13 Hypertension, Hypotension and Therapeutic Intervention

Question 1

Why might people be resistant to taking antihypertensives?

Answer 1

many patients are asymptomatic

Question 2

In what ways is BP physiologically maintained?

Answer 2

Baroreceptor reflex
ANS (symp + paraS)
RAAS (kidneys + vessels)

Question 3

What 3 factors determine drug choice?

Answer 3

Age
Genetics
Comorbidities

Question 4

What are the 4 classes of anti-hypertensives?

Answer 4

A
B
C
D

Question 5

Name 2 types of class A antihypertensives

Answer 5

ACEi

ARBs

Question 6

Name 2 types of ACEi

Answer 6

lisinopril

enalapril

Question 7

What is the MOA of ACEi?

Answer 7

decrease Ang II
(decreases TPR and CO)
reduced degradation of vasodilator kinins (more vasodilation)

Question 8

What are the side effects of ACEi?

Answer 8

dry cough

sudden, severe hypotension if taken with diuretics (short lives)

Question 9

Who is prescribed ACEi?

Answer 9

first line treatment for uncomplicated, mild hypertension in younger patients

Question 10

Name 2 types of ARBs

Answer 10

Losartan

Irbesartan

Question 11

What is the MOA of ARBs?

Answer 11

decreased vasoconstriction (indirect vasodilator)
decreases TPR and CO

Question 12

What are the side effects of ARBs?

Answer 12

non found yet!

Question 13

Why might ARBs be preferable over ACEi?

Answer 13

because they’re now about the same price and aren’t associated with side effects

Question 14

Name a type of Calcium channel blocker

Answer 14

Amlodipine

Question 15

What are the side effects associated with calcium channel blockers?

Answer 15

possible side effects on heart

decreased GIT activity

Question 16

When are calcium channel blockers prescribed?

Answer 16

first line treatment for uncomplicated, mild hypertension

Question 17

What is the initial mechanism of action for diuretics?

Answer 17

increased water/Na excretion from kidneys

decreased blood volume and CO

Question 18

What are the compensatory effects of diuretics?

Answer 18

longer term effect of arterial dilation

reduces TPR

Question 19

what are the side effects of diuretics?

Answer 19

hypokalaemia

Question 20

When are diuretics prescribed?

Answer 20

first line treatment for uncomplicated, mild hypertension

Question 21

What is the MOA of beta blockers?

Answer 21

decrease HR/contractility (decreases CO)

decrease renin secretion (decreases Ang II, and TPR/CO)

Question 22

What side effects are associated with beta adrenoreceptor antagonists?

Answer 22

bronchospasm
exercise intolerance
long term DM2

Question 23

When are beta blockers prescribed?

Answer 23

recent guidance is to avoid

however, there are some well controlled patients on it

Question 24

What is the MOA of alpha1 adrenoreceptor antagonists?

Answer 24

block vasoconstriction

decreases TPR/CO

Question 25

What side effects are associated with alpha 1 adrenoreceptor antagonists?

Answer 25

postural hypotension

Question 26

When are alpha 1 adrenoreceptor antagonists prescribed?

Answer 26

severe hypertension

Question 27

Which 2 classes of antihypertensives directly use RAAS?

Answer 27

Ace inhibitors

Beta blockers

Question 28

Which 2 classes of drugs have no direct effect on RAAS?

Answer 28

calcium channel blockers

diuretics

Question 29

What might you do if hypertension continues to get worse?

Answer 29

DO NOT INCREASE DOSE
this will cause complications

combination therapy

Question 30

What are the preferred combination therapies?

Answer 30

A+C
A+D

one of each category