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Pharm Block III
Antihypertensives
| Question | Answer |
|---|---|
| Hemodynamic Regulation: Autonomic Nervous System - Sympathetics | inc HR, inc myocardial contractility, vasoconstriction |
| Hemodynamic Regulation: Autonomic Nervous System - Parasympathetics | dec HR, dec myocardial contractility, vasodilation |
| Hemodynamic Regulation: Renal System - RAAS | Renin-angiotensin-aldosterone system: inc renal blood flow dec RAAS; dec renal blood flow, dec renal arteriole pressure & inc SNS inc RAAS; |
| Hemodynamic Regulation: Renal System - Angiotensin II | causes vasoconstriction |
| Hemodynamic Regulation: Renal System - Aldosterone | causes Na/H2O retention |
| Hemodynamic Regulation: Local Vasodilators | Nitric Oxide and Prostaglandins |
| Hemodynamic Regulation: Local Vasoconstrictor | Endothelin-I |
| Definition of HTN | SBP >140mmHg or DBP >90; or currently on antihypertensive medication |
| Complications of HTN | heart failure, angina pectoris, myocardial infarction, stroke/transient ischemic attack, nephropathy, peripheral arterial disease, retinopathy |
| Determining etiology of HTN | Essential/primary (85-90% w/unknown cause); Secondary (chronic kidney disease, pheochromocytoma, renovascular hypertension, Cushings syndrome, primary aldosteronism, thyroid and parathyroid disease, drug-induced) --> treat the underlying conditions first |
| Goal of HTN drug therapy | ultimately to reduce CV morbidity and mortality; BP: <140/90 (for DM and CKD: <130/80) |
| Selection of the appropriate HTN therapy | lifestyle modifications (dec wt, dec alcohol intake, inc phys activity, dec Na intake, maintain K, Ca, Mg intake, dec sat fats/chol, stop smoking) and pharmacological (diuretics, ACE-i, ARBs, CCBs, b- & a-blocks, central a2agonists, adrenergic inhib) |
| Chlorothiazide (Diuril) | anti-HTN, thiazide diuretic, *the only IV thiazide available* |
| Hydrochlorothiazide (microzide, hydroDIURIL) | anti-HTN; thiazide diuretic |
| Polythiazide (renese) | anti-HTN, thiazide diuretic |
| Indapamide (lozol) | anti-HTN; thiazide diuretic |
| Metolazone (mykrox, zaroxolyn) | anti-HTN, thiazide diuretic |
| Bumetanide (bumex) | anti-HTN; loop diuretic; IV and PO |
| Furosemide (lasix) | anti-HTN; loop diuretic; IV and PO |
| Torsemide (demadex) | anti-HTN; loop diuretic; IV and PO |
| Ethacrynic acid (edecrin) | anti-HTN; loop diuretic |
| Amiloride (midamor) | anti-HTN; K-sparing diuretic |
| Triamterene (dyrenium) | anti-HTN; K-sparing diuretic |
| Benazepril (lotensin) | anti-HTN; ACE-i |
| Captopril (capoten) | anti-HTN; ACE-i |
| Enalapril (vasotec) | anti-HTN; ACE-i; IV formulation is enalaprilat |
| Fosinopril (monopril) | anti-HTN; ACE-i |
| Lisinopril (prinivil, zestril) | anti-HTN; ACE-i |
| Moexipril (univasc) | anti-HTN; ACE-i |
| Peridopril (aceon) | anti-HTN; ACE-i |
| Quinapril (accupril) | anti-HTN; ACE-i |
| Ramipril (altace) | anti-HTN; ACE-i |
| Trandolapril (mavik) | anti-HTN; ACE-i |
| Candesartan (atacand) | anti-HTN; ARB |
| Eprosartan (teveten) | anti-HTN; ARB |
| Irbesartan (avapro) | anti-HTN; ARB |
| Losartan (cozaar) | anti-HTN; ARB |
| Olmesartan (benicar) | anti-HTN; ARB |
| Telmisartan (micardis) | anti-HTN; ARB |
| Valsartan (diovan) | anti-HTN; ARB |
| Atenolol (tenormin) | anti-HTN; b-blocker, cardioselective |
| Betaxolol (kerlone) | anti-HTN; b-blocker, cardioselective |
| Bisoprolol (zebeta) | anti-HTN; b-blocker, cardioselective |
| Esmolol (brevibloc) | anti-HTN; b-blocker, cardioselective; IV only |
| Metoprolol (lopressor, toprol XL) | anti-HTN; b-blocker, cardioselective |
| Nadolol (corgard) | anti-HTN; b-blocker, non-cardioselective |
| Propanolol (inderal) | anti-HTN; b-blocker, non-cardioselective |
| Timolol (blocardren) | anti-HTN; b-blocker, non-cardioselective |
| Carteolol (cartrol) | anti-HTN; b-blocker with ISA, non-cardioselective |
| Penbutolol (levatol) | anti-HTN; b-blocker with ISA, non-cardioselective |
| Pindolol (visken) | anti-HTN; b-blocker with ISA, non-cardioselective |
| Acebutolol (sectral) | anti-HTN; b-blocker with ISA, cardioselective |
| Carvedilol (coreg) | anti-HTN; b-blocker with ISA, a/b-blockers |
| Labetalol (normodyne, trandate) | anti-HTN; b-blocker with ISA, a/b-blockers |
| Doxazosin (cardura) | anti-HTN; a-blocker |
| Prazosin (minipress) | anti-HTN; a-blocker |
| Terazosin (hytrin) | anti-HTN; a-blocker |
| Phentolamine (regitine) | anti-HTN; a-blocker; rarely used |
| Methyldopa (aldomet) | anti-HTN; central a2-blocker; **used in pregnancy-HTN** |
| Clonidine (catapres) | anti-HTN; central a2-blocker |
| Guanabenz (wytensin) | anti-HTN; central a2-blocker |
| Guanfacine (tenex) | anti-HTN; central a2-blocker |
| Guanethidine (ismelin) | anti-HTN; adrenergic inhibitors |
| Guanadrel (hylorel) | anti-HTN; adrenergic inhibitors |
| Reserpine | anti-HTN; adrenergic inhibitors |
| Amlodipine (norvasc) | anti-HTN; CCB; dihydropiridine (DHP) |
| Felodipine (plendil) | anti-HTN; CCB; dihydropiridine (DHP) |
| Isradipine (dynacirc CR) | anti-HTN; CCB; dihydropiridine (DHP) |
| Nicardipine (cardene) | anti-HTN; CCB; dihydropiridine (DHP) |
| Nifedipine long-acting (adalat CC, procardia XL) | anti-HTN; CCB; dihydropiridine (DHP) |
| Nisoldipine (sular) | anti-HTN; CCB; dihydropiridine (DHP) |
| Nimodipine (nimotop) | anti-HTN; CCB; dihydropiridine (DHP) |
| Diltiazem (cardizem) | anti-HTN; CCB; non-DHP |
| Verapamil (calan, isoptin) | anti-HTN; CCB; non-DHP |
| Hydralazine (apresoline) | anti-HTN; vasodilator |
| Minoxidil (loniten) | anti-HTN; vasodilator |
| Nitroprusside (nipride, nitropress) | anti-HTN; vasodilator |
| Diazoxide (hyperstat IV) | anti-HTN; vasodilator |
| Fenoldopan (corlopam) | anti-HTN; vasodilator |
Created by:
bscaryp