Hypertension Medications
by Erin Sullivan
1. ARBs
1.1. Ind: if not able to tolerate BB/ACEI
1.2. Blocks EFFECT of AG II (not production)
2. CCB
2.1. Dihydropyridine
2.1.1. Vasodilator w/ little effect on cardiac contractility or condution
2.1.2. Nifedipine, Amlodipine
2.2. Non-dihydropyridines
2.2.1. Affect Cardiac contractility and conduction
2.2.2. Used when concomitant Afib
2.2.3. Verapamil, Diltiazem
2.3. Indications: Raynaud's, angina, HTN
2.4. SE: HA, dizziness, lightheadedness, flushing, PERIPHERAL EDEMA
2.5. CI: 2nd/3rd degree heart block, CHF
3. BB
3.1. Ind: HTN especially if hx of MI or tachycardia, angina, acute MI, heart failure, migraines, essential tremors, pheochromocytoma
3.2. NOT monotherapy first line
3.3. SE: fatigue, depression, impotence, masks sympathetic sx of hypoglycemia
3.4. CI: 2nd/3rd degree heart block, decompensated heart failure, asthma/COPD w/ nonslelective agents, may worsen Raynauds/peripheral vascular dz
3.5. Cardioselective: Esmolol, metoprolol, atenolol Nonselective: propranolol Both: Carvedilol, labetalol
4. Diuretics
4.1. Thiazides
4.1.1. Prevent kidney Na+/water reabsorption in distal diluting tubules
4.1.2. SE: hyponatremia, hypokalemia, hypercalcemia, hyperglycemia, hyperurecemia
4.2. Loop
4.2.1. Inhibits water transport across loop of henle
4.2.2. SE: volume depletion, hypokalemia/natremia/calcemia
4.2.3. CI: sulfa allergy
4.3. K+ Sparing
4.3.1. Inhibits aldosterone mediated Na+/H20 absorption
4.3.2. SE: hypercalemia
4.3.3. CI: renal failure, hyponatremia