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Antihypertensive drugs
board prep
18
Medical
Graduate
03/05/2008

Additional Medical Flashcards

 


 

Cards

Term

 

 

 

Antihypertensive drugs (general)

Definition

Primary HTN want to treat the heart/blood vessels/kidney

 

Want to decrease TPR, CO, body fluid volume, BP (last one may result in reflex tachycardia &/or edema from renin activity)

Term

 

 

 

Drugs altering sympathetic activity (alpha 2 agonists)

Definition

Clonidine & Methyldopa (prodrug)

 

W/ alpha 2 stimulation = decrease in sympathetic outflow and decrease in TPR/HR

 

Uses: mild/moderate HTN

Opiate w/drawl (clonidine) for the autonomic SE's

HTN management during pregnancy (methyldopa)

 

SE: Positive Coombs test (methyldopa)

CNS depression

Edema

DI: TCA's decrease anti-HTN effects

Term

 

 

 

Drugs altering sympathetic activity (interfering w/ storage vesicles)

Definition

Reserpine

 

Destroys NE vesicles

Periphery causes decreased CO and TPR

CNS causes decreased NE, DA, 5HT

 

SE: depression (often severe!)

edema, increases GI secretions

 

Guanethidine

 Accumulates in nerve endings and taken up and binds to vessicles inhibiting NE release

 

SE: diarrhea, edema

DI: TCA's block reuptake

Term

 

 

 

Drugs altering sympathetic activity (alpha 1 blockers)

 

Definition

Prazosin, Doxazosin, Terazosin

 

Decreases arteriolar AND venous resistance (watch for reflex tachycardia)

 

Uses: HTN, BPH

SE: "1st dose" syncope d/t dilation

orthostatic hypotension -from venous dilation

urinary incontinence

Term

 

 

 

Drugs altering sympathetic activity (beta blockers)

Definition

Propranolol, metoprolol, acebutolol etc.

 

SE: cardiovascular depression

fatigue

sexual dysfunction

increases LDLs and TGs

 

Caution in: asthmatics

vasospastic disorders

diabetics

Term

 

 

 

Direct acting vasodilators (drugs acting through NO)

Definition

SEVERE HTN

 

Hydralazine:decreases TPR, arteriolar dilation ONLY

SE: SLE-like syndrome in slow acetylators

Edema

Reflex tachycardia

 

Nitroprusside: decreases TPR via dilation of both arteries and veins

Uses: DOC for HTN emergencies

SE: Cyanide toxicity (Sodium nitrite or amyl nitrite are the antidotes along w/ sodium thiosulfate)

Term

 

 

 

 

Drugs acting to open K+ channels (hyperpolarize)

 

 

Definition

Minoxidil

 Causes hyperpolarization of smooth muscle results in arteriolar vasodilation

 

Uses: HTN emergencies, severe HTN, baldness

 

SE: hypertrichosis (hair grows)

hyperglycemia

edema

reflex tachycardia

Term

 

 

 

Calcium channel blockers

Definition

Block L-type Ca2+ channels in heart and vessels

Causes decreased TPR (in those more specific for aterioles...end in -dipine)

 

Prototype = nifedipine

Uses: HTN, angina, antiarrhythmics (verapamil/diltiazem only for the last)

 

SE: reflex tachycardia

gingival hyperplasia (PHENYTOIN does too!)

constipation (verapamil)

 

Term

 

 

 

Diuretics

Definition
Thiazide and loop commonly used in management of HTN but check in diuretic card group
Term

 

 

 

ACE inhibitors

Definition

angiotensin converting enzyme (aka kininase II) converts angiotensin I --> II

Angiotensin II causes increased aldosterone secretion and vasoconstriction (inhibits this!)

 

Captopril (other -prils)

also prevents the degredation of bradykinin

 

Uses: mild/moderate HTN, protective of diabetic nephropathy, CHF

SE: dry cough (from bradykinin)

hyperkalemia (not secreting from kidney)

acute renal failure in renal artery stenosis

Angioedema (rapid swelling in nose, mouth, throat)

 

Contraindication in pregnancy

 

 

Term

 

 

 

ARB's

Definition

Block the angiotensin II from binding to the AT-1 receptors so you get decreased aldosterone secrection and vasodilation but doesn't interfer w/ bradykinin breakdown

 

Losartan (other -sartan's)

Uses: mild/moderate HTN, protective of diabetic nephropathy, CHF

SE: hyperkalemia, acute renal failure in renal artery stenosis, angioedema

Contraindication: pregnancy D

Term

 

 

 

HTN + comorbid condition (angina)

Definition
 use beta blockers, CCBs
Term

 

 

 

HTN + comorbid condition (diabetes)

Definition

use ACEI's or ARB's

Term

 

 

 

HTN + comorbid condition (heart failure)

Definition
ACEI's or ARB's
Term

 

 

 

HTN + comorbid condition (post MI)

Definition
Beta blockers
Term

 

 

 

HTN + comorbid condition (BPH)

Definition
Alpha blockers
Term

 

 

 

HTN + comorbid condition (dyslipidemia)

Definition
DON'T USE beta blockers/thiazides
Term

 

 

 

Pulmonary HTN

Definition

Bosentan: endothelin is a powerful vasoconstrictor and this drug is an ET(a) receptor antagonist

 

SE:assoc w/ vasodilation(flushing, HA, hypotension)

 

Epoprostenol: prostacyclin (PGI2)

Sildenafil: inhibits phosphodiesterase type V

increases cGMP, get pulmonary aa. relaxation

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