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Cardio Pharmacology > Anti-Hypertensive Drugs > Flashcards

Anti-Hypertensive Drugs Flashcards

1
Q

What are the classes of anti-hypertensive drugs?

A
  • Diuretics
  • Beta blockers
  • Vasodilators
  • Mineralocorticoid antagonists
  • Alpha 2 or imidazoline receptor agonist
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2
Q

What are the types of anti-hypertensive vasodilators?

A
  • Calcium channel blockers
  • Alpha 1 blockers
  • Angiotensin converting enzyme inhibitors (ACEi)
  • Angiotensin receptor blockers (ARB)
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3
Q

What is the mechanism of action of thiazide diuretics?

A

Thiazide diuretics work by inhibiting sodium reabsorption at the beginning of the kidney’s distal convoluted tubule (DCT) by blocking the thiazide-sensitive Na+-Cl− symporter

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4
Q

What is an example of a thiazide diuretic and what condition is it used for?

A

Bendrofluazide, used in hypertension (although recent NICE guidelines now recommend other thiazide-like diuretics such as indapamide and chlortalidone)

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5
Q

What is the mechanism of action of loop diuretics?

A

Loop diuretics act by inhibiting the Na-K-Cl cotransporter in the kidney’s thick ascending limb of the loop of Henle, reducing the absorption of NaCl.

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6
Q

What is an example of a loop diuretic and what conditions is it used for?

A

Furosemide, used in heart failure, both acute (usually intravenously) and chronic (usually orally) and resistant hypertension

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7
Q

What are some side effects of diuretics?

A
  • Hypokalaemia, resulting in tiredness
  • Arrhythmias
  • Hyperglycaemia, resulting in diabetes
  • Increase in uric acid, resulting in gout
  • Impotence (erectile dysfunction)
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8
Q

What is the mechanism of action of beta blockers?

A

Blocking of beta 1 and beta 2 adrenoceptors

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9
Q

Which receptors do cardioselective beta blockers act on?

A

Only block beta 1 receptors

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10
Q

Which receptors do non-selective beta blockers act on?

A

Block both beta 1 and beta 2 receptors

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11
Q

What are examples of cardioselective beta blockers and what conditions are they used for?

A

Examples :
- Atenolol
- Bisoprolol

Used for :
- Angina
- Acute coronary syndrome
- Myocardial infarction
- Hypertension
- Heart failure

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12
Q

What are examples of non selective beta blockers and what conditions are they used in?

A

Examples :
- Propanolol
- Carvedilol

Used in :
- Thyrotoxicosis
- Migraine

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13
Q

What is special about carvedilol?

A

It is both an alpha and beta blocker

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14
Q

What are some side effects of beta blockers?

A
  • Bronchospasm
  • Tiredness
  • Cold peripheries
  • Erectile dysfunction
  • Sleep disturbances (including nightmares)
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15
Q

In what conditions are beta blockers contraindicated?

A

Asthma and uncontrolled heart failure (beta blockers can worsen heart failure in the short term, especially cardiogenic shock)

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16
Q

What are the types of calcium channel blockers?

A
  • Dihydropyridines
  • Rate limiting calcium channel blockers
17
Q

What is the mechanism of action of calcium channel blockers?

A

Calcium channel blockers block the inward movement of calcium by binding to the L-type “long-acting” voltage-gated calcium channels in the heart, vascular smooth muscle, and pancreas

18
Q

What is an example of a dihydropyridine, what conditions is it used for and what is a notable side effect?

A
  • Example : Amlodipine
  • Used in hypertension and angina
  • Side effect : Ankle oedema
19
Q

What are examples of rate limiting calcium channel blockers, what conditions are they used in, and what medication should they not be used alongside?

A

Examples :
- Verapamil
- Diltiazem

Used in :
- Hypertension
- Angina
- Supraventricular arrhythmias (AF, SVT)

Avoid use with beta blockers

20
Q

What is the mechanism of action of ACE inhibitors?

A

ACE inhibitors block angiotensin I becoming angiotensin II

21
Q

What are examples of ACE inhibitors?

A

Lisinopril and ramipril

22
Q

What conditions are ACE inhibitors used in?

A
  • Hypertension
  • Heart failure
23
Q

What are the effects of ACE inhibitors on the kidneys?

A
  • Good for kidneys in diabetic nephropathy
  • Bad for kidneys in renal artery stenosis
24
Q

What are some side effects of ACE inhibitors?

A
  • Cough
  • Renal dysfunction
  • Angioneurotic oedema
25
Q

In what situation should ACE inhibitors never be used?

A

Pregnancy induced hypertension

26
Q

What is the mechanism of action of ARBs?

A

ARBs block angiotensin II receptors

27
Q

What is an example of an ARB?

A

Losartan

28
Q

What conditions are ARBs used in?

A
  • Hypertension
  • Heart failure
29
Q

What are the effects of ARBs on the kidneys?

A
  • Good for kidneys in diabetic nephropathy
  • Bad for kidneys in renal artery stenosis
30
Q

What are some side effects of ARBs?

A
  • Renal dysfunction
  • NO cough (in contrast to ACEi)
31
Q

In what situation should ARBs never be used?

A

Pregnancy induced hypertension

32
Q

What is the mechanism of action of alpha blockers?

A

Alpha blockers block alpha adrenoceptors to cause vasodilation

33
Q

What is an example of an alpha blocker, what conditions is it used in and what is a notable side effect?

A
  • Example : Doxazosin
  • Used in hypertension and prostatic hypertrophy
  • Side effect : Postural hypotension
34
Q

What is the mechanism of action of mineralocorticoid antagonists?

A

Mineralocorticoid antagonists block aldosterone receptors

35
Q

What are examples of mineralocorticoid antagonists, what conditions are they used in and what are some side effects?

A

Examples :
- Spironolactone
- Eplerenone

Used in :
- Heart failure
- Resistant hypertension

Side effects :
- Gynaecomastia
- Hyperkalaemia
- Renal impairment

36
Q

What are clonidine and moxonidine?

A
  • Alpha 2 adrenoceptor / imidazoline receptor agonists
  • Centrally acting drugs - lower heart rate and blood pressure

Cardio Pharmacology (5 decks)

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