Antihypertensives & Anesthesia: The Meds That Love to Mess with Your Hemodynamics with Chloe Gomez, DNP, CRNA

Antihypertensive medications don’t have to feel overwhelming or memorization-heavy. In this solo lecture, Chloe Gomez, DNP, CRNA breaks down antihypertensive pharmacology through physiology, mechanisms of action, and real-world anesthesia implications - exactly what SRNAs, CRNAs, and anesthesia providers need for boards and the operating room.

This episode walks through the major classes of antihypertensives, focusing on how each drug lowers blood pressure rather than relying on disconnected lists. You’ll learn how antihypertensives interact with preload, afterload, heart rate, contractility, and systemic vascular resistance, and why those effects matter during induction, maintenance, and emergence from anesthesia.

Key topics covered include:

• Beta blockers (β₁ vs β₂ effects, perioperative continuation, blunted sympathetic response)

• ACE inhibitors (ACE-Is) & ARBs: RAAS physiology, vasodilation, and refractory hypotension

• Calcium channel blockers (DHP vs non-DHP): vascular vs nodal effects

• Alpha agonists and antagonists

• How antihypertensives alter MAP, CO, SVR, and reflex tachycardia

• Why certain antihypertensives increase the risk of induction hypotension

• What to hold, continue, or anticipate on the day of surgery

Throughout the episode, complex pharmacology is tied directly to:

• Hemodynamic management in anesthesia

• Common board scenarios and NBCRNA-style reasoning

• Vasopressor choice and response

• Drug interactions with propofol, volatile agents, opioids, and neuraxial anesthesia

This lecture emphasizes understanding over memorization, helping anesthesia learners build a framework they can use in high-stakes clinical moments - not just exam day.

🎧 Antihypertensives explained for anesthesia learners - fewer flashcards, more confidence, safer patients.