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Pharmacology > Anti-Hypertensives > Flashcards

Anti-Hypertensives Flashcards

1
Q

What is the definition of hypertension?

A

a sustained systolic B.P > 140 mmHg
OR
a sustained diastolic B.P >90 mmHg

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2
Q

What is the initial treatment strategy for hypertension?

A
  • Reduce weight
  • Reduce salt intake
  • Reduce alcohol intake ( it increases circulating fats)
  • More fruit and veg
  • More exercise
  • Less fatty foods
  • Stop smoking
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3
Q

What can hypertension cause?

A
  • Strokes
  • Ischaemic heart disease
  • Peripheral vascular disease
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4
Q

What causes hypertension?

A
  • genetic factors
  • low birth weight
  • diabetes
  • drugs
  • kidney/ cardio-vascular disease
  • environmental factors - long term stress/ diet/ obesity
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5
Q

B.P = ______ X ______

A

B.P = cardiac output X total peripheral resistances

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6
Q

What determines cardiac output?

A
  • volume of blood pumped out
  • heart rate
  • blood volume
  • venous tone
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7
Q

Targets for anti-hypertensive drugs …A,B,C,D.

A

Ace inhibitors ( & angiotensin receptor blockers)
Beta blockers
Calcium channel blockers
Diuretics

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8
Q

Name 5 Ace inhibitors.

A

Its ACE in aPRIL!

  • Benazepril
  • Captopril
  • Enalapril
  • Fasinopril
  • Lisinopril
  • Moexipril
  • Perindopril
  • Quinopril
  • Ramipril
  • Trandolapril
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9
Q

What are the side effects of Ace inhibitors?

A
  • Persistent dry cough (10-20% of people)
  • Rash
  • Renal problems - don’t use in patients with renal disease
  • Hypotension
  • DO NOT use in pregnancy
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10
Q

How are Ace inhibitors taken?

A

Orally

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11
Q

What type of anti-hypertensive drugs are used as first line treatment?

A

Ace inhibitors are recommended as first-line treatment

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12
Q

What are the actions of ace inhibitors?

A
  • They block the enzyme ace which divides angiotensin I to form the potent vasoconstrictor angiotensin II/ reduces angiotensin II.
  • This results in vasodilation
  • Reduces peripheral resistance
  • Reduces both cardiac pre-load and afterload, thereby decreasing cardiac work.
  • check this card
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13
Q

Angiotensin II receptor antagonists/blockers …Name 5 examples.

A
  • Azilsartan medoxomil
  • Candesartan
  • Eprosartan
  • Irbesartan
  • Losartan
  • Olmesartan
  • Telmisartan
  • Valsartan
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14
Q

How do angiotensin II receptor blockers work?
&
What is an advantage?

A
  • They are alternatives to ace - they don’t produce the cough
  • They block angiotensin receptors
  • decrease the activation of AT receptors by angiotensin II
  • They produce arteriole and venous dilation
  • Block aldosterone secretion
  • Used as first line treatment
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15
Q

Side effects of angiotensin II receptor blockers are…

A
  • DO NOT use in pregnancy
  • Hypotension
  • Renal problems
  • Rash
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16
Q

Name 5 beta blockers.

A

Beta blockers = lol

  • Acebutolol
  • Atenolol
  • Betaxolol
  • Carvedilol
  • Metoprolol
  • Nadolol
  • Penbutolol
  • Propranolol
  • Timolol
17
Q

How do beta blockers work?

A
  • Reduce blood pressure
  • Decrease sympathetic outflow from CNS
  • Block vasoconstriction
  • Increase blood flow to kidney so reduce renin secretion
  • Can be use in pregnancy
18
Q

What are the side effects of Beta blockers?

A
  • Fatigue, lethargy and insomnia
  • Erectile dysfunction
  • Impaired concentration/memory
  • Aggravation in asthma sufferers
  • Exacerbation of Raynards disease
  • Bradycardia
19
Q

Name 5 calcium channel blockers.

A

Most end in ine..?

  • Amlodipine
  • Clevidipine
  • Dilitazem
  • Felodipine
  • Isradipine
  • Nicardipine
  • Verapamil
20
Q

How do calcium channel blockers act?

A
  • Dilate arteries
  • Reduce heart contractility
  • Reduce heart rate
  • They do not dilate veins
21
Q

Nifedipine, Amlodipine and Nicardipine …

*may not need this card

A
  • more potent on blood vessels than heart

- may cause headaches, flushing, dizziness, peripheral oedema (ankle swelling)

22
Q

Verapamil, dilitazem

* may not need this card

A
  • more potent on heart than blood vessels

- may cause constipation, heart block and precipitate cardiac failure

23
Q

What are the side effects of calcium channel blockers ?

A
  • headaches, flushing, dizziness, peripheral oedema
  • constipation
  • flushing
  • hypotension
  • precipitate cardiac failure
24
Q

Name three types of diuretic drugs.

A
  • Thiazide diuretics
  • Loop diuretics
  • Potassium - sparing diuretics
25
Q

How do thiazide diuretics act?

A
  • Lower BP initially by increasing NA+ & H20 excretion.
  • This causes decrease in extracellular volume resulting in a decrease in cardiac output and renal blood flow.
  • Decrease in blood volume
26
Q

what are the side effects of thiazide diuretics?

A
  • hypokalaemia (lack of potassium)
  • reduced insulin release
  • increased plasma lipids and urate —-> causing gout
  • erectile dysfunction
27
Q

name a thiazide diuretic

A
  • Hydrochlorothiazide
  • Chlorthiazide
  • Indapamide
  • Bendroflumethiazide
28
Q

how do potassium-sparing diuretics act?

A
  • they are used in combination with loop diuretics and thiazides
  • because they reduce potassium lost in the urine
29
Q

what are the side effects of potassium-sparing diuretics?

A
  • hyperkalaemia

- hypernatremia (to much sodium in the blood)

30
Q

name a potassium sparing diuretic.

A
  • Amiloride
  • Spironolactone
  • Triamterene
31
Q

How do loop diuretics work?

A
  • act promptly by blocking sodium & chloride reabsorption in the kidney
  • cause decrease renal vascular resistance and increase renal blood flow
32
Q

what are the side effects of loop diuretics?

A
  • Hypokalaemia
  • May cause gout
  • Can effect hearing
33
Q

Name a loop diuretic

A
  • Furosemide
  • Torsemide
  • Bumetanide
  • Ethacrynic acid
34
Q

Summary
________inhibitors ( block angiotensin II production) or ARB’s
________(reduce heart rate, dilate arteries, reduce renin release)
_________(reduce heart rate, dilate arteries)
_________ ( increase urine output—> so decreases blood volume.

A

Ace
Beta Blockers
Calcium channel blockers
Diuretics

35
Q

Captopril is an anti-hypertensive drug which blocks the formation of:

A

Angiotensin II

36
Q 
Which of the following (organs) is not a target for anti-hypertensive drugs? 
the kidney
the blood vessel
the liver 
the heart
A

the liver

37
Q

Calcium channel blockers (e.g. nifedipine) work by:

A

reducing the force of contraction of the heart

Pharmacology (6 decks)

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