Notes in antihypertensives

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Published	09/08/2024	Thiazide diuretics enter tubules by {{c1::filtration}} and {{c1::organic acid transporter}}
Published	09/08/2024	Thiazide Diuretics inhibits {{c1::Na+ absorption}} at {{c2::distal convoluted tubule}}
Published	09/08/2024	side effects of thiazide diuretics are:“AHH DANG!” - {{c1::Allergy (rash) - Hypokalemia -Hypomagnesemia - Dehydration - Alkalosis (metabolic) - Nephri…
Published	09/08/2024	metabolism of thiazide diuretics are {{c1::primarily renal}}
Published	09/08/2024	the 5 types of thiazide diuretics are: MICCH {{c1::Metolazone, Indapamide, Chlorothalidone,  Chlorothiazide, Hydrochloro…
Published	09/08/2024	{{c1::Chlorothiazide}} is the only type of thiazide diuretic available IV
Published	09/08/2024	{{c1::thiazide diuretics}} have a 1-2 hr onset and a typically 12-36 hour duration
Published	09/08/2024	Thiazide Diuretics are used for {{c1::hypertension}} and {{c1::heart failure }}
Published	09/08/2024	•Loop diuretics enter {{c1::proximal tubules}} by {{c2::organic acid transporter}}
Published	09/08/2024	Loop Diuretics inhibit {{c1::Na+/Cl- absorption}} at {{c2::ascending Loop of Henle}}
Published	09/08/2024	side effects of loop diuretics are “OHH DAANG!”- {{c1::Ototoxicity - Hypokalemia-Hypomagnesemia - Dehydration - Allergy (rash) - Alkalosis (metab…
Published	09/08/2024	metabolism of loop diuretics is {{c1::primarily renal}}
Published	09/08/2024	(FEBT) {{c1::Furosemide, Ethacrynic acid, Bumetanide, Torsemide }} are loop diuretics
Published	09/08/2024	{{c1::loop diuretics}} have a very rapid (0.5-1hr) onset and a rapid (2-8hrs) duration
Published	09/08/2024	all loop diuretics are available {{c1::IV and PO}}
Published	09/08/2024	Must be cautious of {{c1::ototoxicity}} with IV loop diuretics. If the pt is not making enough urine, the drug concentration is building up in the bod…
Published	09/08/2024	{{c1::Loop Diuretics}} are used for heart failure, hypertension, and acute/chronic hyperkalemia
Published	09/08/2024	aldosterone antagoinsts block effects of {{c1::aldosterone}} in {{c2::distal tubules }}
Published	09/08/2024	Na+/K+ exchange inhibitors inhibit Na+/K+ exchange in {{c1::collecting duct, distal tubule}} – secreted into {{c2::lumen}} by {{c3::proximal tubule ce…
Published	09/08/2024	K+ sparing diuretics work on the K+ exchange at {{c1::distal renal tubules}}
Published	09/08/2024	Hyperkalemia, Gynecomastia, Breast tenderness, Hirsutism are side effects of {{c1::spironolactone (aldactone)}}
Published	09/08/2024	{{c1::hyperkalemia}} is a side effect  of all K+ sparing diuretics
Published	09/08/2024	a {{c1::rash}} is a side effect of all Na+/K exchange inhibitors
Published	09/08/2024	{{c1::spironolactone}} has avery slow (2-3 days) onset and a very slow (2-3 days) duration
Published	09/08/2024	K+ sparing diuretics are available in {{c1::PO}}
Published	09/08/2024	all k+ sparing diuretics metabolize by the liver except {{c1::amiloride}} which is metabolized by the {{c2::kidneys}} as an {{c2::unchanged drug}…
Published	09/08/2024	Aldosterone Antagonists (spironolactone, eplerenone) are used for:  (4) HHHC{{c1::Heart Failure - volume overload, slows progression of HF •Hyper…
Published	09/08/2024	•Na+/K+  Exchange Inhibitors (amiloride, triamterene) are used for:  (3) {{c1::Hypertension (rarely used) •Volume overload Chronic Hypokalem…
Published	09/08/2024	calcium channel blockers cause {{c1::vasodilation}} of mainly {{c1::arteriolar smooth}} muscle
Published	09/08/2024	calcium channel blockers cause a decrease of (3) {{c1::myocardial contractility, AV conduction velocity, and SA node pacemaker rate }}
Published	09/08/2024	Dihydropyridines and non-Dihydropyridines affect the coronary arteries by increasing vaso-{{c1::dilation}} and increasing {{c1::o2 supply}}
Published	09/08/2024	Dihydropyridines affect the peripheral veins by minimal vaso-{{c1::dilation}} and the arterioles by decreasing {{c2::bp (afterload)}} and decreasing {…
Published	09/08/2024	15cdc9c64dcf42408eff264fde2117fd-oa-1
Published	09/08/2024	15cdc9c64dcf42408eff264fde2117fd-oa-2
Published	09/08/2024	15cdc9c64dcf42408eff264fde2117fd-oa-3
Published	09/08/2024	Dihydropyridines CCBs are {{c2::arterial}} vaso{{c1::dilators}}
Published	09/08/2024	Non-dihydropyridines (NDHP) have a negative {{c1::inotropic (weaken the heart's contractions and slow the heart rate)}} and {{c1::chronotropic effect …
Published	09/08/2024	Verapamil and Diltiazem are metabolized through the {{c3::liver}} and affect the {{c2::CYP3A4}} enzyme system increasing the risk …
Published	09/08/2024	side effects on {{c1::NDHP}} are Brady-arrhythmias, Hypotension, Constipation, Gingival hyperplasia, rash
Published	09/08/2024	NDHPs are available (3) {{c1::PO, intermittent IV injection or IV infusion}}
Published	09/08/2024	the onset/duration of {{c1::NDHPs}} is very quick (2hrs/6hrs), (2-3 min/2 hrs IV)
Published	09/08/2024	DHPs all end in {{c1::-dipine}}
Published	09/08/2024	{{c1::Nicardipine}} is the only DHP available in IV. All DHPs are available {{c2::PO.}}
Published	09/08/2024	DHPs are {{c1::hepatic}} metabolism but have fewer {{c1::drug interactions}}
Published	09/08/2024	side effects of DHPs are (2) {{c1::pedal edema and reflex tachycardia}}
Published	09/08/2024	{{c1::Amlodipine}} is very long acting. Although BP will not rebound because of one missed pill, it takes a couple of days for it to fully work.
Published	09/08/2024	Pedal edema caused by DHP is not responsive to {{c1::diuretics }}
Published	09/08/2024	•NDHP is used for: HSVVM •{{c1::Hypertension •Stable angina •Ventricular Rate Control – arrythmias •Vascular Vasospasm •Migraine prophylaxis}}
Published	09/08/2024	•DHP is used for HSV •{{c1::Hypertension •Stable angina •Vascular vasospasm}}
Published	09/08/2024	B1 receptors are located on the {{c1::heart and kidneys}}
Published	09/08/2024	B2 receptors are located in the {{c1::lungs}}
Published	09/08/2024	activation of B1 receptors  {{c1::↑}}HR/Contractility, {{c1::↑}}BP  Blockade of B1 receptros  {{c1::↓}} HR/Contractility, {{c1::↓}}BP
Published	09/08/2024	activation of B1 receptors in the kidneys {{c1::↑}} renin release, {{c1::↑}}BP Blockade of B1 receptors in the kidneys  {{c1::↓}} renin rele…
Published	09/08/2024	activation: of B2 receptors in the lungs cause Broncho{{c1::dilation}} blockade of B2 receptors in the lungs cause Broncho{{c1::constriction}}, Bronch…
Published	09/08/2024	α1 (alpha) receptors are located on {{c1::vasculature }}
Published	09/08/2024	activation of α1 (alpha) receptors cause vaso{{c1::constriction}}
Published	09/08/2024	blockade of α1 (alpha) receptors cause vaso{{c1::dilation}}
Published	09/08/2024	Beta Blockers block {{c1::activation}} of Beta receptors & block {{c1::renin release}} from kidneys
Published	09/08/2024	{{c1::B1 specific}} B-blockers cause more side effects than {{c1::nonspecific}} such as fatigue, depression, decrease in exercise tolerance, maybe hal…
Published	09/08/2024	{{c1::Nebivolol}} and {{c1::Metoprolol}} are the only B1 specific BBs that have moderate lipid solubility while the rest have low
Published	09/08/2024	{{c1::Metoprolol}} and {{c1::Esmolol}} are additionally available as an IV while the rest of the specific B1 BBs are only available PO
Published	09/08/2024	(BAE-MAN) {{c1::Bisoprolol, Atenolol, Esmolol, Metoprolol, Acebutolol, Nebivolol}} are B1 specific BBs
Published	09/08/2024	{{c1::Esmolol}} is RBC esterases metabolized
Published	09/08/2024	all nonspecific BBs are {{c1::hepatic}} metabolism
Published	09/08/2024	(BAE) {{c1::bisoprolol, atenolol, and esmolol}} are the only BBs not metabolized by the liver. BA {{c1::bisoprolol, atenolol}} is metabolized by …
Published	09/08/2024	of the BBs, {{c1::Propranolol}} has a high lipid solubility meaning it can more easily penetrate the blood brain barrier and cause more CNS side …
Published	09/08/2024	{{c1::nonspecific BBs}} have side effects of  Drowsiness, lethargy, confusion, bronchoreactive events, AV nodal blockade
Published	09/08/2024	{{c1::BBs}} are not a preferred anti-HTN drug
Published	09/08/2024	Beta Receptor Blockers (BBs) are used for SSHH MV•{{c1::•Stage FrightStable angina •Heart Failure (carvedilol, metoprolol XL, bisoprolol) •Hypertensio…
Published	09/08/2024	which BBs are used to treat heart failure?{{c1::carvedilol, metoprolol XL, bisoprolol}}
Published	09/08/2024	nonspecific beta blockers are: CLN-PPT{{c1::caverdilollapetalolnadololpropranololpindololtimolol}}
Published	09/08/2024	non-dihydropyridines are: {{c1::verapamil and diltiazem}}
Published	09/08/2024	dihydrophyrdines are: Fan inn{{c1::felodipineamlodipinenifedipineisradipinenicardipinenisoldipine}}
Published	09/08/2024	Na/K+ exchange inhibitors are {{c1::amiloride and triamterene}}
Published	09/08/2024	aldosterone antagonist drugs are: {{c1::spironolactone and eplerenone}}
Published	09/08/2024	{{c1::Direct renin inhibitors (aliskiren)}} act on renin to stop it from converting angiotensiogen to angiotensin I
Published	09/08/2024	{{c1::ACEIs (r-prils)}} act on ACE to stop angiotensin I from converting to angiotensin II
Published	09/08/2024	{{c1::ARBs (r-sartan)}} inhibit angiotensin II
Published	09/08/2024	ACEIs are BCEF- LM-PQRT {{c1::benazepril, captopril, enalapril, fosinopril, and lisinopril, moexipril, perindopril, quinapril, ramipril, trandolapril}…
Published	09/08/2024	{{c1::Captopril}}  is the shortest acting of the ACEI - can be dosed 3-4 times a day -> nice for inpatient -> bad for outpatient compliance…
Published	09/08/2024	metabolism of ACEIs is {{c1::primarily renal}}
Published	09/08/2024	side effects of {{c1::ACEIs}} is Hyperkalemia, Angioedema, Acute Kidney Injury, Cough, Hypotension
Published	09/08/2024	{{c1::Enalapril}} is the only ACEIs available IV. All are available PO.
Published	09/08/2024	onset/peak/duration of {{c1::ACEIs}} is typically 1/2-6/24hrs
Published	09/08/2024	ARBs are VLETO-C {{c1::candesartan, irbesartan, losartan, olmesartan, telmisartan, valsartan}}
Published	09/08/2024	ARBs are available {{c1::PO}}
Published	09/08/2024	onset/peak/duration of {{c1::ARBs}} is typicall 1/2/24 hours
Published	09/08/2024	metabolism of ARBS is {{c1::primarily renal}}
Published	09/08/2024	Hyperkalemia, ?Angioedema, Acute Kidney Injury, Hypotension ar side effects of {{c1::ARBs}}
Published	09/08/2024	ARBS bind to {{c1::A-II receptors}} on {{c1::vasculature}}
Published	09/08/2024	a renin inhibitor medication is {{c1::Aliskiren}}
Published	09/08/2024	Aliskiren is available {{c1::PO}}
Published	09/08/2024	onset/peak/duration of {{c1::aliskiren}} is 1/2wks/24hrs
Published	09/08/2024	metabolism of aliskiren is {{c1::primarily renal}}
Published	09/08/2024	{{c1::aliskiren}} is not used often and there are nolarge trials pointing to a reduction in cardiac events
Published	09/08/2024	if ACEs, potentially ARBs, and renin inhibtors cause angioedema, immediately {{c1::discontinue use}} and start {{c2::close clinical observation}} of {…
Published	09/08/2024	BBs end in {{c1::-lol}}
Published	09/08/2024	DHP CCBs end in {{c1::-dipine}}
Published	09/08/2024	{{c2::Inotropy}}: The ability to influence the {{c1::force}} of cardiac muscle {{c1::contraction}}.
Published	09/08/2024	{{c1::Chronotropic}}: The ability to influence {{c2::heart rate}}
Published	09/08/2024	{{c1::Bisacodyl}} (Dulcolax)
Published	09/08/2024	{{c1::Bismuth Subsalicylate}} (Pepto-Bismol)
Published	09/08/2024	{{c1::Diphenhydramine}}  (Benadryl)
Published	09/08/2024	Within the glomerulus, efferent arterioles are particularly sensitive to {{c1::angiotensin 2}}.  {{c1::Angiotensin 2}} preferentially constr…
Published	09/08/2024	ACEs or ARBs cause relative {{c2::efferent}} arteriole dilation which makes the glomerulus lose filtration pressure so the kidney is not able to do it…
Published	09/08/2024	With ACEIs and ARBs, want a BMP to check {{c1::serum creatinine}} and {{c1::potassium}} levels. It is normal for there to be an elevation in levels wh…
Published	09/08/2024	In a HTN patient and a heart failure patient -> ACEIs can be {{c1::kidney protective}}
Published	09/08/2024	if serum creatinine levels are {{c1::STABLE}}, it is okay to use ACEIs/ARBS for patients with CKD
Published	09/08/2024	if a patient develops a cough when using ACEIs, try switching them to an {{c1::ARB}}
Published	09/08/2024	Peripheral Alpha-1 Receptor Blockers end in {{c1::-zosin}}
Published	09/08/2024	Peripheral Alpha-1 Receptor Blockers block {{c1::alpha-1}} receptors throughout the body
Published	09/08/2024	Peripheral Alpha-1 Receptor  Blockers are all available {{c1::PO}}
Published	09/08/2024	Peripheral Alpha-1 Receptor  Blockers cause {{c1::vasodilation}} which drops BP
Published	09/08/2024	Peripheral Alpha-1 Receptor  Blockers are not a 1st line drug for HTN, but used as an {{c1::add-on }}
Published	09/08/2024	{{c1::Peripheral Alpha-1 Receptor Blockers}} typically have a 2hr onset and 10-18 hr duration
Published	09/08/2024	Peripheral Alpha-1 Receptor  Blockers are metabolized by {{c1::hepatic }}
Published	09/08/2024	SEs {{c1::of Peripheral Alpha-1 Receptor  Blockers}} are first dose syncope, dizziness, lethary
Published	09/08/2024	{{c1::hydralazine}} and {{c1::minoxidil}} are {{c2::direct acting arterial vasodilators}}
Published	09/08/2024	Downside of {{c2::hydralazine}} is that it must be given {{c1::3-4}} times a day so it is less patient friendly
Published	09/08/2024	Reflex tachycardia, drug induced lupus (rash) are SEs of {{c1::hydralazine }}
Published	09/08/2024	direct acting arterial vasodilators are {{c1::hepatic}} metabolism
Published	09/08/2024	Hair growth and Sodium/water retention are SEs of {{c1::minoxidil }}
Published	09/08/2024	Alpha-2 receptors are negative feedback of alpha 1 receptors. So when alpha-2 receptors are stimulated, it causes {{c1::vasodilation}} as opposed to w…
Published	09/08/2024	Alpha-2 receptor agonists stimulate {{c1::vasodilation}}
Published	09/08/2024	clonidine and methyldopa are {{c1::Alpha-2 receptor agonists}}
Published	09/08/2024	Alpha-2 receptor agonists are {{c1::primarily hepatic}} metabolism
Published	09/08/2024	both {{c3::Alpha-2 receptor agonists}} cause Dry mouth, sedation, mental status, and confusion, except {{c2::clonidine}} also causes {{c1::rebound hyp…
Published	09/08/2024	Guanfacine & Guanabenz – centrally acting {{c1::alpha-2 agonists}}, rarely used for HTN
Published	09/08/2024	{{c1::Thiazides, Loops, ACEI, ARB, BB, Aldosterone blockers}} are initial therapy options for compelling indications for treating HFrEF and HFpEF
Published	09/08/2024	{{c1::BB, ACEI, ARB, Aldosterone blockers}} are initial therapy options that have compelling indications to treat post-MIs
Published	09/08/2024	{{c1::BB, ACEI, CCB, Thiazides}} are initial therapy options that have compelling indications to treat CAD
Published	09/08/2024	Compelling Indication refers to a clinical scenario where HTN + another existing comorbidity may be treated with a {{c1::single drug}}
Published	09/08/2024	{{c1::Thiazides, ACEI, ARB, CCB}} are Initial Therapy Options that have compelling indications to treat {{c2::diabetes }}
Published	09/08/2024	{{c1::ACEI, ARB}} are initial Therapy Options that have compelling indications to treat {{c2::CKD}}
Published	09/08/2024	{{c2::Thiazides, ACEI}} are initial Therapy Options that have compelling indications for {{c1::Recurrent Stroke Prevention}}
Published	09/08/2024	{{c1::BB, NDHP CCB}}  (for ventricular rate ctrl) are initial Therapy Options that have compelling indications to treat {{c2::Atrial Fi…
Published	09/08/2024	{{c2::Methyldopa, Labetalol, Nifedipine}} are initial Therapy Options that have compelling indications to use in {{c1::pregnant pts }}
Published	09/08/2024	NEVER use a dual therapy combination of {{c1::ACEIs}} and {{c2::ARBs}} for therapy
Published	09/08/2024	CCBs can be used as a dual combination therapy with {{c1::thiazides, ACEIs, and ARBS }}
Published	09/08/2024	Thiazides can be used as a dual combination therapy with {{c1::ACEIs, ARBs, and CCBs}}
Published	09/08/2024	{{c1::Beta Blockers}} are not a preferred anti-HTN agent in absence of comorbid conditions (e.g. HF, CAD)
Published	09/08/2024	If you need triple combination therapy for HTN, consider: {{c1::ACE/or ARB + THIAZIDE + CCB}}
Published	09/08/2024	{{c2::Diuretics}} work well in all ethnicities but especially for {{c1::African American}} patients
Published	09/08/2024	Diuretics should be used with caution in {{c1::elderly}} patients -> increase in urine production, so take patient should take it in the morning or…
Published	09/08/2024	If {{c1::diuretics}} are not used as first line, then excellent add on agent (2nd or 3rd)
Published	09/08/2024	As anti-HTN medications: {{c1::Thiazides}}  are better than {{c2::K+ sparing}} and {{c2::loop diuretics}} which are about {{c3::equal}}.&nbs…
Published	09/08/2024	want to  administer diuretics {{c1::early}} in the day
Published	09/08/2024	check {{c1::Metabolic Panel (SCr, K, Mg)}} when prescribing diuretics
Published	09/08/2024	{{c2::CCBs}} and {{c2::Duretics}} work well in all ethnicities but especially in {{c1::African-American}} patients
Published	09/08/2024	{{c1::CCBs}} work well in elderly
Published	09/08/2024	{{c2::Beta Blockers}} may mask signs of {{c1::hypoglycemia}}
Published	09/08/2024	Use BBs with caution in patients with {{c1::asthma (cause bronchoconstriction), diabetes}}
Published	09/08/2024	{{c2::RAAS}} meds work well in all ethnicities & the elderly but are not as effective in African American patients so need to add a {{c1::diuretic…
Published	09/08/2024	Use RAAS meds with caution in r{{c1::enal insufficiency/dialysis}} or {{c1::dynamic renal fxn}}
Published	09/08/2024	•Check {{c1::Metabolic Panel (SCr, K)}} when prescribing RAAS meds
Published	09/08/2024	{{c1::Alpha-1 Receptor  Blockers}} are reserved for unique cases: males with {{c2::benign prostatic hypertrophy}}.
Published	09/08/2024	{{c1::Alpha-1 Receptor  Blockers}} have Adverse Effects of 1st dose syncope, dizziness, lethargy
Published	09/08/2024	{{c2::Alpha-1 Receptor  Blockers}} cause an ↑ in {{c1::CV events}} when used as monotherapy
Published	09/08/2024	{{c1::Alpha2-receptor Agonists}} are used as add-on therapy if target BP not achieved or ADRs intolerable on first line therapies
Published	09/08/2024	{{c2::Vasodilators}} are used as add-on therapy after other classes if target BP not achieved or ADRs intolerable •May need to use with {{c1::diuretic…
Published	09/08/2024	{{c2::Esmolol}} and {{c1::Labetalol}} are BBs that can be used in HTN emergencies
Published	09/08/2024	{{c1::Enalaprilat}} is an ACEI that can be used in HTN emergencies
Published	09/08/2024	{{c1::Hydralazine}} is an (arterial vasodilator) that can be used in HTN emergencies
Published	09/08/2024	{{c1::Nitroprusside  and Nitroglycerin (NTG)}} are venodilators that can be used in HTN emergencies
Published	09/08/2024	{{c1::Clevidipine and Nicardipine}} are CCBs that can be used in HTN emergencies
Status	Last Update	Fields