Antihypertensives Cheat Sheet

i.e. atenolol, metopr­olol, bisopr­olol, timolol (eye drops), labetalol (IV)
MOA
- blocks SNS stimul­ation of Beta 1
- Reduced renin and aldost­erone release and fluid balance
- Vasodi­lation of aterioles= Decreased PVR and BP
- Decreased myocardial stimul­ation
- Decreased HR
- Decreased conduction through AV node
- Prolonged SA node recovery
- Decreases myocardial O2 demand and contra­ctility
*reduces the work of the heart
Indica­tions
- HTN, angina, dysrhy­thmias
Contra­ind­ica­tions
- Allergy
- Uncomp­ensated HF
- Cardio­genic shock
- Heart block
- Bradyc­ardia
- Pregnancy
- Severe pulmonary disease (B2)
- Raynau­d's disease
Adverse Effects
- Can worsen angina or cause MI if stopped quickly
- Symptoms of HF (coughing, SOB, Edema, fatigue)
- Can mask signs of hypogl­ycemia
- CV: AV block, bradyc­ardia, HF, PV insuff­ici­ency, hypote­nsion
- Resp: bronch­ospasm, bronch­oco­nst­riction
- CNS: dizziness, depres­sion, lethargy
- GI: nausea, dry mouth, vomiting, consti­pation, diarrhea
- Hema: thromb­ocy­topenia

i.e. losartan, eprosa­rtan, valsartan, irbesa­rtan, telmis­artan
MOA
- blocks binding of angiot­ensin II to receptors
- Affects smooth muscle and adrenal gland
- Blocks vasoco­nst­riction and secretion of aldost­erone
Indica­tions
- HTN, HF (decrease preloa­d/a­fte­rload), decreased mortality after MI
Contra­ind­ica­tions
- allergy, pregna­ncy/BF, kidney dysfun­ction (caution), older adults
Adverse Effects
- URI, headache, hypote­nsion, tachyc­ardia, S/S of toxicity
Intera­ctions
- Cimeti­dine, phenob­arb­ital, rifampin, K+ supple­ments

i.e. Amlodipine (dihyd­rop­yri­dines), Diltiazem (benzo­thi­aze­pines), Verapamil (pheny­lak­yla­mines)
MOA
- Blocks Ca access to cells causing:
- decreased contra­ctility
- decreased conduc­tivity of the heart
- decreased demand for O2
- dilation of coronary arteries (decreased afterload, increased oxygen supply)
decreases work of the heart
Indica­tions
- Angina
- HTN
- SVT
- Atrial fib/fl­utter
- Migraines
- Intrac­ranial aneurysm rupture
Contra­ind­ica­tions
- allergy, acute MI, 2 or 3 heart block, hypote­nsion
Adverse Effects
- Hypote­nsion
- Palpit­ations
- Tachyc­ardia or bradyc­ardia
- HF
- Consti­pation
- Nausea
- Dermatitis
- Dyspnea
- Rash/f­lushing
- Peripheral edema
Intera­ctions*
- beta blocker, digoxin, h2 blockers, cyclos­porin
- grapefruit

MOA
- dilation of blood vessels (relax­ation of smooth muscle) esp coronary vessels
- decreased afterload and preload
Indica­tions
- Angina (stable, unstable, vasosp­astic)
Contra­ind­ica­tions
- allergy, anemia, closed­-angle glaucoma, hypote­nsion, head injury
Adverse Effects
- headache, tachyc­ardia, postural hypote­nsion, reflex tachyc­ardia, tolerance
Intera­ctions
- alcohol, beta blockers, CCB, antips­ych­otics, erectile dysfun­ction medica­tions

i.e. ramipril, fosinopril sodium, lisino­pril, enalapril, perind­opril, captopril
MOA
- Suppresses formation of angiot­ensin II from the RAAS system
- Reduces PVR
- Increases CO
Indica­tions
- HTN (decreased afterload, prevents formation of ACE II)
- HF (prevents Na and water resorp­tion, causes diuresis, decreases preload)
- Protective effects on kidney (decreases GFR)
Contra­ind­ica­tions
- History of angioe­dema, renal artery stenosis, K+ >5m­mol/L
Adverse Effects
- Hyperk­alemia
- Fatigue, mood changes, dizziness, headache
- Dry, non-pr­odu­ctive cough
- Hypote­nsion
- Angioedema
- Rash, thromb­ocy­tosis, loss of taste, protei­nuria, pruritis, anemia, neutro­penia
Intera­cti­ons**
- NSAIDS
- Potassium sparing diuretics
- Lithium and ACE inhibitors