Cardiovascular and Nephrology Pharmacology

Vocabulary flashcards covering cardiovascular pharmacology, hypertension management, heart failure, vasopressors, and diuretic drug classes.

Hypertension Diagnosis

Condition diagnosed by a systolic blood pressure over $130\,\text{mmHg}$ or a diastolic blood pressure over $80\,\text{mmHg}$, assessed across more than one visit per the 2017 AHA/ACC guidelines.

Normal Blood Pressure

Blood pressure defined as a systolic blood pressure under $120\,\text{mmHg}$ and a diastolic blood pressure under $80\,\text{mmHg}$.

Angiotensin Converting Enzyme Inhibitors (ACEI)

Drug class including Lisinopril (Zestril) and Captopril (Capoten) that inhibits the conversion of angiotensin one to angiotensin two; indicated for HTN, ACS, chronic kidney disease, stroke prevention, and heart failure, with a Black Box warning for teratogenicity.

Captopril (Capoten)

An ACE inhibitor indicated for HTN, ACS, chronic kidney disease, stroke prevention, and heart failure that specifically carries a risk of neutropenia.

Angiotensin Receptor Blockers (ARB)

Drug class including Losartan (Cozaar) and Valsartan (Diovan) that inhibits angiotensin two receptors; less likely to cause cough and angioedema compared to ACEIs, but carries a Black Box warning for teratogenicity.

Thiazide Diuretics

The most prescribed class of diuretics, including Hydrochlorothiazide (HCTZ) and Chlorthalidone, which blocks reabsorption of sodium and chloride in the early distal convoluted tubule.

Dihydropyridine Calcium Channel Blockers

Calcium channel blockers such as Amlodipine (Norvasc) and Nicardipine (Cardene) that relax vascular smooth muscle without impacting heart rate; often used as first-line HTN treatment in African Americans.

Non-dihydropyridine Calcium Channel Blockers

Calcium channel blockers including Verapamil and Diltiazem (Cardizem) that decrease cardiac cellular excitability and contractility; contraindicated in 2nd & 3rd degree AV blocks, SSS, and hypotension.

Hydralazine

A direct vasodilator that directly dilates arteries; indicated for heart failure, hypertensive urgency, and HTN, with adverse effects including lupus-like syndrome, reflex tachycardia, hypotension, and headache.

Bidil

A combination medication containing hydralazine (arterial dilator) and isosorbide dinitrate (venous dilator) used for heart failure with reduced EF.

Sodium Nitroprusside (Nipride)

An IV-only direct vasodilator for acute heart failure and acute hypertension with Black Box warnings for cyanide toxicity and hypotension.

Methyldopa

An alpha-two adrenergic agonist used for hypertension that is considered relatively safe in pregnancy.

Aliskiren

A renin blocker used as an alternative agent for HTN (never first-line) that carries a Black Box warning for teratogenicity.

Alpha One Adrenergic Antagonists

Drug class including Doxazosin (Cardura) and Prazosin (Minipress) that inhibits alpha-one receptors to treat BPH and HTN; can cause orthostatic hypotension and reflex tachycardia.

Phosphodiesterase Inhibitors (PDI)

Parenteral-only drugs including Amrinone and Milrinone that increase contractility and vasodilation for heart failure with reduced EF; side effects include dysrhythmias and hypotension.

Sacubitril-Valsartan (Entresto)

An ARNI (angiotensin receptor, neprilysin inhibitor) that inhibits neprilysin to increase vasodilation and blocks the RAAS; indicated for heart failure and not safe in pregnancy.

Dobutamine

A beta-one agonist administered IV for acute decompensated heart failure that acts as a vasopressor without causing vasoconstriction or significant blood pressure increase.

Epinephrine Concentrations

Epinephrine formulated at $1:10,000$ concentration for IV infusion, compared to $1:1,000$ concentration for anaphylaxis (e.g., EpiPen).

Dopamine Dosing

A vasopressor with dose-dependent effects: low dose activates dopaminergic receptors (renal perfusion), medium dose activates dopaminergic and beta-adrenergic receptors, and high dose activates alpha-adrenergic receptors.

Extravasation

A Black Box warning risk associated with vasopressors infused peripherally; prevented by central line infusion via a pump and treated with direct injections of phentolamine.

Aldosterone

A hormone in the nephron that increases sodium and water reabsorption back into the body.

Loop Diuretics

The most potent class of diuretics (e.g., Bumetanide, Furosemide) that blocks sodium and chloride reabsorption in the loop of Henle; carries Black Box warnings for fluid and electrolyte imbalances and can cause ototoxicity.

Spironolactone

A potassium-sparing diuretic and aldosterone antagonist indicated for hypertension, edema, and heart failure that can cause hyperkalemia.

Mannitol

An osmotic diuretic acting as a hypertonic solution that interferes with water reabsorption; used to reduce ICP and IOP, and increase diuresis in renal failure.

Antidiuretic Hormone (ADH)

Medication that decreases urine output and causes vasoconstriction; indicated for shock and cardiac arrest, with off-label use for diabetes insipidus.

Acetazolamide

A carbonic anhydrase inhibitor that increases renal excretion of sodium, potassium, bicarbonate, and water; indicated for glaucoma and acute mountain sickness.