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Hypertension Drugs
IUSM
17
Pharmacology
Professional
03/02/2015

Additional Pharmacology Flashcards

 


 

Cards

Term
chlorthalidone
Definition
Class: thiazide diuretic, antihypertensive drug

Mechanism: lower BP by increasing urinary sodium excretion, decrease plasma volume and decrease cardiac output; chronically decrease peripheral vascular resistance

Indication: hypertension, 1st line

Adverse Effects: (reduce relative intravascular volume and activates RAAS --> inc. renin and ALD activity --> increase secretion/excretion of potassium --> HYPOKALEMIA), ventricular arrhythmias
Term
verapamil
Definition
Class: calcium channel blocker type I, antihypertensive

Mechanism: direct interaction w/ VG L-type Ca ch. in outer membrane; 1* effect = decrease vascular resistance

Indication: HTN, dec. CV events and deaths, reduce stroke > MI; preferred drug in OLDER patients and CONCURRENT ANGINA

Adverse Effects: (9%) constipation, HA, dizziness, nausea, galactorrhea, hepatotoxicity, AV block, bradycardia, CHF
Term
diltiazem
Definition
Class: calcium channel blocker type I, antihypertensive

Mechanism: direct interaction w/ VG L-type Ca ch. in outer membrane; 1* effect = decrease vascular resistance

Indication: HTN, dec. CV events and deaths, reduce stroke > MI; preferred drug in OLDER patients and CONCURRENT ANGINA

Adverse Effects: (4%) dizziness, HA, fatigue, blurred vision, flushing, AV block, bradycardia
Term
aliskiren
Definition
Class: RAAS interruption, antihypertensive

Mechanism: inhibition of renin

Effects: dose-dependent inhibiton of renin and reduction of BP

Indication: HTN (alone or combo, but combo superior)

Adverse Effects: (no cough or angioneurotic edema)

Pharmacokinetics: T1/2 20-45hr in plasma
Term
captopril
Definition
Class: RAAS inhibitors, antihypertensive

Mechanism: ACE-inhibition, decrease AT II, decrease ALD, increase renin, increase bradykinin (dilatory effects), decreased BP

Effects: rapid and slow decrease in BP, decreases vascular and cardiac hypertrophy and remodeling, enhanced response to diuretics, potassium sparring, delays development of DM nephropathy

Indication: Drug of choice for HTN pts w/ comorbidities (CHF, CHD, chronic renal dz - DM or non-DM)

Contraindication: renal artery stenosis as etiology of chronic renal dz

Adverse Effects: rash, fever, puritus, loss of taste, hypotension, cough, angioedema, teratogen, hyperkalemia

Pharmaockinetics: active drug, t1/2 3hrs w/ duration of 12hr effects
Term
candesartan
Definition
Class: RAAS inhibitor, antihypertensive

Mechanism: angiotensin II receptor (AT1) antagonist, selective and competitive

Effects: dose-dependent decrease in PVR

Indication: HTN esp. with persistent cough from ACE-I treatment (replace ACE-I with ARB)

Adverse Effects: no cough, but teratogen, angioedema, acute renal failure, hyperkalemia
Term
1st choice HTN therapy
Definition
low dose thiazide + K+ sparing diuretics
Term
2nd choice HTN therapy
Definition
based on compelling indication
Term
prostatism + HTN (2nd choice therapy)
Definition
alpha-blocker
Term
coronary disease + HTN (2nd choice therapy)
Definition
beta blocker or ACE-I/ARB
Term
tachyarrhythmia + HTN (2nd choice therapy)
Definition
beta blocker
Term
heart failure + HTN (2nd choice therapy)
Definition
beta blocker or ACE-I/ARB
Term
proteinuria + HTN (2nd choice therapy)
Definition
ACE-I/ARB
Term
elderly + HTN (2nd choice therapy)
Definition
CCB
Term
systolic HTN (2nd choice therapy)
Definition
CCB
Term
angina + HTN (2nd choice therapy)
Definition
CCB
Term
peripheral vascular dz + HTN (2nd choice therapy)
Definition
CCB
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