Hypertension and Angina Pharmacotherapy Study Guide

Comprehensive vocabulary flashcards covering drug classes, mechanisms of action, key medications, clinical uses, precautions, and adverse effects for the pharmacologic treatment of hypertension and angina.

Thiazide Diuretics

A first-line drug class for hypertension (including hydrochlorothiazide, chlorthalidone, and indapamide) that decreases $\text{Na}^+$, $\text{Cl}^-$, and $\text{H}_2\text{O}$ reabsorption, leading to decreased blood volume, decreased cardiac output ($\text{CO}$), and decreased peripheral resistance ($\text{PR}$); adverse effects include hypokalemia, hyperuricemia, photosensitivity, and dehydration.

Loop Diuretics

A class of diuretics (furosemide, bumetanide, torsemide) used for severe hypertension and edema that blocks the $\text{Na}^+/\text{K}^+/2\text{Cl}^-$ transporter in the loop of Henle; common side effects include hypokalemia, hypotension, and dehydration.

Potassium-Sparing Diuretics

Antihypertensive adjunct agents (amiloride, triamterene) that inhibit $\text{Na}^+$ reabsorption while sparing $\text{K}^+$, with common side effects of hyperkalemia and nausea.

Aldosterone Antagonists

Agents (spironolactone, eplerenone) indicated for resistant hypertension that block aldosterone to decrease $\text{Na}^+$ reabsorption; notable side effects include hyperkalemia, gynecomastia, and menstrual irregularities.

ACE Inhibitors

Medications (lisinopril, enalapril, ramipril) used for hypertension, heart failure, and angina with coexisting hypertension or heart failure that inhibit ACE to decrease Ang II and aldosterone, increase bradykinin, and promote vasodilation; common effects include cough, angioedema, and hyperkalemia, and they are contraindicated in pregnancy.

ARBs (Angiotensin Receptor Blockers)

A class of drugs (losartan, valsartan, irbesartan) used for hypertension and heart failure that blocks Ang II receptors to decrease vasoconstriction; side effects include dizziness and muscle cramps, and they are contraindicated in pregnancy.

Beta-Adrenergic Blockers

Drugs (atenolol, metoprolol, nadolol, propranolol) that block beta-receptors to decrease heart rate ($\text{HR}$), cardiac output ($\text{CO}$), blood pressure ($\text{BP}$), and myocardial oxygen demand; primary uses include hypertension, arrhythmias, and stable (exertional) angina, with precautions to avoid abrupt discontinuation.

Alpha1 Blockers

Agents (prazosin, doxazosin, terazosin) indicated for hypertension and benign prostatic hyperplasia (BPH) that induce vasodilation to decrease peripheral resistance ($\text{PR}$); common adverse effects include orthostatic hypotension and dizziness.

Calcium Channel Blockers

Cardiovascular agents (amlodipine, verapamil, diltiazem, nicardipine, nifedipine) that block L-type calcium channels to decrease vascular resistance, myocardial contractility, and cardiac workload, causing vasodilation; used for hypertension, variant angina, and stable angina, with precautions to limit caffeine and alcohol.

Central Alpha2 Agonists

Antihypertensive agents (clonidine, methyldopa) used for resistant hypertension that decrease central sympathetic outflow to lower blood pressure ($\text{BP}$); associated with sedation, dry mouth, and orthostatic hypotension.

Direct Vasodilators

Antihypertensive drugs (hydralazine, minoxidil) for severe or resistant hypertension that relax vascular smooth muscle to decrease peripheral resistance ($\text{PR}$); associated with headache, lupus-like syndrome (hydralazine), and hair growth (minoxidil).

Direct Renin Inhibitors

A drug class represented by aliskiren used in hypertension that blocks renin, leading to decreased Ang I and Ang II levels; adverse effects include diarrhea, hyperkalemia, and dizziness.

Nitrates

Antianginal medications (nitroglycerin, isosorbide dinitrate, isosorbide mononitrate) that are converted to nitric oxide to dilate arteries and veins and increase oxygen supply to the heart; used for acute angina relief and angina prevention, with warnings to avoid alcohol and take on an empty stomach.

Antiplatelet Agents

Agents (aspirin, clopidogrel) that inhibit platelet aggregation to prevent myocardial infarction (MI) and stroke in patients with angina; adverse effects include bleeding risk and GI upset.

Anticoagulants

Therapeutic medications (heparin, warfarin) indicated for unstable angina and post-MI that inhibit clotting factors; cause bleeding and bruising, with warfarin specifically requiring INR monitoring.

Anti-hyperlipidemics

Lipid-lowering agents (atorvastatin, rosuvastatin) that decrease LDL cholesterol and stabilize plaques to reduce atherosclerosis risk; associated with myopathy, liver enzyme elevation, and GI symptoms.

Hydralazine

A direct vasodilator used for severe/resistant hypertension by relaxing vascular smooth muscle to decrease peripheral resistance ($\text{PR}$); notably causes headache and a drug-induced lupus-like syndrome.

Minoxidil

A direct vasodilator used for severe/resistant hypertension that relaxes smooth muscle to lower peripheral resistance ($\text{PR}$); uniquely noted for causing hair growth.

Warfarin

An anticoagulant drug used for unstable angina and post-MI that works by inhibiting clotting factors; carries a risk of bleeding and bruising and specifically requires international normalized ratio (INR) monitoring.

Aliskiren

The key drug among direct renin inhibitors used for hypertension; it blocks renin to decrease levels of Ang I and Ang II, with primary side effects of diarrhea, hyperkalemia, and dizziness.