MOA
Diuretics
Decrease plasma and stroke volumes which decreases cardiac output and lowers BP.
can cause hepatic toxicity and hemolytic anemia
FOR FUN :)
What drug is used in patients that are pregnant with HTN
Methyldopa
What does thiazides interact with?
Lithium
Who are the Direct Vasodilators
Hydralazine and Minoxidil
Thiazides
inhibit NA+ and Cl- reabsorption in the distal convoluted tubule by inhibition of the Na-Cl cotransport. This increases the excretion of Na and Cl and causes relaxation of vascular smooth muscle.
Side effects of thiazides
Hypokalemia, Hypercalemia, hypomagnesium, hyperglycemia, hyperurecemia, sexual dysfunction, dyslip
Clorthaladone 12.5-25
Hydroclorithiazide 12.5-50
Indabapide
Mometazone 2.5-5 HTN and 5-20 in CHF and renal
What are the drug reactions of ACE's
1. NSAIDS- can cause acute kidney injury and reduce antihypertensive response
2. K-sparing diuretics may exacerbate ACE
What do direct vasodilators do aka MOA
directly relax arteriolar smooth muscle resulting in vasodilation and BP lowering
Loop
Prevent Na reabsorption in the thick ascending loop of henle, through inhibition of Na-K-2Cl cotransport.
Side effects of loop
HypOkalcemia, HypOcalemia, hypomagneisum, hyperglycemia, dyslip, hyperuricemia and OTOTOXCITY
Drugs in Loop class
Forosemide 10-40
Toresmide 5-10
Ethycrynic acid 25-100
Butemide .5-10
What are the drug reactions of ARBS
DO NOT USE WITH ACE
What are the side effects of direct vasodilators
H: lupus like syndrome
M: hypertrichosis
K-sparing
blocks Na channels in the late distal tubule and collecting ducts which inhibit Na reabsorption from the lumen. It decreases the function of the Na/K ATPase pump which results in K retention.
S: ED, gynecomastia, BPH
E: NONE
Spironlactone
Epleronone
What are the drug reactions of CCB's?
DO not use with BB, digoxin, clonidine and amiodarone because it will decrease HR.
Do not use with other CYP3A4 inhibitors or inducers
Who causes rebound HTN
beta blockers
block the conversion of angiotensin 1 to angiotensin 2. Decreases systolic and diastolic blood pressure, and aldosterone.
What are the side effects for benzapril, enalapril, etc?
Acute kidney injury, hypotension, angioedema, dry cough, hyperkalemia
What are the ACES
Benzapril 20-40
Enalapril 10-40
Lisinopril 10-40
Ramipril 2.5-20
Captopril 25-50
FOR FUN: WHAT DRUG HAS A TENDENCY TO CAUSE orthostatic hypotension, sedation, dry mouth and vision distrubances
Central alpha 2 agonists aka: clonidine, guanabenz, guanfacine and methyldopa
What is the first line in African Americans
Thiazide and CCB