Anti-hypertensives Flashcards
What is the mechanism of action of ACE inhibitors?
ACE inhibitors block the conversion of angiotensin I to angiotensin II, leading to vasodilation and reduced aldosterone secretion.
Name a class of antihypertensive drugs that inhibit the renin-angiotensin-aldosterone system.
Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs).
Name an example of an ACE inhibitor.
Lisinopril, captopril, enalapril, peindopril
What is the primary mechanism of action of ARBs?
ARBs block the action of angiotensin II at its receptor, preventing vasoconstriction and aldosterone release.
Which receptor do ARBs primarily target?
Answer: Angiotensin II type 1 (AT1) receptors.
Name an example of an ARB.
Losartan, Candesartan, valsartan, Olmesartan, Telmisartan
What is the primary mechanism of action of calcium channel blockers (CCBs)?
CCBs inhibit the influx of calcium ions into vascular smooth muscle cells, leading to vasodilation.
Name two classes of CCBs.
Dihydropyridine CCBs (e.g., amlodipine) and non-dihydropyridine CCBs (e.g., verapamil, diltiazem).
How do dihydropyridine CCBs primarily affect blood vessels?
Dihydropyridine CCBs primarily cause vasodilation of peripheral arteries.
Which type of CCBs is more selective for cardiac tissue?
Non-dihydropyridine CCBs (e.g., verapamil, diltiazem).
Name an example of a dihydropyridine CCB.
Amlodipine.
What is the primary mechanism of action of beta-blockers?
Beta-blockers inhibit the action of catecholamines (e.g., adrenaline) at beta-adrenergic receptors, leading to decreased heart rate and contractility.
Which beta-adrenergic receptors do beta-blockers primarily target?
Beta-1 adrenergic receptors in the heart.
Name an example of a cardioselective beta-blocker.
Atenolol, betaxolol, bisoprolol, esmolol, acebutolol, metoprolol, and nebivolol.
What is the primary mechanism of action of thiazide diuretics?
Thiazide diuretics inhibit sodium reabsorption in the distal convoluted tubule of the nephron, leading to diuresis and decreased blood volume.
How do thiazide diuretics contribute to blood pressure reduction?
Thiazide diuretics reduce blood volume, leading to decreased preload and cardiac output, thus lowering blood pressure.
Name an example of a thiazide diuretic.
Chlorthalidone,
Hydrochlorothiazide, Indapamide,Metolazone
What is the primary mechanism of action of loop diuretics?
Loop diuretics inhibit sodium-potassium-chloride cotransport in the ascending loop of Henle, leading to diuresis and decreased blood volume.
Which part of the nephron do loop diuretics primarily act on?
The ascending loop of Henle.
Name an example of a loop diuretic
Furosemide,bumetanide, and torsemide
What is the primary mechanism of action of aldosterone receptor antagonists?
Answer: Aldosterone receptor antagonists block the action of aldosterone in the distal nephron, leading to increased sodium and water excretion.
Name an example of an aldosterone receptor antagonist.
Spironolactone.Eplerenone
What is the primary mechanism of action of central alpha-2 agonists?
Central alpha-2 agonists stimulate alpha-2 adrenergic receptors in the brainstem, reducing sympathetic outflow and lowering blood pressure.
Name an example of a central alpha-2 agonist.
Clonidine.
What is the primary mechanism of action of peripheral alpha-1 blockers?
Peripheral alpha-1 blockers block alpha-1 adrenergic receptors in peripheral blood vessels, leading to vasodilation and decreased blood pressure.
Name an example of a peripheral alpha-1 blocker.
Prazosin
What is the primary mechanism of action of direct vasodilators?
Direct vasodilators relax vascular smooth muscle, leading to peripheral vasodilation and decreased blood pressure.
Which antihypertensive drugs are contraindicated in pregnancy due to teratogenic effects?
ACE inhibitors, ARBs, and direct renin inhibitors are contraindicated in pregnancy due to potential teratogenic effects.
What are the major factors influencing arterial blood pressure?
Cardiac output, Total Peripheral resistance, stroke volume and HR.
What Beta and M receptors are found in the heart
B1 and M2 receptors
What receptors are found in arteries?
Alpha 1 and beta 2 receptors
Which of the following is a common side effect of ACE inhibitors?
a) Hyperkalemia
b) Hypokalemia
c) Hypernatremia
d) Hypoglycemia
Answer: a) Hyperkalemia
Beta-blockers exert their antihypertensive effect primarily by:
a) Blocking alpha receptors
b) Increasing renin secretion
c) Reducing heart rate and contractility
d) Dilating blood vessels
c) Reducing heart rate and contractility
Which class of antihypertensive drugs is contraindicated in patients with asthma?
a) Beta-blockers
b) Calcium channel blockers
c) Diuretics
d) ACE inhibitors
a) Beta-blockers
Calcium channel blockers primarily target:
a) Renin
b) Angiotensin II receptors
c) Aldosterone
d) Calcium channels in vascular smooth muscle
d) Calcium channels in vascular smooth muscle
Diuretics lower blood pressure by:
a) Decreasing blood volume
b) Inhibiting the sympathetic nervous system
c) Increasing renin secretion
d) Blocking angiotensin II receptors
Answer: a) Decreasing blood volume
Thiazide diuretics are commonly used as first-line therapy in hypertension because they:
a) Have a rapid onset of action
b) Are well tolerated and cost-effective
c) Have minimal side effects
d) Have a long duration of action
Answer: b) Are well tolerated and cost-effective
Which of the following antihypertensive drugs can cause a persistent dry cough as a side effect?
a) Losartan
b) Amlodipine
c) Lisinopril
d) Propranolol
Answer: c) Lisinopril
Which of the following drugs is NOT a calcium channel blocker?
a) Verapamil
b) Diltiazem
c) Amlodipine
d) Enalapril
Answer: d) Enalapril
Which antihypertensive drug is commonly associated with a side effect known as “reflex tachycardia”?
a) ACE inhibitors
b) Beta-blockers
c) Calcium channel blockers
d) Diuretics
c) Calcium channel blockers
Which of the following is a side effect associated with alpha-blockers used in hypertension treatment?
a) Bradycardia
b) Hypokalemia
c) Orthostatic hypotension
d) Hyperglycemia
c) Orthostatic hypotension
Which of the following statements regarding angiotensin II receptor blockers (ARBs) is true?
a) They inhibit the conversion of angiotensin I to angiotensin II.
b) They increase aldosterone secretion.
c) They cause a dry cough as a common side effect.
d) They block the action of angiotensin II on its receptors.
Answer: d) They block the action of angiotensin II on its receptors.
Which antihypertensive medication is known to cause peripheral edema as a common side effect?
a) Hydrochlorothiazide
b) Losartan
c) Amlodipine
d) Propranolol
c) Amlodipine
Which class of antihypertensive drugs is associated with a risk of rebound hypertension if stopped abruptly?
a) Diuretics
b) Beta-blockers
c) Alpha-blockers
d) Alpha-2 adrenergic agonists
Answer: b) Beta-blockers
Which antihypertensive medication is known to cause a side effect of photosensitivity?
a) Hydrochlorothiazide
b) Ramipril
c) Valsartan
d) Amlodipine
Answer: a) Hydrochlorothiazide
How does ACE inhibitors affect the adrenal gland?
Affects the adrenal gland in 2 ways, via cortex- Decreases aldosterone in the blood, causes decrease in Na reabsorption in distal tubule and collecting duct, decrease in potassium secretion and decrease in H20 reabsorption–> leading to decrease in BV–> decrease in VR–> decrease in contractile force and decrease in SV–> decrease in CO–> decrease in MAP
via adrenal medulla: 3 parts: Decrease in adrenaline and noradrenaline–> affects the b2 arterioles, alpha 1 arterioles, b1 heart.
b2R- decrease in VSMC relax, Decrease vasodilation–> increase TPR
a1R- Decrease in VSMC contract–> decrease in vasoconstriction–> decrease in TPR (cancel) each other out,
Then the main one is the heart one–> decrease contractile force–> decrease SV–> decrease CO –> decrease HR–> decrease CO –> decrease MAP
Which antihypertensive drug class is not as effective in patients with heart failure? (more than 1)
a) ACE inhibitors
b) Beta-blockers
c) Calcium channel blockers
d) Loop diuretics
Beta blockers & Calcium channel blockers
