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The flashcards below were created by user
kyleannkelsey
on FreezingBlue Flashcards.
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What should you monitor in patients on BBs?
- BP
- Heart rate
- Adverse effects
- Comorbidities
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What is the MOA of alpha-blockers?
Block postsynaptic alpa-receptors, causing vasodilation
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Name the alpha-blockers for HTN:
Prazosin, Terazosin and Doxazosin (-azosin)
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What group are alpha-blockers particularly useful in when treating HTN?
BPH (treats both at the same time)
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What are the Central alpha 2-agonists used for HTN?
- Methyldopa
- Clonidine
- Guanfacine
- Guanabenz
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What is the MOA of Central alpha 2-agonists?
- STIMULATE alpha- 2 receptors in CNS
- Inhibiting sympathetic outflow to Heart, kidneys, and periphery
- Decreases HR, CO and TPR
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What are Central alpha 2-agonists mainly used for?
Resistant Hypertension
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What antihypertensive drugs are likely to cause rebound HTN, so require tapering when coming off them?
Central alpha 2-agonists and BBs
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Most of the side effects of Central alpha 2-agonists are due to what issue?
Anticholinergic properties (Orthostatic hypotension, Sedation, Dizziness, Xerostomia, Fatigue)
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How should you discontinue a BB or Central alpha 2-agonists (no angina present)?
Over 4-5 days
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How should you discontinue a BB when angina is present?
Over 1-2 weeks
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How should you discontinue a Central alpha 2-agonists and a BB and why?
- Taper BB first
- Taper AA second
- (Vasoconstriction properties of the chatecholemines are unopposed if you do it the opposite way around)
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Central alpha 2-agonists require what monitoring?
BP and Side effects
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Which alpha 2 –agonist is most useful for menopause?
Clonidine
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Which alpha 2 –agonist is most useful for smoking cessation?
Clonidine
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Which alpha 2 –agonist is most useful for ADHD tics?
Clonidine and Guanfacine
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Which alpha 2 –agonist is most useful for Pregnancy?
Methyldopa (being replaced by Labetolol)
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Are alpha 2-agonists a good choice for elderly?
No
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What is the MOA of direct vasodilators?
Direct relaxation of arteriolar smooth muscle, activate baroreceptors
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What HTN related indication are Direct vasodilators most used for?
Resistant HTN
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Which drugs are direct vasodilators?
Hydralazine, Minoxidil
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Which is more potent: Minoxidil or Hydralazine?
Minoxidil
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What are the major side effects of direct vasodilators?
Reflex tachycardia, H20/Na retention, edema and Hypertrychosis
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Hydralazine should be given with what diuretic?
Thaizides
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Minoxidil should be given with what diuretic?
Loops
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Why would you give a direct vasodilator with a BB?
Reduce rebound tachycardia
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What is the MOA of adrenergic antagonists for HTN?
Decrease NE stores in periphery leading to decreased sympathetic tone
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What are the adrenergic antagonists used for HTN?
Reserpine
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What dose do you need to keep Reserpine under to minimize depression?
0.25mg/day
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HTN drugs to caution in Diabetes Mellitus
B -blocker, high-dose thiazides
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HTN drugs to recommend in Diabetes Mellitus
ACEI/ARBs, thiazides, CCB
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HTN drugs to caution in Asthma/COPD
Nonselective B-blocker
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HTN drugs to caution in PVD
Nonselective B-blocker
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HTN drugs CI in CHF
Nondihydropyridine CCB, clonidine
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HTN drugs to recommend in CHF
ACE-I, diuretics, B-blocker (bisoprolol, carvedilol, metoprolol succinate), aldosterone antagonists, ARB
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HTN drugs to caution in IHD
Hydralazine, minoxidil
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HTN drugs to recommend in IHD
B-blocker, ACE-I/ARB
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HTN drugs to caution in Gout/Hyperuricemia
Diuretics
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