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Cheatography

Anti-hypertensives Cheat Sheet (DRAFT) by

Drug classes, side effects

This is a draft cheat sheet. It is a work in progress and is not finished yet.

Renal tubular inhibitory diuretics

CAI
Thiazide or thiazi­de-like diuretics
Loop diuretics
K sparring diuretics
Decreases H+ and Na ion exchange so Na remians in lumen and gets excreted with HCO3- and water.
In mild HTN alone or in edema caused by nephritic syndrome, liver cirrhosis, HF
 
Excrete Na & Cl without K, which may lead to hyperk­ale­mia­--c­aridac risk.
Drug design concept originates from anti-b­act­erial sulfan­ilamide (weak CAI)
Two groups:
1. Hetero­cyclic sulfon­amides; Acetaz­ola­mide, Methaz­olamide
Hydroc­hlo­rot­hiazide or Indapamide; thiazide like
Furose­mide; Azosemide; Ethacrynic acid
Spiron­ola­ctone; hormonal SE; Amiloride: less hormonal SE; Triame­trine
2. Metadi­sul­famoyl benz deriv.; Dichlo­rph­ena­mide, Chlora­min­oph­enamide
NOT given to sulpha­-al­lergic patients: CAI- Thiazide Diuretics- Loop diuretics except ethacrynic a'

Osmotic diuretics

Given in high concen­tra­tions to increase osmotic pressure in urine and increase its secretion into urine along with water.
Decreases IOP
1. Glycer­ine­/gl­ycerol
2. Mannitol: Taken IV; Safe on kidney so for renal function diagnosis, acute renal failure or cerebral edema
3. Sorbitol (D-glu­cit­ol)­/Is­oso­rbide

Vasodi­lators

Hydral­azine HCl
Sodium nitrop­russide
K channel agonists
Best in combin­ation to avoid individual increase in dose leading to unwanted SE.
Indicated for hypert­ensive emerge­ncies (very potent VD)
Diazoxide: IV for emergency BP lowering in hospit­alized pt.
   
Minoxidil: for severe HTN and alopecia.
 

Sympat­holytic

Affects central nerves:
Affects peripheral nerves:
a-methyl dopa
Reserpine, guanet­hidine; deplete NT store
Clonidine
Prazosin: a1 antagonist
 
Propra­nolol, atenolol: B blockers
 

RAS inhibitors

ACEI
ARBS
Captopril: thiol gp attaches to Zn of the metall­oenzyme and respon­sible for SE urticaria or rash
Candes­artan: Prodrug that gives free acid from hydrolysis of ethyl ester
Gen2 (prodr­ugs): Lisino­pril, Quinapril, Enalapril
Losartan (non-p­eptide imidaz­ole): Orally active, potent, selective to AT1 on angiot­ensin II receptor.
No thiol gp. . Long acting ACEI.
Valsartan