Cheatography
https://cheatography.com
Antihypertensive Drug Class
1. For ALL drugs - know the class of anti-hypertensive
2. For ALL classes – know the pharmacologic effects, physiologic effects, and monitoring.
3. For ALL REPRESENTATIVE drugs – know the dosing
This is a draft cheat sheet. It is a work in progress and is not finished yet.
Drug Classes of Anti-hypertensive
Thiazides |
- HCTZ 12.5 – 25 mg QD
- Chlorthalidone 12.5 – 25 mg QD |
Calcium Channel Blockers (CCBs) |
- Amlodipine 5 – 10 mg QD
- Diltiazem 180 – 360 mg QD |
β-Blockers |
- Metoprolol 25 – 200 mg QD
- Carvedilol 12.5 – 50 mg BID |
Angiotensin-Converting Enzyme (ACEIs) |
Lisinopril 10 – 40 mg QD |
Angiotensin-Receptor Blockers (ARBs) |
Valsartan 80 – 320 mg QD |
Renin Inhibitors |
Aliskiren 150 – 300 mg QD |
Aldosterone Receptor Blockers |
- Spironolactone 25 mg – 50 mg QD
- Eplerenone 25 – 50 mg QD |
α1-Blockers |
Doxazosin 2 – 8 mg QD at night |
α2-Agonist |
Clonidine 0.1 – 0.3 mg TID (Patch 0.1 – 0.3 mg QD) |
Mechanism of Action
Thiazides:
- Hydrochlorothiazide
- Chlorthalidone |
Inhibit Na+ reabsorption in distal tubule |
Calcium Channel Blockers (CCBs):
- Amlodipine (DPH)
- Diltiazem (non-DPH) |
BOTH: Inhibition of L-type Ca2+ channel
NON-DPH: AV node conduction → ↑HR |
β-Blockers:
- Metoprolol
- Carvedilol |
Block NE at β-AR |
Angiotensin-Converting Enzyme (ACEIs):
- Lisinopril |
Inhibit ACE production of Angiotensin-II (AngII) |
Angiotensin-Receptor Blockers (ARBs):
- Valsartan |
Block Angiotensin-II (AngII) at AT1 receptor |
Renin Inhibitors
- Aliskiren |
Inhibit renin production of Angiotensin-I (AngI) |
Aldosterone Receptor Blockers:
- Spironolactone
- Eplerenone |
Inhibit aldosterone receptor |
α1-Blockers |
Block NE at α-AR |
α2-Agonist |
Stimulate α2-AR (pre-synaptic) |
Physiology
Thiazides:
- Hydrochlorothiazide
- Chlorthalidone |
Mild diuretic, but powerful antihypertensive |
Calcium Channel Blockers (CCBs):
- Amlodipine (DPH)
- Diltiazem (non-DPH) |
BOTH: Vasodilator (arterial)
NON-DPH: ↓HR & ↓CO |
β-Blockers:
- Metoprolol
- Carvedilol |
- Bradycardia (↓HR)
- ↓contractility |
Angiotensin-Converting Enzyme (ACEIs):
- Lisinopril |
Vasodilator (arterial/venous/renal) |
Angiotensin-Receptor Blockers (ARBs):
- Valsartan |
Vasodilator (arterial/venous/renal) |
Renin Inhibitors
- Aliskiren |
Vasodilator (arterial/venous/renal) |
Aldosterone Receptor Blockers:
- Spironolactone
- Eplerenone |
Mild diuretic |
α1-Blockers |
Vasodilator |
α2-Agonist |
- ↓HR & ↓contractility
- Vasodilation |
Adverse Drug Reactions (ADRs)
Thiazides:
- Hydrochlorothiazide
- Chlorthalidone |
- Hypotension
– Hypovolemia/hyponatremia
– Hypokalemia
– Hypercalcemia
– Hyperuricemia
– Lipid/glucose disturbances |
Calcium Channel Blockers (CCBs):
- Amlodipine (DPH)
- Diltiazem (non-DPH) |
- Hypotension
– Peripheral edema
– GI/Constipation |
β-Blockers:
- Metoprolol
- Carvedilol |
- Hypotension
– Bradycardia
– Fatigue
– Sexual dysfunction
– Lipid/glucose disturbances |
Angiotensin-Converting Enzyme (ACEIs):
- Lisinopril |
- Cough (ACEIs only)
– Hypotension (careful in volume depletion)
– Hyperkalemia
– Acute kidney injury
– Angioedema (acute/chronic) |
Angiotensin-Receptor Blockers (ARBs):
- Valsartan |
– Hypotension (careful in volume depletion)
– Hyperkalemia
– Acute kidney injury
– Angioedema (acute/chronic) |
Renin Inhibitors
- Aliskiren |
– Hypotension (careful in volume depletion)
– Hyperkalemia
– Acute kidney injury
– Angioedema (?) |
Aldosterone Receptor Blockers:
- Spironolactone
- Eplerenone |
– Hypotension
– Hyperkalemia
– Acute kidney injury
– Gynecomastia |
α1-Blockers |
– Orthostatic hypotension
– Dizziness
– Fatigue
– Tolerance |
α2-Agonist |
– Hypotension
– Bradycardia
– Fatigue
– Somnolence
– Discontinuation syndrome!!!! |
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