| Term | Definition |
|---|
| diuretics, efficacy | greater in blacks and elderly; used to augment anti-htn effects of other drugs |
| diuretics, contraindications | hyperlipidemia: tend to elevate plasma LDL and TG |
| ß-adrenergic antagonists, efficacy | smokers respond poorly |
| ß-adrenergic antagonists, MOA heart | heart: decreases HR/contractility results in decreased BP |
| ß-adrenergic antagonists, MOA in kidney | decreased renin release, thus decreased Ang II |
| ß-adrenergic antagonists, adverse effects | asthma: exacerbation with non-specific antagonists; HYPERLIPIDEMIA; male sexual dysfunction; masks signs of hypoglcemia in DM; may exacerbate CHF |
| labetalol and carvedilol, MOA | block alpha 1, ß1 and ß2 |
| carvedilol and labetalol, uses | very good efficacy in lowering blood pressure especially in presence of heart failure; PO for long-term management of CHF and hypertension (labetalol and carvedilol); IV for treatment of hypertensive emergencies (labetalol only) |
| clonidine, MOA | pre-synaptic alpha2-agonist in periphery: decreases NE release from post-ganglionic nerve terminals; won't see reflex tachy b/c blocking sympathetics |
| alpha methyldopa, consideration | drug of choice for treatment of chronic hypertension in women in their child-bearing years |
| alpha methyldopa, adverse effect | + direct Coombs test (presence of auto-antibodies to RBCs) producing a frank hemolytic anemia |
| prazosin, terazosin, doxazosin; MOA | selective antagonist at vascular smooth muscle alpha1 receptors |
| prazosin, terazosin, doxazosin; added benefit | lowers LDL, TG and total chol. (improves poor lipid profile) |
| verapamil and diltiazem; MOA | direct vasodilator activity by inhibiting both Ca+2 entry into vascular smooth muscle and Ca+2 release from the sarcoplasmic reticulum |
| verapamil/diltiazem, adverse effects | cardiodepression (may counteract baroreceptor mediated reflex tachycardia) |
| nifedipine, MOA | same as verapamil/ diltiazem (inhibit calcium entry into vascular smooth m.) but greater vascular effect and significantly less cardiodepressant activity |
| nifedipine, adverse effects | PROMINENT REFLEX TACHYCARDIA (use with a ß-blocker) |
| hydralazine, MOA | direct vasodilation via guanylate cyclase stimulation (similar to nitrovasodilators) |
| hydralazine, considerations | tachyphylaxis due to prominent baroreflex perturbation leading to increased HR, increased CO, increased Na+/water retention (sympathetic stimulation of renin release); use ß-blockers and diuretics as concommitant therapy |
| hydralazine, adverse effects | SLE-like syndrome (metabolism by N-acetylation); palpitation/tachycardia |
| minoxidil, MOA | direct arteriolar vasodilation via stimulation of vascular smooth muscle K+ channel opening |
| minoxidil, uses | only for severe, refractory hypertension |
| minoxidil, considerations | tachyphylaxis due to baroreflex-mediated increases in sympathetic tone; use with ß-blocker and diuretic |
| sodium nitroprusside, uses | parenterally infused agent used in hypertensive emergencies and the rapid management of CHF |
| sodium nitroprusside, MOA | donates NO (EDRF) -> cGMP-mediated Ca+2 sequestration |
| sodium nitroprusside, adverse effects | extended continuous infusion may produce methemoglobinemia, CYANIDE poisoning and cell death due to inhibition of cellular respiration |
| captopril, enalapril, lisinopril, class | ACE-inhibitors;examples of |
| ACE-inhibitors, considerations | less efficacy in African-Americans as monotherapy |
| ACE-inhibitors, adverse effects | dry persistant cough d/t increased bradykinin; CONTRAINDICATED DURING PREGNANCY |
| Angiotensin receptor blockers: "-sartan"; MOA | specific antagonists of angiotensin II at AT1 receptors on vascular smooth muscle |
| Angiotensin receptor blockers, adverse effects | minimal side effects (thus most popular antiHTN class), no cough, PREGNANCY CONTRAINDICATION |
| hydralazine, uses | use limited to resistant, fulminant hypertension and management of hypertensive emergency |
Combine with other sets
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