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HYPERTENSION DRUGS
EXAM1
89
Pharmacology
Graduate
12/02/2012

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Term
SODIUM NITROPHRUSSIVE
Definition
IV INFUSION PUMP,
VASODILATOR FOR HYPERTENSIVE EMER AND HF
DURATION 1-10 MIN
Term
SODIUM NITROPHRUSSIVE
Definition
MOA: dilate peripheral and venous vessels
resulting in reduced PVR result of activation of Guanylyl Cyclase either via release of NO or by direct enzyme stimulation result inc intracellular Cgmp
Term
SODIUM NITROPHRUSSIVE
Definition
SE: Drug metabolized slowly to THIOCYANATE
fatique weakness
slurred speech,
psychosis,
cyanide accumulation
metabolic acidosis
arrhymias,
excessive hypotension
Term
DIAZOXIDE
Definition
LA IV direct arteriolar vd
one dose (90% albumin bound)
To treat Hypertensive Emer and will cause tachycardia
Similar to Thiazide Diuretics (cross allergenicity)
Term
DIAZOXIDE
Definition
SE: cause CHF, CVA and MI
Hyperglycemia (inhibit insulin reslease)
Hypotension
Sodium and Water retention (minor)
Term
FENOLDOPHAM
Definition
Periperal arterial vd
Used for Hypertension Emer and post op
hypertension continous infusion
Term
FENOLDOPHAM
Definition
MOA: agonist of Dopamine result in dilation of peripheral arterial arteries
and naturiesis
Conjungation mechanism
Term
FENOLDOPHAM
Definition
SE: reflex tachycardia,
headache,
flushing
avoid in glaucoma patients
Term
TRIMETHOPHAN
Definition
Ganglionic blocker and continuous iv
infusion
Indication for: hypertensive crisis
and dissecting aortic aneurysm
Term
HYDRALAZINE
Definition
SE: DIZZINESS,
HEADACHE,
ANXIETY
TACHYCARDIA
NAUSEA AND VOMITTING
DIARRHEA,
ANEMIA
DYSPNEA, EDEMA, NASAL CONGESTION
Term
SODIUM NITROPRUSSIDE
Definition
TACHYCARDIA
HYPOTENSION
POSSIBLE CYANIDE TOXICITY
Term
HYPERTENSION EMERGENCY (CRISIS)
Definition
DIASTOLIC >130 mmHg
Term
HYPERTENSION EMERGENCY (CRISIS)
Definition
Na Nitroprussive
Diazoxide
Fenoldopam
Trimethophan
Term
Vasodilator is directly relaxes arteriolar smooth muscle
Definition
is more potent than A1 blocker
Term
Vasodilator is not effective if used alone why?
Definition
cause reflex tachycardia that why is administer BBD before given vasodilator
Term
Vasodilator
Definition
Hydralazine HCL
Minodixil
Sodium Nitroprusside
Diazoxide
Term
Hydrazaline
Definition
Direct arteriolar
Management for CHF patient
Drug may increase renal blood flow
Metabolism by ACETYLATION;
slow acetylators will develop Lupus like syndrome
Term
Hydralazine
Definition
SE:
Lupus Like Syndrome (NEVER CAUSE RENAL DAMAGE)
Reflex tachycardia (add B blockers before)
Fluid retension by stimulating RAAS (add diuretic also)
Headache
Nausea
Leg/ankle edema
Term
MINOXIDIL
Definition
Indication: severe hypertension refractory to other treatments
Useful in malignant hypertension
Used in patient with renal failure
Alternative to nephectomy
Topical use for ALOPLECIA
Term
MINOXIDIL
Definition
SE:
Reflex Tachycardia
Fluid retention
Hypertrichosis
Term
CALCIUM CHANNEL BLOCKERS
Definition
Benzothiapepines
Dihydropyrines
Phenylalkalines
Term
CALCIUM CHANNEL BLOCKERS
Definition
Cause smooth muscle relaxation by blocking
the binding of calcium to its receptor
and preventing muscle contraction
This causes decresed peripheral smooth muscle tone, decrease systemic vascular resistance
Result: decreased blood pressure
Term
CALCIUM CHANNEL Blockers
Definition
Benzothiazipe: Diltiazem
Phenylalkamine: Verapamil
Dihyropyridines:
amlodipine
nimodipine
nicardipine
nifedipine
bepridil
Term
CALCIUM CHANNEL BLOCKERS
Definition
TREAT:
Angina
Hypertension
Dysrhhymias
Migraine headaches
Term
CALCIUM CHANNEL BLOCKERS
Definition
SE:
Hypotension
Palpitaion
Tachycardia
Constipation
Nausea
Rash
Flushing
Peripheral edema
Dermatitis
Term
ANGIOTENSIN II RECEPTOR BLOCKERS:
Definition
WELL TOLERATED
DO NOT CAUSE COUGHING
Term
ANGIOTENSIN II RECEPTOR BLOCKERS:
Definition
MOA: BLOCK THE RECEPTOR THAT RECEIVE
ANGIOTENSIN II
BLOCK VASOCONSTRICTIN AND RELEASE OF ALDOSTERONE
Term
ANGIOTENSIN II RECEPTOR BLOCKERS:
Definition
IOSARTAN
EPOSARTAN
VALSARTAN
IRBESARTAN
CANDESARTAN
TELMISARTAN
Term
ANGIOTENSIN II RECEPTOR BLOCKERS:
Definition
TREAT:
hypertension
CHF
used alone or with other agent such as
diuretic
Term
ANGIOTENSIN II RECEPTOR BLOCKERS:
Definition
SE:
Upper respiratory infection
Headache
Dizziness
Inability to sleep
Dysnea
Heartburn
Nasal Congestion
Back Pain
Fatique
Term
ANGIOTENSIN II RECEPTOR BLOCKERS:
Definition
is given first line in normal person b/w
25-60 years old
Term
Angiotensin-Converting Enzyme Inhibitors
(ACE Inhibitors)
Definition
Large group of safe and effective drugs
Often used as first-line agents for CHF
and hypertension
May combined with thiazide diauretic and CCB
Term
Angiotensin-Converting Enzyme Inhibitors
(ACE Inhibitors)
RAAS-Renin Angiotensin-Aldosterone Sys
Definition
Prevent ACE thus Preventing the formation of angiotensin II
Also prevent the breakdown of the vasodilating substance, bradykinin
Term
Angiotensin-Converting Enzyme Inhibitors
(ACE Inhibitors)
Definition
Captopril: short half-life, must be dosed more frequently than others
Term
Enalapril: the only ACEI available in oral and parenteral forms
Definition
Angiotensin-Converting Enzyme Inhibitors
(ACE Inhibitors)
Term
Angiotensin-Converting Enzyme Inhibitors
(ACE Inhibitors)
Definition
Lisinopril and quinapril
long half-lives, once a day dosing
Term
Angiotensin-Converting Enzyme Inhibitors
(ACE Inhibitors)
Definition
Hypertension
Drugs choice fo CHF
Slows progression of left ventricular hypertrophy after an MI
Renal protective effects with diabetic patient
Term
Angiotensin-Converting Enzyme Inhibitors
(ACE Inhibitors)
Definition
SE:
Fatigue
Dizziness
Headache
Mood changes
Impaired taste
REMEMBER DRY-NONPRODUCTIVE COUGH, REVERSES WHEN THERAPY IS STOPPED
Term
Angiotensin-Converting Enzyme Inhibitors
(ACE Inhibitors)
Definition
FIRST DOSE HYPOTENSIVE EFFECT MAY OCCUR
Term
DOXAZOSIN
Definition
ALPHA 1 BLOCKER (PERIPHERAL ACTING)
Term
PRAZOSIN
Definition
ALPHA 1 BLOCKER (PERIPHERAL ACTING)
Term
TERAZOSIN
Definition
ALPHA 1 BLOCKER (PERIPHERAL ACTING)
Term
ALPHA 1 BLOCKER (PERIPHERAL ACTING)
Definition
Inhibit release of Norepinephrine and also deplete norepinephrine stores, thus DO NOT stimuulated SNS leading to decreased blood pressure
Term
ALPHA 2 BLOCKER (CENTRAL ACTING ADRENERGIC
Definition
SNS IS DECREASED
Term
CLONIDINE
Definition
ALPHA 2 BLOCKER (CENTRAL ACTING ADRENERGIC
Term
GUANABENZ
Definition
ALPHA 2 BLOCKER (CENTRAL ACTING ADRENERGIC
Term
GUANFACINE
Definition
ALPHA 2 BLOCKER (CENTRAL ACTING ADRENERGIC
Term
METHYLDOPA
Definition
USED FOR HYPERTENSION IN PREGNANCY
Term
ALPHA 2 BLOCKER (CENTRAL ACTING ADRENERGIC
Definition
INDICATION FOR moderate to severe hypertension
Term
CLONIDINE
Definition
MOA: A2 agonist in the medulla to reduce SNS tone resulting in reduce BP
Lipid soluble and enters the brain
Administered BID or Patch (7days)
Term
CLONIDINE
Definition
SE:
Dry mouth,
Mental Depression
REMEMBER:Rebound life threatening hypertension on rapid withdraw
Fluid retention,
Impotence,
Gynecomastia
Nervousness,
Tachycardia
Headache
Sweating
Term
METHYLDOPA
Definition
MOA:
REMEMBER A2 AGONIST FALSE TRRANSMITTER ANALOG OF L-DOPA converted to a-methyldopamine and a-methylnorepinepherine parallels synthesis of NE
Term
METHYLDOPA
Definition
Sedation
Impaired concentration
Nightmares
Parasympathetic Overactivity
Diarrhea
Lupus like syndrome
Impotence,
FALSE positive Coombs test
Term
Reserpine
Definition
A1 adrenergic (Peripheral Blockers)
Term
Guanadrel
Definition
A1 adrenergic (Peripheral Blockers)
Term
Guanethidine
Definition
A1 adrenergic (Peripheral Blockers)
Term
A1 adrenergic (Peripheral Blockers)
Definition
Reserpine
Guanadrel
Guanethidine
Term
RESERPINE
Definition
Alkaloid roots of Rau Serpentina
1st drugs used in HTN
MOA:
depletes catecholamines from peripheral and central storage vessicles
Must take 2 weeks before efficacy
Term
RESERPINE
Definition
SE:
CNS depression
sedation
EPS or Parkinsonism
Impotence
Orthotic Hypotension
Parasympathetic overactivity brady
Nasal stuff
GI
Weight gain
Urinary
Retension,
Glaucoma
Blurred vision
Term
Guanethedine
Definition
MOA: inhibits release of Catecholamines
at sympathetic nerves, uptake is needed for drug to work, because replaces NE will cause depletion of NE stores
Term
Guanethedine
Definition
Most potent of all antihypertensive agents due to sympathetic blockade
Term
Guanethedine
Definition
SE:
Explosive Diarrhea
Postural hypotension
Impotence,
NO DROWSINESS because does not enter CNS
Drug not used due to severe SE
Term
Guanethedine
Definition
NO DROWSINESS because does not enter CNS
Term
Alpha ! blockers
Definition
BPH BPH BPH and management of severe CHF when used with cardiac glycosides and diuretics
Term
ALPHA 2 BLOCKER (CENTRAL ACTING ADRENERGIC
Definition
Either used alone or with other agents
Usually used after other agents have failed due to side effects
Used for severe Dysmenorrhea, Menopausal flushing, glaucoma
Term
Clonidine
Definition
is used in the management of withdrawal symptoms in opioid, crack addict, nicotine dependent persons
Term
Adrenergic agents blockers
Definition
SE:
Dry mouth
Drowsiness
Sedasion
Constipation
Headaches
Sleep Disturbances
Nausea
Rash
Cardiac Disturbances (palpitations
Term
Adrenergic agents blockers
Definition
HIGH INCIDENCE OF ORTHOSTATIC HYPOTENTION
Term
HYDROCHLOROTHIAZIDE (HCTZ)
Definition
THIAZIDE DIURETIC
POTASSIUM SPARING DIURETICS
MOA: REDUCE BLOOD VOLUME BY DEPLETING NA STORE
SE: hypokalemia
Term
HYDROCHLOROTHIAZIDE (HCTZ)
Definition
1st line for hypertension in mild to moderate hypertension
Term
Pherosemide
Definition
Thiazide Diuretic
Term
Normal
Definition
systolic <13O
Diastolic <85
Term
Optimal
Definition
between <120
<80
Term
High normal
Definition
130-139
85-89
Term
Stage 1
Definition
140-159
90-99
Term
Stage 2
Definition
160-169
100-109
Term
Stage 3
Definition
180-209
110-119
Term
Stage 4
Definition
>210
>120
Term
Iosartan
Definition
AT2 antagonist
treat hypertension with Nephropathy
Term
Irbesartan
Definition
AT2 antagonist
treat hypertension with Nephropathy
Term
Valsartan
Definition
AT2 antagonist
treat hypertension with Hear Failure
Term
Iosartan
Definition
AT2 antagonist
treat hypertension with left ventricular hypertrophy
Term
Enalapril
Definition
ACEI for Left ventricular dysfunciton and CHF
Term
Captopril
Definition
ACEI for Left ventricular dysfunciton and CHF
and for Diabetic nephropathy
Term
Trandolapril
Definition
ACEI for Left ventricular dysfunciton and CHF after MI
Term
Fosinopril
Definition
ACEI with CHF
Term
Lisinopril
Definition
ACEI with CHF
And also for MI
Term
Quinapril
Definition
ACEI with CHF
Term
Ramimpril
Definition
ACEI to reduce the risk of MI, stroke, and death from CVD
and also for CHF after MI
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