Diuretics
Thiazides place in therapy
1st line HTN?
Quinapril drug class
ACEI
Calcium channel blockers place in therapy
1st line HTN
Bonus: 1st line in African Americans
Which beta blocker is cardioselective with ISA
Acebutolol
Mechanism of action alpha antagonists
Antagonize A1 receptors to decrease sympathetic NS effects, decrease PVR
What is the most commonly used alpha agonist?
Clonidine
Class of metolazone
Thiazide
Less effective in low renin producers
What is the difference between DHPs and NDHPs?
DHPs are highly vascular selective and NDHPs are cardiac selective
Cardioselective beta blockers
Alpha antagonists place in therapy
4th-5th line HTN, potent vasodilators, 1st line for BPH
Alpha agonists place in therapy
5th line and beyond for HTN
Demographic efficacy of potassium sparing diuretics
Effective in all
ARBs mechanism of action
Blocks action of angiotensin II at receptor site
What is the difference between Verapamil and Diltiazem?
Diltiazem has less cardiac selectivity and less chronotropic and inotropic effects
What type of beta blocker is labetalol?
Alpha/beta blocker
Which alpha antagonists are used for HTN and BPH?
Terazosin and doxazosin
Alpha agonists mechanism of action
Stimulates A2 receptors in CNS, inhibiting sympathetic outflow causing vasodilation leading to decreased PVR and CO
Mechanism of action of loop diuretics
Decreased reabsorption of Na+ in loop of Henle
What makes Moexpril stand out from other ACEIs?
Hepatically cleared rather than renally
Adverse effects of DHPs
Peripheral edema, orthostatic hypotension, reflex tachycardia
Beta blockers place in therapy
Used after preferred agents for HTN, angina, and migraine prophylaxis
3 adverse effects of alpha antagonists
First dose effect - orthostatic hypotension with palpitations, syncope, reflex tachycardia, postural hypotension, worsens stress incontinence
What is the extended release form of clonidine used for ADHD?
Kapvay
What makes ethacrynic acid stand out among loop diuretics?
It is not a sulfonamide and can be used with a sulfa allergy
4 adverse effects of ACEI
Cough, angioedema, renal dysfunction, fetal anomalies, hyperkalemia, hypotension with 1st doses
Other than HTN, what can NDHPs be used for?
Supraventricular tachyarrhythmias, ventricular rate control in a fib
4 adverse effects of beta blockers
Tiredness, decreased exercise capacity, ED, increased SVR, bronchospasm with non-selective agents, increased triglycerides, decreased HDL, tachycardia from upregulation, angina, possible MI
What is required with long term use of alpha antagonists?
Diuretics
Adverse effects of alpha agonists
Potentially severe rebound HTN with abrupt discontinuation, dry mouth, drowsiness, depression, constipation, ED, N/V, weakness, fatigue?