Antihypertensive Drugs Cheat Sheet: Classes, Mechanisms & Key Side Effects
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Antihypertensive Drug Cheat Sheet
🧠 Hypertension Basics
Normal BP: <120/<80 mmHg
Stage 1 HTN: 130–139 / 80–89 mmHg
Stage 2 HTN: ≥140 / ≥90 mmHg
HTN Crisis: ≥180 / ≥120 mmHg
Complications: Stroke, MI, CKD, HF, ED
💦 Diuretics
| Type | MOA | Key Drugs | Key AEs | Notes |
|---|---|---|---|---|
| Thiazide | ↓ Na/Cl reabsorption (DCT) | HCTZ, chlorthalidone | ↓K+, ↑glucose/lipids/uric acid | 1st-line |
| Loop | ↓ Na/K/2Cl (Loop of Henle) | Furosemide, bumetanide | ↓K+, ↓Ca, ototoxicity | Use in renal failure |
| K+ Sparing | Block aldosterone or Na+ channel | Spironolactone, amiloride | ↑K+, gynecomastia (spirono) | Use with thiazides |
| Others | Acetazolamide (CAI), Mannitol (osmotic), Tolvaptan (V2 antag) | CAI: metabolic alkalosis; Mannitol: cerebral edema |
🧬 RAAS Inhibitors
| Drug Class | MOA | Key Drugs | AEs | Contraindications |
|---|---|---|---|---|
| ACEIs (-pril) | Block Ang I → II | Ramipril, enalapril | Cough, ↑K+, angioedema | Pregnancy, renal artery stenosis |
| ARBs (-sartan) | Block AT1 receptor | Losartan, valsartan | Less cough, ↑K+ | Same as above |
| Renin Inhibitor | Block renin → no Ang I | Aliskiren | Similar to ARB | Don’t combine w/ ACEI or ARB |
| Aldosterone Antag. | Block aldosterone receptor | Spironolactone | ↑K+, gynecomastia | Hyperkalemia, Addison’s |
💥 Vasodilators
| Type | MOA | Drugs | AEs | Notes |
|---|---|---|---|---|
| Nitrates | ↑NO → relax veins | Nitroglycerin | Headache, tolerance | Low dose = veins, high = arteries |
| Direct (oral) | ↓Ca, open K+ | Hydralazine, minoxidil | Lupus (hydr), hirsutism (mino) | Combine w/ BB |
| IV Emergencies | Direct dilation | Nitroprusside, fenoldopam | Cyanide tox (nitro) | HTN crisis |
| CCBs | ↓ Ca influx | DHP: Amlodipine; Non-DHP: Verapamil | Edema, bradycardia (NDHP) | DHP for BP, NDHP for HR |
🧘 Sympatholytics
| Drug Class | MOA | Drugs | AEs | Notes |
|---|---|---|---|---|
| Beta Blockers (-lol) | ↓ CO, renin | Metoprolol (β1), propranolol (NS) | Bradycardia, fatigue | Post-MI, migraine |
| Alpha Blockers (-zosin) | Block α1 → vasodilation | Prazosin, doxazosin | Postural hypotension | BPH bonus |
| Alpha-2 Agonist | Central ↓ SNS | Clonidine | Sedation, rebound HTN | Patch available |
🟢 First-Line Drugs (2020 Guidelines)
✅ ACEI, ARB, DHP CCB, Thiazides
🧠 MEMO-TRICKS
ACEI = “Cough-pril”
ARBs = Use when “ACE Coughs”
Loops Lose Ca, Thiazides Take Ca
K+ sparing? Think Spiro saves potassium
Clonidine = Calm Central Control