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HTN 2

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morauch630's version from 2017-12-08 03:02

Section

Question Answer
Propranolol (Inderal)‏ Beta – Blocker
Carteolol (Cartol)‏ Beta – Blocker
Nadolol (Corgard)‏ Beta – Blocker
Penbutolol (Levatol)‏ Beta – Blocker
Pindolol (Visken)‏Beta – Blocker
Sotalol (Betapace, Sotacor, Betapace AF)‏ Beta – Blocker. Used only for arrhythmias
Timolol (Blocadren)‏Beta – Blocker
Metoprolol (Lopressor, Toprol)‏Beta – Blocker
Atenolol (Tenormin)‏ Beta – Blocker
Acebutolol (Sectral)‏BB
Betaxolol (Kerlone)‏BB
Bisoprolol (Zebeta)‏BB
Esmolol (Brevibloc)‏BB. Only IV
Carvedilol (Coreg)‏BB. Has beta and alpha blocking properties
Labetalol (Normodyne, Trandate)‏BB. Has beta and alpha blocking properties
Nebivolol (Bystolic)BB. Highly beta – 1 selective
Prazosin (Minipress)Alpha - 1 blockers
Terazosin (Hytrin)‏Alpha - 1 blockers
Doxazosin (Cardura)‏Alpha - 1 blockers
Alfuzosin (Uroxatral)‏Alpha - 1 blockers
Tamsulosin (Flomax)‏Alpha - 1 blockers
Guanadrel (Hylorel)‏Peripherally active alpha – 2
ReserpinePeripherally active alpha – 2
Clonidine (Catapres)‏Centrally active alpha – 2
Guanabenz (Wytensin)‏Centrally active alpha – 2
Guanfacine (Tenex)‏Centrally active alpha – 2
Methyldopa (Aldomet)‏Centrally active alpha – 2
Hydralzine (Apresoline)‏Direct Vasodilators. IV and PO
Minoxidil (Loniten)‏Direct Vasodilator
Hydrochlorothiazide (HydroDiuril)‏Thiazide Diuretic
Chlorothiazide (Diuril)‏Thiazide Diuretic
Chlorthalidone (Hygroton)‏Thiazide Diuretic
Indapamide (Lozol)‏Thiazide Diuretic
Metolazone (Zaroxolyn)‏Thiazide Diuretic
Methyclothiazide (Enduron)‏Thiazide Diuretic
Triamterene (Dyrenium)‏Potassium sparing diuretic - Na channel blocker
Amiloride (Midamor)‏Potassium sparing diuretic - Na channel blocker
Spironolactone (Aldactone)‏Potassium sparing diuretic - Aldosterone antagonist
Eplerenone (Inspra)‏Potassium sparing diuretic - Aldosterone antagonist
Hydrochlorothiazide/amiloride (Moduretic)‏Potassium sparing diuretic - combo with thiazide
Hydrochlorothiazide/spironolactone (Aldactazide, Spirozide)‏Potassium sparing diuretic - combo with thiazide
Hydrochlorothiazide/triamterene (Dyazide, Maxzide)‏Potassium sparing diuretic - combo with thiazide
Furosemide (lasix)Loop Diuretic
Bumetanide (Bumex)Loop Diuretic
Torsemide (Demadex)Loop Diuretic
Ethacrynic acid (edecrin)Loop Diuretic. (IV prep only)
Captiopril (capoten)Ace inhibitor
Lisinopril (Zestil, Prinvil)Ace inhibitor
Benazepril (Lotensin)Ace inhibitor
Enalapril (Vasotec)Ace inhibitor
Quinapril (Accupril)Ace inhibitor
Moexipril (Univasc)Ace inhibitor
Ramipril (Altace)Ace inhibitor
Trandolapril (Mavik)Ace inhibitor
Fosinopril (Monopril)Ace inhibitor
Perindopril (Aceon)Ace inhibitor
Nifedipine (Procardia, Adalat)‏CCBs – (Dihydropyridines)‏ *comes in Immediate and sustained release
Amlodipine (Norvasc)‏ CCBs – (Dihydropyridines)
Felodipine (Plendil)‏ CCBs – (Dihydropyridines)
Isradipine (DynaCirc)‏ CCBs – (Dihydropyridines)
Nicardipine (Cardene)‏ CCBs – (Dihydropyridines) *Immediate and sustained release, Comes in an IV form for continuous infusion*
Nisoldipine (Sular)‏ CCBs – (Dihydropyridines)
Clevidipine (Cleviprex) CCBs – (Dihydropyridines ) IV & Lipid emulsion
Verapamil (Calan, Isoptin, Verelan)‏CCBs - (Phenylalkylamines)‏ *Immediate and sustained release, IV and PO*
Diltiazem (Cardizem, Tiazac, Cartia)‏CCBs - Names (Benzothiazepines)‏ *Immediate and sustained release, Two different types of SR, IV and PO*
memorize

Alpha receptors

Question Answer
Alpha 1 receptorsVasoconstriction, Decreased motility and tone of GI tract, Increased renin secretion, Gluconeogensis in the liver
Alpha 2 receptorsVasoconstriction
List 3 subtypes of alpha blockersAlpha -1 blockers, Centrally acting alpha – 2 blockers, Peripherally acting alpha – 2 blockers
memorize

Mechanism of action

Question Answer
Alpha – 1 BlockersBlockage of receptors causes: Dilatation of arterioles and veins, Relaxation of smooth muscle in prostate and bladder neck
Centrally Acting Alpha – 2 BlockersStimulation of inhibitory alpha receptors in the CNS. Leading to: Decreased peripheral vascular resistance, Decreased HR, Decreased renal vascular resistance
Peripherally Acting Alpha – 2 BlockersInhibit the release of norepinephrine from peripheral nerves - Vasodilatation
Direct Vasodilators – Mechanism of ActionRelaxation of arteriolar smooth muscle leading to decreased peripheral vascular resistance, Causes reflex increase in HR and renin release
memorize

Kinetics

Question Answer
Alpha – Blockers bioavailabilityvariable
Alpha – Blockers distributionMost are highly protein bound
Alpha – 1 blockers metabolismhepatically
Alpha – Blockers excretionbile
Direct Vasodilators distributionhigh first pass effect
Direct Vasodilators metabolismliver
Direct Vasodilators excretionrenal
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Adverse effects/drug interactions/Cautions

Question Answer
Alpha – Blockers – Adverse EffectsMarked hypotension, Especially with first few doses Alpha – 1 blockers, Urinary frequency, Dry mouth, Constipation, Headache, CNS depression, Drowsiness , Hallucinations (Reserpine)
Increased levels of alpha – blockers byAlcohol, beta – blockers, cimetidine, verapamil
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Increased effects of levodopa by methyldopa
Question Answer
Alpha – Blockers – CautionsAdditive hypotensive effects, Rebound hypertension with abrupt withdrawal of clonidine, Avoid driving or operating machinery until effects known, Warn patient of the possibility of syncope
Direct Vasodilators – Adverse EffectsTachycardia, Headache, Constipation, Nausea / vomiting, Dizziness, Angina (Minoxidil), Hair growth (Minoxidil)
Increased levels of hydralazine byBeta – blockers and indomethacin
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