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CPR Theme #4 - HTN
Hydrochlorothiazide HCTZ
Mechanism of Action
Inhibits Reabsorption NaCl and H2O
Indications
Edema
Mild to Moderate Hypertension
Side Effects
Hypokalemia
Hyponatremia
Dehydration
Hyperglycemia
Gout
Contraindications
Sulfa Allergy
Pregnancy and Breastfeeding
1 min
Acetazolamide
Indications
Glaucoma
Altitude Sickness
Pseudotumor Cerebri
CHF
Metabolic Alkalosis
Mechanism of Action
Carbonic Anhydrase Inhibitor
Sodium Bicarbonate (NaHCO3) Diuresis
Side Effects
Metabolic Acidosis
Paresthesias
1 min
Hypertension Medications
Diuretics
ACE Inhibitors
Angiotensin Receptor Blockers (ARBs)
Beta Blockers
Dihydropyridine Calcium Channel Blockers
2 mins
ACE Inhibitors
-Pril Suffix
Indications
Hypertension
CHF
Diabetic Nephropathy
Mechanism of Action
Inhibits ACE
Decreases GFR
Inhibits Constriction of Efferent Arteriole
Side Effect
Increased Bradykinin
Cough
1 min
ACE Inhibitor Toxicity
CAPTOPRIL Mnemonic
Cough
Angioedema
Potassium Changes (Hyperkalemia)
Taste Change
Hypotension
Pregnancy Changes
Rash
Increased Renin
Lower Angiotensin II
2 mins
Angiotensin Receptor Blockers (ARBs)
-sartan suffix
Indications
Hypertension
CHF
Diabetic Nephropathy
Mechanism of Action
Angiotensin II Receptor Blockers
Side Effect
Hyperkalemia
Contraindication
Pregnancy
1 min
Loop Diuretics
Mechanism of Action
Thick Ascending Limb of Loop of Henle
Inhibits Na+-K+-2Cl- Symporter
Sulfa Drug
Drug Names
Furosemide
Lasix
Side Effects
Gout
Ototoxicity
Hypocalcemia
Hypokalemia
4 mins
Ethacrynic Acid
Mechanism of Action
Non-sulfa Drug
Phenoxyacetic Acid Derivative
Loop Diuretic
Inhibits Na+-K+-2Cl- Cotransporter
Thick Ascending Loop of Henle
Clinical Use
Diuresis
Side Effects
Hypokalemia
Ototoxicity
Gout
2 mins
Thiazide Diuretics
Early Distal Tubule
Inhibits Na/Cl Reabsorption
Sulfa Drug
Hyperglycemia
Hyperlipidemia
Hypercalcemia
Hyperuricemia
Hyponatremia
Hypokalemic Metabolic Alkalosis
2 mins
K+ Sparing Diuretics
Indications
CHF and Hypertension
Hypokalemia
Hyperaldosteronism
Mechanism of Action
Collecting Tubule
Spironolactone
Competitive Aldosterone Receptor Antagonist
Amiloride and Triamterene
Block Na+ Channels
Side Effects
Hyperkalemia
Gynecomastia
2 mins
Spironolactone (Aldactone)
Mechanisms
Inhibition of Aldosterone
Potassium Retention
Indications
Hypertension
Edema
Heart Failure
Side Effects
Hyperkalemia
Endocrine Effects
Consideration
Avoid Potassium Supplements
2 mins
Selective Beta-1 Blockers
Characteristics
"-olol" Suffix
Drug Names
Beta-1 Selective
Atenolol
Esmolol
Metoprolol
Partial Beta agonists
Acebutolol
1 min
Nonselective Beta-Blockers
"-olol" Suffix
Nonselective
Propranolol
Timolol
Nadolol
Partial β Agonist
Pindolol
Nonselective β with α Blocking
Carvedilol
Labetalol
2 mins
Systemic Effects of Beta-Blockers
Respiratory
Bronchoconstriction
Metabolic
Decreased Insulin
Decreased Glycolysis and Lipolysis
Eye
Reduces Intraocular Pressure
1 min
Cardiovascular Effects of Beta-Blockers
Cardiac Myocytes and Vasculature
Decrease cAMP
Decreases SA and AV Node Conduction Velocity
Lower Blood Pressure
Decrease O2 Consumption
Decreases Mortality Post-MI
2 mins
Beta Blocker Antidote
Antidote
Glucagon
29 secs
Selective Alpha-1 Blockers
"-osin" suffix
Mechanism of Action
Blocks Alpha1 Receptors
Indications
Hypertension
Benign Prostatic Hyperplasia (BPH)
Side Effects
Syncope
Orthostatic Hypotension
1 min
Prazosin (Minipress)
-osin suffix
Mechanisms
Selective Alpha-1 Receptor Blocker
Indications
Hypertension
Benign Prostatic Hyperplasia (BPH)
Nightmares
Side Effects
Orthostatic Hypotension
Tachycardia
Priapism / Inhibition of Ejaculation
Nasal Congestion
Considerations
First Dose Effect
Administer at Bedtime
2 mins
Minoxidil (Loniten, Rogaine)
Mechanism
Vasodilates Arterioles
Indications
Severe Hypertension
Baldness
Side Effects
Reflex Tachycardia
Blood Volume Expansion
Hypertrichosis
Pericardial Effusion
Rash
Considerations
Give with Beta Blocker and Diuretic
2 mins
Nitroprusside
Mechanism of Action
Direct Release of NO
Increase cGMP
Short Half-Life
Indications
Malignant Hypertension
Side Effect
Cyanide Toxicity
1 min
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