pharmacology: antihypertensive drugs Flashcards Preview

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Flashcards in pharmacology: antihypertensive drugs Deck (30):
1

what are the antihypertensive drugs?

drugs altering sympathetic activity:
-alpha 2 agonists (clonidine and mythyldopa)
-drugs interfering with storage vesicles (reserpine and guanethidine)
-alpha 1 blockers (prazosin, doxazosin, terazosin)
-beta blockers

direct acting vasodilators:
-NO acting: hydralazine, nitroprusside
-open potassium channels (minoxidil and diazoxide)

calcium-channel blockers
-verapamil, diltiazem
-dihydropyridines (-dipines)

diuretics

ACEIs and ARBs)
ACEIs: prils
ARBs: sartan

2

what are the alpha 2 agonists? mechanism?

clonidine and methyldopa
mechanism: decrease sympathetic outflow causing decreased TPR and HR

3

clonidine and methyldopa uses

(alpha 2 agonists)
mild-to-moderate HTN, opiate withdrawal

4

what is the DOC of hypertensive management in pregnancy?

methyldopa

5

what are the side effects of clonidine and methyldopa? drug interactions?

SE: positive coomb's (methyldopa), CNS depression, edema
interactions: TCA decrease antihypertensive effects (alpha 2 is trying to lower NE while TCAs are blocking NE reuptake)

6

what are the drugs that interfere with storage vesicles?

reserpine (destroys vesicles - DEPRESSION) and guanethidine (accumulated into nerve endings by reuptake and inhibit NE release - not clinically relevant)

7

what are the alpha 1 blockers? mechanism?

-zosin (prazosin, doxazosin, terazosin)
decreased arteriolar and venous resistance

8

which drugs are used to treat both HTN and BPH? mechanism?

alpha 1 blockers (-ZOSIN) - decreases urinary frequency and nocturia by decreasing the tone of urinary sphincters causing better emptying of the bladder

9

alpha 1 blocker side effects

first-dose syncope, orthostatic hypotension (decreased preload), urinary incontinence

10

what are the side effects of beta blockers?

cardiovascular depression
fatigue (CNS depressant)
sexual dysfunction
increased LDLs and TGs (if already high)

*caution with asthma, vasospastic disorders, diabetics)

11

what are the direct-acting vasodilators?

-drugs acting through NO
hydralazine and nitroprusside

-drugs acting to open potassium channels
minoxidil and diazoxide

12

hydralazine side effects

SLE like syndrome and slow acetylators
edema
reflex tachycardia

13

nitroprusside use and side effect

use: hypertensive emergencies (DOC IV)
side effect: cyanide toxicity (co-administered with nitrites and thiosulfate) - can only use for 24-36 hours

14

drugs altering sympathetic activity vs direct vasodilators?

sympathetic activity: no reflex tachy, risk of orthostatic hypotension, increased PANS activity causing increased secretion which makes it bad for COPD

direct acting vasodilators: reflex tachy, no orthostatic hypotension, no increased PANS (less GI/GU problems), better for COPD

15

what are the drugs acting to open potassium channels? mechanism?

minoxidil and diazoxide (cause hyperpolarization of smooth muscle which results in arteriolar vasodilation)

16

minoxidil and diazoxide use and side effects

use: hypertensive emergencies, severe hypertension, baldness (minoxidil is rogaine)
SE: hyertrichosis (too much hair), hyperglycemia (decreased insulin release), edema, reflex tachy

17

what are the calcium channel blockers? mechanism?

verapamil, diltiazem, dihydropyridiens (-dipines)
block L-trpe Ca channels in heart and blood vessels causing decreased CO and TPR

18

calcium channel blockers uses and side effects

use: HTN, angina, antiarrhythmics (verapamil and diltizem)
SE: reflex tachy (dipine), gingival hyperplasia (dipines)
constipation (verpamil)

19

what are the ACEIs? mechanism?

-prils
block formation of angiotensin II which causes both decreased aldosterone and vasodilation
also prevent bradykinin degradation

20

what are the ARBs? mechanism?

-sartans
block AT1 receptors

21

what is the renin inhibitor?

aliskiren

22

ACEI and ARB uses

mild-to-moderate HTN, protective of diabetic nephropathy, CHF (prevent remodeling)

23

ACEI and ARB side effects and contraindication

SE: dry cough (ACEI), hyperkalemia, acute renal failure in renal artery stenosis (no renin to bring more fluid), angioedema
contraindication: pregnancy

24

DOC for angina

beta blockers and CCBs

25

DOC diabetes

ACEIs and ARBs

26

DOC heart failure

ACEIs, ARBs, beta blockers

27

DOC post-MI

beta blockers

28

DOC BPH

alpha blockers

29

DOC dyslipidemias

alpha blockers, CCBs, ACEI/ARBs
NO BETA BLOCKERS AND THIAZIDES!!

30

what is used for treatment of pulmonary HTN?

bosentan, sildenafil (inhibits PDE, increasing cGMP, pulmonary artery relaxation)