Anti-hypertensive Drugs

Question 1

Examples of ACE-I

Answer 1

Ramipril, Lisinopril

Question 2

Mechanism of action of ACE-I

Answer 2

Inhibit ACE, reducing the level of angiotensin II causing reduced vasoconstriction, reduced levels of aldosterone reducing water retention

Question 3

ADRs of ACE-I

Answer 3

Dry cough, First dose hypertension, Hypotension, Hyperkalaemia, Headaches, Reduced renal function

Question 4

DDIs of ACE-I

Answer 4

Hypokalaemia with thiazide and loop diuretics

Hypotension with diuretics

Question 5

Examples of beta blockers

Answer 5

Atenolol, Bisoprolol

Question 6

Mechanism of action beta blockers (hypertension)

Answer 6

Reduce SNS, reduce contractility and heart rate, reduces cardiac output

Question 7

ADRs of beta blockers

Answer 7

Reduced exercise tolerance, Bronchospasm, Bradycardia

Question 8

DDIs of beta blockers

Answer 8

Bradycardia with cardiac glycosides, Reduced effectiveness with beta agonists

Question 9

Types of Ca channel blockers

Answer 9

Dihydropyridines, Phenylalkylamines, Benzothiazepines

Question 10

Example of dihydropyridine

Answer 10

Amilodipine

Question 11

Example of phenylalkylamine

Answer 11

Verapamil

Question 12

Example of benzothiaepine

Answer 12

Diltiazam

Question 13

Mechanism of action of dihydropyridines

Answer 13

Reduce Ca influx into vascular smooth muscle causing vasodilation

Question 14

Mechanism of action of phenylalkylamines and benzothiazepines

Answer 14

Slow conduction through the SA and AV nodes

Question 15

ADRs of dihydropyridines

Answer 15

Tachycardia, Palpitations, Flushing, Sweating, Oedema, Headaches

Question 16

ADRs of phenylalkylamines

Answer 16

Constipation, Bradycardia, Reduced contractility

Question 17

ADRs of benzothiazepines

Answer 17

Bradycardia, Reduced contracility

Question 18

Example of cardiac glycosides

Answer 18

Digoxin

Question 19

Mechanism of action of cardiac glycosides

Answer 19

Inhibit Na/K ATPase reducing Na conc, reverses the NCX reducing intracellular Ca reducing contractility

Question 20

ADRs of digoxin

Answer 20

Nausea, Vomiting, Dizziness, Agitation, Depression, Convulsions, Psychosis, Arrhythmia

Question 21

Management pathway for hypertension

Answer 21

1. 55 or black = Ca channel blocker
2. Add either ACE-I or Ca channel blocker
3. Add thiazide diuretic
4. Increase diuretic or add beta blocker

Question 22

Management for heart failure

Answer 22

Beta blockers, ACE-I, Cardiac glycosides, Thiazide diuretics, Aldosterone antagonists