Anti-hypertensives Flashcards
What causes hypertension
. Pre existing condition . Genes . Diabetes . Environment (smoking alcohol) . Low birth weight . Drugs (pill caffeine steroids) . Kidney/ CV diseases
Having hypertension can lead to…
. 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
BP equation
BP= COxTPR
What determines CO
Heart rate
Stroke volume
Plasma volume
What are the initial treatments of hypertension
. Reduce: salt in diet, weight, alcohol intake
. Stop: smoking, fatty foods
. Increase : exercise, fruit and veg intake.
. Decrease: tea and coffee.
How is BP controlled in the body
Baroreceports- aortic arch- cartoid sinus
Act on medulla
Which then impacts on the SA node and arterioles
What are the for targets for hypertension drugs
Kidney
Heart
Brain
Blood vessels
How does the renin angiotensin system work
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
What is an example of an ACE inhibitor
ACE April
CAPTOPRIL
How do ACE inhibitors work
. Block ACE and then stop vasoconstriction
. Reduce our TPR
What are the side effects of ACE inhibitors
. Dry persistent cough (10-20%) . Rash . Renal problems (efferent) . Hypotension?? . Not suitable in pregnancy
What is an example of an angiotensin receptor antagonist
Sartan
Losartan
How do angiotensin receptor antagonists work
. Block AT receptors
. Cause vasodilation
. No cough
What are the side effects of angiotensin receptor antagonists
Dizziness
Hyperkalaemia
Expensive
What is an example of a beta blocker
Atenolol
How do beta blockers work
. 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)
What are the side effects of beta blockers
. Lethargy . Loss concentration/ memory . Aching limbs . Exabation of raynoids . Aggravated asthma .ED
An example of a short acting A blocker
Prazosin
- a1 antagonist. Cause arteriolar / venous dilation
An example of a longer acting A blocker
Doxazosin
Act on treazosin
How do A blockers work
Block NAdr and adrenaline on blood vessels to cause vasodilation.
What are the side effects of a blockers
Can cause postral hypotension
What are 2 examples of calcium channel blockers (CCB)
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
What do CCB do
. Increase AV node conduction
. Increase myocardial contractility
. Increase arterial tone (vasoconstriciron)
. Increase HR
An example of a thiazide- like diuretic
Bendrofluerthazide
