MN553antihypertensives Unit 7
ARB's - ANSAngiotensin II Receptor Blockers
ACEI's - ANSangiotensin converting enzyme inhibitors
DRI's - ANSDirect Renin Inhibitors
ACEI - ANS-pril, Benzapril, captopril, Enalopril, Enalaprilat, Fosinopril, Lisinopril, Moexipril,
Perindopril, Quinapril, Ramipipril, Trandolopril
ARB's - ANS-sartan, Candesartan, Eprosartan, Losartan, Omestartan, Temisartan, Valsartan
Direct Renin Inhibitor - ANSAliskiren
Losartan - ANSwell absorbed with or without food
Captopril - ANSrapidly absorbed and more bio availability if taken on empty stomach
Kidney is the primary organ of excretion for all _______ except_________ - ANSACEI's,
fosinopril and moexipril
Three contraindications for using an ACEI - ANSBilateral renal artery stenosis, history of
angioedema, pregnancy
DRI's not used in__________+ - ANSdiabetic patients with less than 60ml/min of renal function
Captopril - ANSshort half life, take either BID or TID
Target BP for diabetic: - ANS130/80, less than 140
Concurrent use of potassium supplements________ - ANSmay result in hyperkalemia
Stage one hypertension - ANS140-159/90-99
Treat stage I hypertension - ANSconsider ACEI's ARB's CCB (calcium Channel blockers or
combo
ACEI/ARB - ANSdrug of choice for HTN in younger, white pts with HF or MI
To prevent diabetic nephropathy - ANSACEIs or ARB's prescribed
, Stage 2 hypertension - ANS160+/100+, 2 drug combo thiazide + ACEIs, ARB, BB, CCB
Angina and Ischemic Heart Disease - ANSACEI,s decrease preload and volume
Stage A heart failure - ANSPatients at high risk for developing heart failure
Treatment for Stage A Heart Failure - ANSACEI's
Stage B heart failure - ANSstructural heart disease but no symptoms
Treatment for Stage B HF - ANSACEI's, ARB only in pt can't handle ACEI's, BB
Stage C HF - ANSStructural heart disease with prior or current symptoms of HF
Stage C HF treatment - ANSACEI's BB, Diuretics, Digoxin, Spironolactone
Stage D HF - ANSrefractory HF
extreme measure or QOL care
Calcium Channel Blockers - ANSlower calcium influx into smooth muscle, vasodilation
Two classes of CCBs - ANSnon-dihydropyridine (Type I), dihydropyridines (Type 2)
Non-Dihydropyridine CCBs - ANS- The non-dihydropyridines consists of verapamil and
dilitiazem and are used primarily for arrhythmias to control/slow HR, and sometimes for HTN
and angina.
> They are negative inotropes (decrease contraction force) and negative chronotropes
(decrease HR)
> The difference from Dihydropyridine is that these agents inhibit Ca2+ ions from entering the
"slow" channels or voltage-sensitive areas of vascular smooth muscle and myocardium during
depolarization, resulting in coronary vasodilation.
Verapamil - ANScalcium channel blocker, not recommended in patients with HF, due to negative
inotropic effects
Dihydropyridines - ANSNifedipine
Amlodipine, do not affect conduction through the AV node
ADRs of CCBs - ANSdecreased HR/ BP, prolonged PR interval, heart block, CHF, constipation,
decrease esophageal tone so GERD increases
Cardiac Glycosides - ANSdrugs used to improve heart output by increasing the muscular
contraction
ARB's - ANSAngiotensin II Receptor Blockers
ACEI's - ANSangiotensin converting enzyme inhibitors
DRI's - ANSDirect Renin Inhibitors
ACEI - ANS-pril, Benzapril, captopril, Enalopril, Enalaprilat, Fosinopril, Lisinopril, Moexipril,
Perindopril, Quinapril, Ramipipril, Trandolopril
ARB's - ANS-sartan, Candesartan, Eprosartan, Losartan, Omestartan, Temisartan, Valsartan
Direct Renin Inhibitor - ANSAliskiren
Losartan - ANSwell absorbed with or without food
Captopril - ANSrapidly absorbed and more bio availability if taken on empty stomach
Kidney is the primary organ of excretion for all _______ except_________ - ANSACEI's,
fosinopril and moexipril
Three contraindications for using an ACEI - ANSBilateral renal artery stenosis, history of
angioedema, pregnancy
DRI's not used in__________+ - ANSdiabetic patients with less than 60ml/min of renal function
Captopril - ANSshort half life, take either BID or TID
Target BP for diabetic: - ANS130/80, less than 140
Concurrent use of potassium supplements________ - ANSmay result in hyperkalemia
Stage one hypertension - ANS140-159/90-99
Treat stage I hypertension - ANSconsider ACEI's ARB's CCB (calcium Channel blockers or
combo
ACEI/ARB - ANSdrug of choice for HTN in younger, white pts with HF or MI
To prevent diabetic nephropathy - ANSACEIs or ARB's prescribed
, Stage 2 hypertension - ANS160+/100+, 2 drug combo thiazide + ACEIs, ARB, BB, CCB
Angina and Ischemic Heart Disease - ANSACEI,s decrease preload and volume
Stage A heart failure - ANSPatients at high risk for developing heart failure
Treatment for Stage A Heart Failure - ANSACEI's
Stage B heart failure - ANSstructural heart disease but no symptoms
Treatment for Stage B HF - ANSACEI's, ARB only in pt can't handle ACEI's, BB
Stage C HF - ANSStructural heart disease with prior or current symptoms of HF
Stage C HF treatment - ANSACEI's BB, Diuretics, Digoxin, Spironolactone
Stage D HF - ANSrefractory HF
extreme measure or QOL care
Calcium Channel Blockers - ANSlower calcium influx into smooth muscle, vasodilation
Two classes of CCBs - ANSnon-dihydropyridine (Type I), dihydropyridines (Type 2)
Non-Dihydropyridine CCBs - ANS- The non-dihydropyridines consists of verapamil and
dilitiazem and are used primarily for arrhythmias to control/slow HR, and sometimes for HTN
and angina.
> They are negative inotropes (decrease contraction force) and negative chronotropes
(decrease HR)
> The difference from Dihydropyridine is that these agents inhibit Ca2+ ions from entering the
"slow" channels or voltage-sensitive areas of vascular smooth muscle and myocardium during
depolarization, resulting in coronary vasodilation.
Verapamil - ANScalcium channel blocker, not recommended in patients with HF, due to negative
inotropic effects
Dihydropyridines - ANSNifedipine
Amlodipine, do not affect conduction through the AV node
ADRs of CCBs - ANSdecreased HR/ BP, prolonged PR interval, heart block, CHF, constipation,
decrease esophageal tone so GERD increases
Cardiac Glycosides - ANSdrugs used to improve heart output by increasing the muscular
contraction
