Anti-hypertensive Medications Flashcards
1
Q
Antihypertensive therapy
A
- Diuretics
- ACEI / AT1-R antagonist
- Ca-blocker
- Beta-blocker
2
Q
Examples of ACEI
A
- Captopril
- Enalapril
- Ramipril
- Lisinopril
3
Q
MOA of ACEI
A
Mechanism of action: inhibition of ACE → ↓ conversion of angiotensin I to angiotensin II
Main effects:
- ↓ Angiotensin II
- ↓ Vasoconstriction → ↓ blood pressure
- ↓ Secretion of aldosterone → ↓ reabsorption of Na+ and water → ↓ blood pressure
- Dilation of efferent arteriole → ↑ renal plasma flow → ↓ GFR → ↓ filtration fraction
- ↑ Renin secretion (due to lack of feedback inhibition) → ↑ angiotensin I - ↓ Breakdown of bradykinin → ↑ production of arachidonic acid metabolites → ↑ vasodilation → ↓ blood pressure
4
Q
Clinical uses of ACEI
A
- Hypertension
- Cardiac failure
- Following myocardial infarction
- Renal insufficiency
5
Q
Adverse effects of ACEI
A
- severe hypotension
- acute renal failure
- hyperkalemia
- angioedema & dry cough
6
Q
Contraindication of ACEI
A
pregnancy
7
Q
Examples of Ang II Receptor (AT1) blockers (ARB)
A
- Lorsartan
- Valsartan
- Candesartan
- Eprosartan
- Irbesartan
- Telmisartan
8
Q
MOA of ARB
A
Mechanism of action: inhibition of angiotensin II receptor type 1 (AT1 receptor)
Main effects:
- ↓ Vasoconstriction → ↓ blood pressure
- ↓ Secretion of aldosterone → ↓ reabsorption of Na+ and water → ↓ blood pressure
- ↑ Renin secretion (compensatory) → ↑ angiotensin I → ↑ angiotensin II
9
Q
Adverse effects of ARB
A
Less/no dry cough (unlike in ACEI)
10
Q
Contraindication of ARB
A
Pregnancy
11
Q
Examples of non-selective beta-blockers
A
- Proponolol
- Pindolol
- Carvedilol
12
Q
Examples of cardioselective beta-blockers
A
- Atenolol
- Bisoprolol
- Metoprolol
13
Q
Beta-blockers approved to treat heart failure
A
- Bisoprolol
- Metoprolol
- Carvedilol
14
Q
Clinical uses of beta-blockers
A
- Hypertension
- Cardiac failure
- Following myocardial infarction
- Abnormal heart rhythm
- Anxiety disorders
15
Q
Adverse effects of beta-blockers
A
- Hypotension
- Bradycardia
- AV nodal block
- Reduced exercising capacity
- Bronchoconstriction (esp. asthmatics)
- CNS: vivid dreams, clinical depression