blockers?
Impaired exercise tolerance
What are the side effects of the non-selective beta blockers?
Increased airway resistance
What are the side effects of the lipophilic beta blockers?
What additional risk must be considered for diabetic patients taking beta blockers
Epinephrine is released when glucose is low, but its effect is blocked so the typical hypoglycemic symptoms may not present
What drugs are vasodilators used for treating HTN?
When are vasodilators used for?
Used in combo for patients not responding to first line treatment for HTN
Side effects of hyralazine
NSAIDs can reduce effectiveness
What is a unique side effect of nitroprusside?
What are the ACE inhibitor drugs?
What advantages does lisinopril have over enalopril?
Not metabolized, excreted unchanged by kidney
Side effects of ACE inhibitors
Contraindications of ACE inhibitors
Bilateral renal stenosis
How do ACE inhibitors affect renal function in diabetics?
Preserve renal function
Mechanism of action for Losartan
Angiotensin II receptor blocker
Mediates vasoconstriction and sodium retention
What is the major contraindication for losartan treatment?
Causes fetal renal failure
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