Anti Hypertensive Flashcards
What are the two types of diuretics and which one is stronger.
Thiazide (mild) and loop diuretics (stronger)
Example of a thiazide diuretic
Bendroflumethiazide
Example of loop diuretic
Furosemide
Mechanism of thiazide diuretics
Promote Na and water excretion from the kidneys inhibiting re-absorption in the loop of henley or distal tubule
What are thiazide diuretics used for
Hypertension (in combination with ACEi and Ca channel blocker usually)
What are loop diuretics used for
Heart failure
What are the side effects of diuretics
Hypokalaemia (tiredness, arrhythmias), hyperglycaemia (diabetes) and increased uric acid (gout)
What are the two types of beta blockers
(cardio)Selective beta blockers and non selective beta blockers
Example of a cardioselective beta blocker
Atenolol
Example of non-selective beta blocker
Propranolol
Mechanism of action for cardioselective beta blockers
Only block B1 receptors-B1 adrenoceptors stimulate increase in cAMP, PKa, CICR via RyR2 and increase contractility
Mechanism of action for non-selective beta blockers
Block B1 and B2 receptors, B2 adrenoceptors cause vasodilation of the coronary arteries and increase heart rate
What are cardioselective beta blockers used for
Angina, heart failure and hypertension.
What are non-selective beta blockers used for
Thyrotoxicosis (grave’s disease)
Side effects of beta blockers
Tiredness, cold peripheries, can cause heart failure long term, bradycardia and fatigue (CO2 and skeletal muscle perfusion in exercise are regulated by adrenoceptors
What condition do you not prescribe beta blockers and why
Asthma as it causes bronchospasms
Two types of calcium channel blockers
Dihydropyridines and rate limiting calcium antagonists
Give example of dihydropyridines
Amlodipine
Give examples of rate limiting calcium antagonists
Verapamil and diltiazem
Mechanism of action of calcium channel blockers
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.
What are calcium channel blockers used for
Hypertension, angina and SV arrhythmias.
Side effects of calcium channel blockers
Ankle oedema, hypotension, dizziness. Amlodipine is better as less unwanted effects on cardiac muscle.
Examples of alpha blockers (alpha-1 adrenoceptor antagonists)
Prazosin and doxazosin
Mechanism of action of alpha blockers
Block vascular alpha-1 adrenoceptors (decrease TPR and MABP)
What are alpha blockers used for
Hypertension
What are side effects of alpha blockers
Postural hypotension
Examples of ACE inhibitors
Lisinopril (prils)
Mechanism of action for ACEi
Blocks conversion of angiotensin 1 to angiotensin 2.
Side effects with ACEi
Dry cough and hypotension (esp. alongside diuretic
Examples of angiotension receptor blockers (ARBs)
Losartan (sartans)
Mechanism of action of ARBs
Competitively blocks angiotensin 2 at AT1 receptors. Venous dilation (decreased preload) and arteriolar dilation (decreased afterload and decreased TPR). Overall decreasing MABP
