diuretics/antihypertensives
thiazide diuretics
- hydrochlorothiazide
MOA: pull Na, K, H2O off, dilates arterioles
USE: increase urine output, HTN, edema, HF, nephrotic syndrome, ascites
AE/SE: orthostatic hypotension, hyponatremia, hypokalemia, SJS, renal failure
contraindication in renal failure. ceiling threshold
loop diuretic
- furosemide
MOA: inhibits reabsorption of Na, K, H2O
USE: HF, renal dysfunction, HTN, nephrotic syndrome, acute pulmonary/peripheral edema
SE/AE: electrolyte imbalances, orthostatic hypotension, hyperglycemia, SJS
ADMIN: IV over 1-2mins, infusion @ 4mg/min
potassium-sparing diuretics
- spironolactone
MOA: promotes Na H2O excretion and K retention. can be used with furosemide
USE: peripheral/pulmonary edema, fluid overload, HTN, ascites, hypokalemia
SE/AE: hyperkalemia, SJS, hepatotoxicity, deepening of voice, gynecomastia, menstrual irregularity
ADMIN: given @ same time each day, preferably morning
beta-adrenergic blockers
- metoprolol
MOA: promotes BP reduction by blocking Beta 1 receptors
USE: HTN, AMI, HF, angina
SE/AE: bradycardia, hypotension, bronchospasm, erectile dysfunction
abrupt withdrawal can lead to exacerbation in angina, MI, ventricular dysrhythmias
alpha-adrenergic blockers
- prazosin hydrochloride
MOA: dilates peripheral blood vessels by blocking alpha-adrenergic receptors
USE: control HTN
SE/AE: pancreatitis, elevated liver enzymes, orthostatic hypotension
first dose phenomenon -> orthostatic hypotension, palpitations, dizziness, syncope
ACE inhibitors
- lisinopril
MOA: blocks release of aldosterone
USE: HTN, MI, HF
SE/AE: hypotension, headache, dizziness, hyperkalemia, dry hacking cough
ARB inhibitors
- losartan
MOA: blocks angiotension II from binding to receptor sites
USE: HTN, diabetic nephropathy, proteinurea
SE/AE: weakness, dizziness, cough, hypotension, anemia, angioedema
calcium channel blocker
- diltiazem
MOA: promotes vasodilation
USE: HTN, angina, dysrhythmia
SE/AE: peripheral edema, dizziness, dyspepsia, bradycardia, hypotension
cultural response to antihypertensive agents
AAs respond best to diuretics.
asians respond best to beta blockers
physiological risk factors
- excessive saturated fat and simple carbs
- alcohol increase renin secretion
- obesity increases CO, stroke volume, left ventricular filling