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Antihypertensives

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Question
Answer
Hemodynamic Regulation: Autonomic Nervous System - Sympathetics   inc HR, inc myocardial contractility, vasoconstriction  
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Hemodynamic Regulation: Autonomic Nervous System - Parasympathetics   dec HR, dec myocardial contractility, vasodilation  
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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;  
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Hemodynamic Regulation: Renal System - Angiotensin II   causes vasoconstriction  
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Hemodynamic Regulation: Renal System - Aldosterone   causes Na/H2O retention  
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Hemodynamic Regulation: Local Vasodilators   Nitric Oxide and Prostaglandins  
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Hemodynamic Regulation: Local Vasoconstrictor   Endothelin-I  
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Definition of HTN   SBP >140mmHg or DBP >90; or currently on antihypertensive medication  
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Complications of HTN   heart failure, angina pectoris, myocardial infarction, stroke/transient ischemic attack, nephropathy, peripheral arterial disease, retinopathy  
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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  
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Goal of HTN drug therapy   ultimately to reduce CV morbidity and mortality; BP: <140/90 (for DM and CKD: <130/80)  
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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)  
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Chlorothiazide (Diuril)   anti-HTN, thiazide diuretic, *the only IV thiazide available*  
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Hydrochlorothiazide (microzide, hydroDIURIL)   anti-HTN; thiazide diuretic  
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Polythiazide (renese)   anti-HTN, thiazide diuretic  
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Indapamide (lozol)   anti-HTN; thiazide diuretic  
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Metolazone (mykrox, zaroxolyn)   anti-HTN, thiazide diuretic  
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Bumetanide (bumex)   anti-HTN; loop diuretic; IV and PO  
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Furosemide (lasix)   anti-HTN; loop diuretic; IV and PO  
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Torsemide (demadex)   anti-HTN; loop diuretic; IV and PO  
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Ethacrynic acid (edecrin)   anti-HTN; loop diuretic  
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Amiloride (midamor)   anti-HTN; K-sparing diuretic  
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Triamterene (dyrenium)   anti-HTN; K-sparing diuretic  
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Benazepril (lotensin)   anti-HTN; ACE-i  
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Captopril (capoten)   anti-HTN; ACE-i  
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Enalapril (vasotec)   anti-HTN; ACE-i; IV formulation is enalaprilat  
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Fosinopril (monopril)   anti-HTN; ACE-i  
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Lisinopril (prinivil, zestril)   anti-HTN; ACE-i  
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Moexipril (univasc)   anti-HTN; ACE-i  
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Peridopril (aceon)   anti-HTN; ACE-i  
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Quinapril (accupril)   anti-HTN; ACE-i  
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Ramipril (altace)   anti-HTN; ACE-i  
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Trandolapril (mavik)   anti-HTN; ACE-i  
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Candesartan (atacand)   anti-HTN; ARB  
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Eprosartan (teveten)   anti-HTN; ARB  
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Irbesartan (avapro)   anti-HTN; ARB  
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Losartan (cozaar)   anti-HTN; ARB  
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Olmesartan (benicar)   anti-HTN; ARB  
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Telmisartan (micardis)   anti-HTN; ARB  
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Valsartan (diovan)   anti-HTN; ARB  
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Atenolol (tenormin)   anti-HTN; b-blocker, cardioselective  
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Betaxolol (kerlone)   anti-HTN; b-blocker, cardioselective  
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Bisoprolol (zebeta)   anti-HTN; b-blocker, cardioselective  
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Esmolol (brevibloc)   anti-HTN; b-blocker, cardioselective; IV only  
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Metoprolol (lopressor, toprol XL)   anti-HTN; b-blocker, cardioselective  
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Nadolol (corgard)   anti-HTN; b-blocker, non-cardioselective  
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Propanolol (inderal)   anti-HTN; b-blocker, non-cardioselective  
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Timolol (blocardren)   anti-HTN; b-blocker, non-cardioselective  
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Carteolol (cartrol)   anti-HTN; b-blocker with ISA, non-cardioselective  
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Penbutolol (levatol)   anti-HTN; b-blocker with ISA, non-cardioselective  
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Pindolol (visken)   anti-HTN; b-blocker with ISA, non-cardioselective  
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Acebutolol (sectral)   anti-HTN; b-blocker with ISA, cardioselective  
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Carvedilol (coreg)   anti-HTN; b-blocker with ISA, a/b-blockers  
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Labetalol (normodyne, trandate)   anti-HTN; b-blocker with ISA, a/b-blockers  
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Doxazosin (cardura)   anti-HTN; a-blocker  
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Prazosin (minipress)   anti-HTN; a-blocker  
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Terazosin (hytrin)   anti-HTN; a-blocker  
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Phentolamine (regitine)   anti-HTN; a-blocker; rarely used  
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Methyldopa (aldomet)   anti-HTN; central a2-blocker; **used in pregnancy-HTN**  
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Clonidine (catapres)   anti-HTN; central a2-blocker  
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Guanabenz (wytensin)   anti-HTN; central a2-blocker  
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Guanfacine (tenex)   anti-HTN; central a2-blocker  
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Guanethidine (ismelin)   anti-HTN; adrenergic inhibitors  
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Guanadrel (hylorel)   anti-HTN; adrenergic inhibitors  
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Reserpine   anti-HTN; adrenergic inhibitors  
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Amlodipine (norvasc)   anti-HTN; CCB; dihydropiridine (DHP)  
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Felodipine (plendil)   anti-HTN; CCB; dihydropiridine (DHP)  
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Isradipine (dynacirc CR)   anti-HTN; CCB; dihydropiridine (DHP)  
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Nicardipine (cardene)   anti-HTN; CCB; dihydropiridine (DHP)  
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Nifedipine long-acting (adalat CC, procardia XL)   anti-HTN; CCB; dihydropiridine (DHP)  
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Nisoldipine (sular)   anti-HTN; CCB; dihydropiridine (DHP)  
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Nimodipine (nimotop)   anti-HTN; CCB; dihydropiridine (DHP)  
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Diltiazem (cardizem)   anti-HTN; CCB; non-DHP  
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Verapamil (calan, isoptin)   anti-HTN; CCB; non-DHP  
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Hydralazine (apresoline)   anti-HTN; vasodilator  
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Minoxidil (loniten)   anti-HTN; vasodilator  
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Nitroprusside (nipride, nitropress)   anti-HTN; vasodilator  
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Diazoxide (hyperstat IV)   anti-HTN; vasodilator  
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Fenoldopan (corlopam)   anti-HTN; vasodilator  
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