Anti Hypertensive

Question 1

What are the two types of diuretics and which one is stronger.

Answer 1

Thiazide (mild) and loop diuretics (stronger)

Question 2

Example of a thiazide diuretic

Answer 2

Bendroflumethiazide

Question 3

Example of loop diuretic

Answer 3

Furosemide

Question 4

Mechanism of thiazide diuretics

Answer 4

Promote Na and water excretion from the kidneys inhibiting re-absorption in the loop of henley or distal tubule

Question 5

What are thiazide diuretics used for

Answer 5

Hypertension (in combination with ACEi and Ca channel blocker usually)

Question 6

What are loop diuretics used for

Answer 6

Heart failure

Question 7

What are the side effects of diuretics

Answer 7

Hypokalaemia (tiredness, arrhythmias), hyperglycaemia (diabetes) and increased uric acid (gout)

Question 8

What are the two types of beta blockers

Answer 8

(cardio)Selective beta blockers and non selective beta blockers

Question 9

Example of a cardioselective beta blocker

Answer 9

Atenolol

Question 10

Example of non-selective beta blocker

Answer 10

Propranolol

Question 11

Mechanism of action for cardioselective beta blockers

Answer 11

Only block B1 receptors-B1 adrenoceptors stimulate increase in cAMP, PKa, CICR via RyR2 and increase contractility

Question 12

Mechanism of action for non-selective beta blockers

Answer 12

Block B1 and B2 receptors, B2 adrenoceptors cause vasodilation of the coronary arteries and increase heart rate

Question 13

What are cardioselective beta blockers used for

Answer 13

Angina, heart failure and hypertension.

Question 14

What are non-selective beta blockers used for

Answer 14

Thyrotoxicosis (grave’s disease)

Question 15

Side effects of beta blockers

Answer 15

Tiredness, cold peripheries, can cause heart failure long term, bradycardia and fatigue (CO2 and skeletal muscle perfusion in exercise are regulated by adrenoceptors

Question 16

What condition do you not prescribe beta blockers and why

Answer 16

Asthma as it causes bronchospasms

Question 17

Two types of calcium channel blockers

Answer 17

Dihydropyridines and rate limiting calcium antagonists

Question 18

Give example of dihydropyridines

Answer 18

Amlodipine

Question 19

Give examples of rate limiting calcium antagonists

Answer 19

Verapamil and diltiazem

Question 20

Mechanism of action of calcium channel blockers

Answer 20

Alpha-1 adrenoceptors stimulate L-type Ca2+ channels in vascular smooth muscle cells, causing increase in muscle contraction. Ca channels blockers cause decrease in calcium entry, decreased TPR and MABP. Coronory vasodilation v. useful for angina and hypertension.

Question 21

What are calcium channel blockers used for

Answer 21

Hypertension, angina and SV arrhythmias.

Question 22

Side effects of calcium channel blockers

Answer 22

Ankle oedema, hypotension, dizziness. Amlodipine is better as less unwanted effects on cardiac muscle.

Question 23

Examples of alpha blockers (alpha-1 adrenoceptor antagonists)

Answer 23

Prazosin and doxazosin

Question 24

Mechanism of action of alpha blockers

Answer 24

Block vascular alpha-1 adrenoceptors (decrease TPR and MABP)

Question 25

What are alpha blockers used for

Answer 25

Hypertension

Question 26

What are side effects of alpha blockers

Answer 26

Postural hypotension

Question 27

Examples of ACE inhibitors

Answer 27

Lisinopril (prils)

Question 28

Mechanism of action for ACEi

Answer 28

Blocks conversion of angiotensin 1 to angiotensin 2.

Question 29

Side effects with ACEi

Answer 29

Dry cough and hypotension (esp. alongside diuretic

Question 30

Examples of angiotension receptor blockers (ARBs)

Answer 30

Losartan (sartans)

Question 31

Mechanism of action of ARBs

Answer 31

Competitively blocks angiotensin 2 at AT1 receptors. Venous dilation (decreased preload) and arteriolar dilation (decreased afterload and decreased TPR). Overall decreasing MABP