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TERMS TO LEARN

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Acanthosis Nigricans Warty growths and hyperpigmentation characteristically found in the axilla and groin; associated with certain drugs, endocrine disorders, obesity, or malignancy.
Alopecia Absence or loss of hair.
Angina Chest discomfort caused by insufficient cardiac blood flow resulting in cardiac ischemia.
Conn's Syndrome Primary hyperaldosteronism.
Hypertensive Emergnecy Hypertensive urgency with end-organ damage.
Hypertensive Urgency Severely elevated BP (systolic >220 or diastolic >120) with no evidence of end-organ damage.
Hypertrichosis Excessive hair growth.
Lupus-Like Syndrome Drug-induced syndrome resembling the symptoms associated with SLE; rarely demonstrates nephritic component.
Pheochromocytoma Catecholamine-secreting tumor of the adrenal gland.
Quinidine Syncope Recurrent light-headedness and fainting associated with use of quinidine.
Reye's Syndrome A rare syndrome of encephalitis and hepatic dysfunction seen in children recovering from a viral illness linked to aspirin.
Rhabdomyolysis Destruction of skeletal muscle cells.
Thrombotic Thrombocytopenic Purpura Coagulopathy seen in adults; associated with central nervous system involvement.
Tinnitis Ringing in the ears.
Tolerance Repeated administration of medication leads to decreased effectiveness.
Torsade de Pointes A ventricular arrhythmia often induced by antiarrhythmic drugs (especially those that prolong the QT interval). Its morphology is that of a polymorphic ventricular tachycardia often with an increasing then decreasing QRS amplitude.
Wolff-Parkinson-White Syndrome Syndrome associated with ventricular arrhythmias due to the presence of an accessory conduction pathway between the SA and AV nodes.

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I. ANTIHYPERTENSIVE DRUGS

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CLASSIFICATION OF ANTIHYPERTENSIVE DRUGS

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Modified from Trevor AJ, Katzung BG, Masters SB: Katzung & Trevor's Pharmacology Examination & Board Review, 6th ed, p 99. Originally published by Appleton & Lange. © 2002 by the McGraw-Hill Companies, Inc.

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ANTIHYPERTENSIVES: CLASSIFICATION OF ANTIADRENERGIC AGENTS

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ANTIHYPERTENSIVES: ANTIADRENERGIC AGENTS

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Drug Pharmacokinetics Mechanism of Action Clinical Uses Side Effects
Centrally Acting α2 Agonists
Methyldopa
  • A: PO and IV

  • M: Hepatic and intestinal metabolism by COMT

  • E: Parent drug and metabolites excreted primarily in urine

  • Believed to work in the relay area of the solitary nucleus

  • Act as α2-receptor agonists to reduce sympathetic tone to peripheral structures (decrease peripheral resistance, HR, and plasma renin activity)

  • Hypertension

  • Plasma volume is increased (body's attempt to reestablish homeostasis) leading to mild edema

  • Sedation, dizziness, and headache (diminish as tolerance develops)

  • Mild bradycardia

  • Flu-like symptoms with fever

  • Lupus-like syndrome

  • Positive Coombs' test with no increase in hemolytic anemia

Clonidine (Catapres, Duraclon, Kapvay)
  • A: PO, transdermal patch, and epidural

  • M: Hepatic

  • E: Majority excreted unchanged in urine

  • Hypertension

  • Epidural infusion for pain management

  • Drowsiness, dizziness, and headache (subside with tolerance)

  • Plasma volume is increased (body's attempt to reestablish homeostasis) leading to mild edema

  • Xerostomia

  • Constipation

  • Patch can cause itching, ...

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