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Pharmacology > Anti-hypertensives > Flashcards

Anti-hypertensives Flashcards

1
Q

What causes hypertension

A 
. Pre existing condition
. Genes
. Diabetes 
. Environment (smoking alcohol)
. Low birth weight
. Drugs (pill caffeine steroids)
. Kidney/ CV diseases
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2
Q

Having hypertension can lead to…

A

. Stroke- bv burst in brain
. Blood clot
. Peripheral vascular disease- arm/ leg not enough o2
. Iaschemic ❤️ disease - damage to coronary muscle and not enough o2

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3
Q

BP equation

A

BP= COxTPR

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4
Q

What determines CO

A

Heart rate
Stroke volume
Plasma volume

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5
Q

What are the initial treatments of hypertension

A

. Reduce: salt in diet, weight, alcohol intake
. Stop: smoking, fatty foods
. Increase : exercise, fruit and veg intake.
. Decrease: tea and coffee.

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6
Q

How is BP controlled in the body

A

Baroreceports- aortic arch- cartoid sinus

Act on medulla

Which then impacts on the SA node and arterioles

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7
Q

What are the for targets for hypertension drugs

A

Kidney
Heart
Brain
Blood vessels

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8
Q

How does the renin angiotensin system work

A 
Have low BP
Renin released in kidney
Activates : angiotensin 
                   Angiotensin I
                   Angiotensin II

The ACE enzyme works on angiotensin I in the lungs. This enzyme secrets aldosterone and causes vasoconstriction

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9
Q

What is an example of an ACE inhibitor

ACE April

A

CAPTOPRIL

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10
Q

How do ACE inhibitors work

A

. Block ACE and then stop vasoconstriction

. Reduce our TPR

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11
Q

What are the side effects of ACE inhibitors

A 
. Dry persistent cough (10-20%)
. Rash
. Renal problems (efferent)
. Hypotension??
. Not suitable in pregnancy
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12
Q

What is an example of an angiotensin receptor antagonist

Sartan

A

Losartan

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13
Q

How do angiotensin receptor antagonists work

A

. Block AT receptors
. Cause vasodilation
. No cough

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14
Q

What are the side effects of angiotensin receptor antagonists

A

Dizziness
Hyperkalaemia
Expensive

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15
Q

What is an example of a beta blocker

A

Atenolol

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16
Q

How do beta blockers work

A

. Sympathetic nervous system
. B1 B2 receptors
. Nerves in the ❤️, glomerulus, clonidine methyldopa (brain)
. Decrease HR (CO ❤️)
. Stops vasoconstriciron (brain)
. Increase blood flow to kidney (reduce renin secretion)

17
Q

What are the side effects of beta blockers

A 
. Lethargy
. Loss concentration/ memory
. Aching limbs
. Exabation of raynoids
. Aggravated asthma
.ED
18
Q

An example of a short acting A blocker

A

Prazosin

  • a1 antagonist. Cause arteriolar / venous dilation
19
Q

An example of a longer acting A blocker

A

Doxazosin

Act on treazosin

20
Q

How do A blockers work

A

Block NAdr and adrenaline on blood vessels to cause vasodilation.

21
Q

What are the side effects of a blockers

A

Can cause postral hypotension

22
Q

What are 2 examples of calcium channel blockers (CCB)

A

Nifedipine (potent on blood vessels)
- se HA, flushing, dizziness, peripheral odema

Veraparil (potent on ❤️)
- se constipation, ❤️ block, precipitate cardiac failure not use with bb

Both interact with grape fruit

23
Q

What do CCB do

A

. Increase AV node conduction
. Increase myocardial contractility
. Increase arterial tone (vasoconstriciron)
. Increase HR

24
Q

An example of a thiazide- like diuretic

A

Bendrofluerthazide

25
Q

How do thiazide like diuretics work

A

. Increase urine output which decreases blood volume and then decreases bp

26
Q

What are the side effects of thiazide like diuretics

A

Hypocalcaemia
Reduction in insulin released
Increase in plasma lipid/ urate- leading to gout
ED

27
Q

What is an example of a potassium sparing diuretic

A

Spironalide

28
Q

How do potassium sparing diuretics work

A

Block the sodium/ potassium pump

Can be used alongside thiazides

29
Q

What are the side effects of potassium sparing diuretics

A

. Increase potassium and decrease sodium in blood leading to hypercalcaemia and hyponatrocrine

30
Q

What is an example of a loop diuretic

A

Furosemide

31
Q

How do loop diuretics work

A

For severe hypertension

Short duration of action

32
Q

What are the side effects of loop diuretics

A

. Hearing loss
. Gout
. Hypocalcaemia

33
Q

Name 3 vasodilators

A

Hydralazine: short acting non selective k channel opener

Minoxidil: powerful vasodilator used in extreme hypertension

Intravenous nitrates/ sodium nitroprusside: emergency

34
Q

If a patient is under 55 and not black what are the 3 stages of action

A

1 - A or B
2- A& C or A&D
3 A&C&D

35
Q

If a patient is over 55 or black what is the 3 stages of action

A

1- C or D
2- A&C or A&D
3- A&C&D

36
Q

What is hypertension

A

A sustained systolic b.p >140mmHg
A sustained diastolic b.p >90mmHg

1/4 adults

Pharmacology (11 decks)

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