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DIR 2, 404L

Anti-HTN drugs

QuestionAnswer
aliskiren Tekturna- TC: Renin inhibitor; Ind: HTN; MoA: Inhibits conversion of angiotensinogen to angiotensin I. Pregnancy Category: C (1st)/D (2nd & 3rd). BBW: Use in pregnancy- Drugs acting on RAS can cause fetal injury or death. Pearls: Monitor like an ACEi.
metoprolol succinate Toprol XL-- TC: Relatively cardioselective beta-1 blocker; Ind: HTN, angina, HF; MoA: Blocks beta-1 receptor, decreases HR & CO & decrease SBP & DBP. Preg Cat: C. BBW: Abrupt d/c may cause exacerbations of angina or MI, so taper. Pearls: Dose QD.
metoprolol tartrate Lopressor (IR)-- TC: Relatively cardioselective beta-1 blocker; Ind: HTN, angina, HF; MoA: Same as succinate. Preg Cat C. Same BBW as succinate. Pearls: Dose BID. Pt will feel awful at first.
Nonselective beta-blockers? "Tim Pinches His Nasal Problem 'Cause..." (...he has a runny nose): Timolol Pindolol Hismolol Nadolol Propranolol Carvedilol
carvedilol Coreg, Coreg CR-- TC: Beta blocker with alpha-blocking activity; Ind: HTN, Mild HF, LVD s/p MI. MoA: block beta & alpha receptor activity. Preg Cat: C (1st)/D (2& 3). Don't use if asthma.
B1-selective beta-blockers? "AMEBA-NC" Atenolol Metoprolol Esmolol Betaxolol Acebutolol Nevibolol Celiprolol
amlodipine Norvasc, Caduet (with atorvastatin), Lotrel- TC: CCB- dihydropyridine! Ind: HTN, stable angina. MoA: (Ca2+ antag/slow-channel blocker) inhibits transmembrane influx of Ca2+ ions into vasc & cardiac SM. Pearls: Warn of dizziness, edema.
verapamil Calan (SR), Isoptin(SR), Verelan-- TC: CCB (non-dihydropyridine); Ind: HTN, angina, arrhythmia. MoA- Keeps Ca from areas of vasc & cardiac SM, relaxes coronary vasc SM and causes coronary vasodil; incr's O2 to <3 in angina pts. C. Constipation in elderly.
diltiazem Cardizem CD, Cardizem SR, Cartia XT, etc.- TC: CCB (non-dihydropyridine); Ind: HTN, angina. MoA:Keeps Ca++ from areas of vasc & cardiac SM, relaxes coronary vasc SM and causes coronary vasodil; incr's O2 to <3 in angina pts. C.
lisinopril Zestril, Prinivil- TC: ACEi. Ind: HTN, HF, acute MI. MoA: Blocks conversion of angiotensin I to angiotensin II,increasing plasma renin activity & less aldosterone secretion. C (1)/D (2, 3). Pearl: Avoid chronic NSAIDs. Cough, K levels, angioedema.
losartan Cozaar, Hyzaar (w/ HCTZ)- TC: Angiotens II recep block. Ind: HTN; Moa:Antag angiotensin II receptor, block vasoconstric & aldost secr d/t angiotensin II. (If Hyzaar, also inhib Na+ reabs in distal tubules. C. BBW: RAS affected, fetal injury/death.
digoxin Digitek, Lanoxin (don't swap)- TC: antiarrhythmic(cardiac glycoside); Ind: HF, afib; MoA: Inhib Na/K ATPase pump, ^Ca influx, ^contractility. Also, direct suppression of AV node conduc. C.
nitroglycerin Nitro-Bid, Nitro-Dur, Nitrostat, NitroQuick- TC: Vasodilator. Ind: Angina, HTN. MoA: Relax SM, vasodilate periph veins, arteries; Lower cardiac O2 demand via lower preload C. Burn in MRI if patch.
Created by: dfernand
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