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CPT > 3. Hypertension > Flashcards

3. Hypertension Flashcards

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1
Q

What are the actions of angiotensin-II?

A

Vasoconstriction
Stimulation of aldosterone which acts at distal renal tubule
Cardiac and vascular muscle cell growth
ADH release from posterior pituitary

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2
Q

What do ACE-i do?

A

Limit conversion of angiotensin-I o angiotensin-II by inhibiting circulating and tissue ACE

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3
Q

What does a reduction in angiotensin-II activity result in?

A 
Vasodilation
Reduction in aldosterone release
Reduced AD release
Reduced cell growth and proliferation 
All contributing to antihypertensive effects
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4
Q

What are the most common ACEi?

A

LisinoPRIL

RamiPRIL

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5
Q

What are some adverse affects to ACEi?

A 
Hypotension
Dry cough (bradykinin association)
Hyperkalaemia (low aldosterone)
Cause or worsen renal failure
Angioedema
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6
Q

What are the contradictions of ACEi?

A 
Renal artery stenosis
AKD
Pregnancy
CKD
Idiopathic angioedema
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7
Q

What are the important drug interactions with ACEi?

A

Hyperkalaemic drugs
NSAIDs
Other antihypertensive agents

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8
Q

What are the most common angiotensin-II and receptor antagonists (ARBs) prescribed?

A

CandeSARTAN

LoSARTAN

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9
Q

What are some adverse effects with ARBs?

A

Hypotension
Hyperkalaemia
Cause or worsen renal failure

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10
Q

What are the contraindications for ARBs?

A

Renal artery stenosis
AKD
Pregnancy
CKD

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11
Q

What are some important drug interactions with ARBs?

A

Hyperkalaemic drugs

NSAIDs

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12
Q

What are L-type calcium channels?

A

Allow inward Ca2+ flux into cells - voltage operated calcium channel
Expressed throughout the body, including vascular smooth muscle cells and cardiac myocytes plus SA and AV node

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13
Q

What is the role of calcium channel blockers?

A

Target calcium initiated smooth muscle contraction

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14
Q

What are the 2 main categories of calcium channel blockers?

A

Dihydropyridines

Non-dihydropyridines (phenylalkylamines and benzothiazepines)

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15
Q

What is the role of dihydropyridines?

A

Selective for peripheral vasculature

Little chronotropic or inotropic effects

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16
Q

What is the role of phenylalkylamines?

A

Depresses SAN and slows AV conduction, negative inotropy

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17
Q

When are CCBs usually given?

A

Primary choice antihypertensive in low renin patients

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18
Q

Gives some examples of dihydropyridines?

A

AmlodIPINE
NifedIPINE
NimodIPINE

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19
Q

What is nimodipine useful for?

A

Selectivity for cerebral vasculature so useful for ischaemic effects of subarachnoid haemorrhage

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20
Q

What are the adverse effects of dihydropyridine drugs?

A

Ankle swelling
Flushing
Headaches
Palpitations

21
Q

What are the contraindications for dihydropyridine drugs?

A

Unstable angina

Severe aortic stenosis

22
Q

What are some important drug interactions with dihydropyridine drugs?

A

Amlodipine + simvastatin (increased effect of statin)

23
Q

Name the phenylalkylamines drug

A

Verapamil

24
Q

What is phenylalkylamines used for?

A

Arrhythmia
Angina
Hypertension

25
Q

What are the adverse effects of phenylalkylamines?

A

Constipation
Bradycardia
Heart block
Cardiac failure

26
Q

What are the contraindications for phenylalkylamines?

A

Poor LV function

AV nodal conduction delay

27
Q

What are the important drug interactions with phenylalkylamines?

A

Beta blockers

Other antihypertensive and antiarrhythmic agents

28
Q

Name a benzothiazapine

A

Diltiazem

29
Q

Name a thiazide diuretic

A

Bendroflumethiazide

30
Q

Name a thiazide-like diuretic

A

Indapamide

31
Q

What do thiazide and thiazide-like diuretics do?

A

Inhibit Na+/Cl- co-transporter in distal convoluted tubule

Decrease Na+ and H2O reabsorption

32
Q

What are the adverse effects of thiazide and thiazide-like diuretics?

A 
Hypokalaemia
Hyponatraemia
Hyperuricemia (gout)
Arrhythmia
Increased glucose
Small increase in cholesterol and triglyceride
33
Q

What are the contraindications for thiazide and thiazide-like diuretics?

A

Hypokalaemia
Hyponatraemia
Gout

34
Q

What are the important drug interactions with thiazide and thiazide-like diuretics?

A

NSAIDs

Decrease K+ drugs such as loop diuretics

35
Q

What drug is given in resistant hypertension?

A

Spironolactone - aldosterone receptor antagonist

36
Q

What are the adverse effects of spironolactone?

A

Hyperkalaemia

Gynaecomastia

37
Q

What are the contraindications of spironolactone?

A

Hyperkalaemia

Addison’s

38
Q

What are the important drug interactions with spironolactone?

A

Increased K+ drugs

Pregnancy

39
Q

What is the role of beta-adrenoceptor blockers?

A

Decrease sympathetic tone by blocking NA and reducing myocardial contraction resulting in reduced cardiac output
Decreased renin secretion

40
Q

What are the adverse effects of beta-adrenoceptor blockers?

A 
Bronchospasm
Heart block
Raynaud’s
Lethargy
Impotence
Mask tachycardia
41
Q

What are the contraindication for beta-adrenoceptor blockers?

A

Asthma
COPD
Haemodynamic instability
Hepatic failure

42
Q

What are the important drug interactions with beta-adrenoceptor blockers?

A

Non-dihydropyridine CCBs verapamil and diltiazem

43
Q

Name some beta-adrenoceptor blockers

A

LabetaLOL
BisoproLOL
MetoproLOL

44
Q

Name a alpha-adrenoceptor blocker

A

DoxazOSIN

45
Q

What is the role of alpha-adrenoceptor blockers?

A

Reduce peripheral vascular resistance

Selective antagonism of alpha-1 adrenoceptors

46
Q

What are the adverse effects of alpha-adrenoceptor blockers?

A 
Postural hypotension
Dizziness
Syncope
Headache
Fatigue
47
Q

What are the contraindications for alpha-adrenoceptor blockers?

A

Postural hypotension

48
Q

What are the important drug interactions with alpha-adrenoceptor blockers?

A

Dihydropyridine CCBs - oedema

CPT (30 decks)

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