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ch 47

drugs for hypertension

Thiazide Diuretics - **FIRST LINE DRUGS FOR HYPERTENSION** - reduce blood volume and arterial resistance
Thiazide Diuretics: Hydrochlorothiazide - used most widely
Thiazide Diuretics adverse effects: - hypokalemia ( avoid by eating K+ rich foods) - dehydration, hyperglycemia, hyperuricemia
Loop Diuretics - Produce much greater diuresis than Thiazides -For patients who need greaer diuresis and with low GFR
Loop Diuretics adverse effects - hypokalemia, dehydration, hyperglycemia, HEARING LOSS
Potassium Sparing Diuretics - degree of diuresis is small only have modest hypotensive effects
Potassium Sparing Diuretics adverse effects - Hyperkalemia - NOT TO BE USED WITH OTHER DIURETICS OR K+ SUPPLEMENTS
Sympatholytics (Antiadrenergic Drugs) - suppress influence of the sympathetic nervous system 5 categories 1. Beta blockers 2. alpha 1 blockers 3. alpha/beta blockers 4. centrally acting alpha 2 angonist 5 adrenergic neuron blockers
Sympatholytics (Antiadrenergic Drugs): Beta Blockers ("OLOL") - less effective in African Americans
Sympatholytics (Antiadrenergic Drugs): Beta Blockers actions - decrease HR and contractility - supress reflex tachycardia - reduces release of renin from kidney - long term use reduces peripheral vascular resistance
Beta Blockers ADVERSE EFFECTS - bradycardia - decreased AV conduction - reduced contractility - NOT to be used on pt's w/ sick sinus syndrome or AV block -AVOIDED IN ASTHMA PATIENTS
Beta Blockers and diabetes - can mask signs of hypoglycemia
Beta Blockers SIDE EFFECTS -Depression, dreams, insomnia, sexual dysfunction
ALPHA 1 BLOCKERS ("OSIN") -prevent stimulation of alpha 1 receptors on arteries and veins preventing vasoconstriction
ALPHA 1 BLOCKERS ("OSIN"): disturbing side effect - Orthostatic hypotension - NOT TO BE USED AS FIRST LINE THERAPY
Alpha/ Beta Blockers : CARVEDILOL & LABETALOL "LOL' NOT OLOL - Unusual because they block both alpha and beta - side effects: bradycardia, AV Heart block, asthma, postural hypotension
Centrally Acting Alpha 2 Agonists (clonidine & methyldopa) - act within brainstem to suppress sympathetic outflow to the heart and blood vessels - Adverse effects: DRY MOUTH , sedation, rebound hypertension
Adrenergic Neuron Blockers: RESERPINE - Depletes NE from postganglionic sympathetic nerve terminals, reducing sympathetic stimulation of the heart and blood vessels
Adrenergic Neuron Blockers: RESERPINE adverse effects - depletes serotonin & catecholamines - DEEP DEPRESSION, NOT TO BE USED IN PATIENT WITH HX OF DEPRESSION!!!
Created by: KristinL