Anti-hypertensives Flashcards
What are the main classes of anti-hypertensives?
ACEi
ARDs
CCBs
Diuretics
What are examples of ACEis?
Ramipril
Lisonpril
What are ACEis used for?
Hypertension
Heart failure
What is the route of ACEis?
Oral
What is the mechanism of ACEis?
Inhibits conversion of angiotensin-1 to angiotensin-2
- vasodilation
- reduced aldosterone release
Acts as a diuretic
What are side effects of ACEis?
Dry cough
Angioedema
Renal failure
Hyperkalaemia
What causes the dry cough?
Prevention of the breakdown of bradykinin
What follow up is needed when starting an ACEi?
U+Es 2 weeks after starting
What are examples of ARBs?
Candesartan
Losartan
What are ARBs used for?
Hypertension
Heart failure
What is the route of administration for ARBs?
Oral
What is the mechanism of ARBs?
AT1 receptor antagonist
- vasodilation by inhibiting angiotensin-2 mediated vasoconstriction
What are the side effects of ARBs?
Renal failure Hyperkalaemia Dizziness Nausea Headaches
What are the exmaples of CCB?
Amlodipine
Verapamil
Diltiazem
What is the use of amlodipine?
Hypertension
What is the route of administration of amlodipine?
Oral
What is the mechanism of amlodipine?
Inhibits L-type calcium channels
- vasodilation
- prevent smooth muscle contraction (peripheral vasculature)
What are the side effects of amlodipine?
Tachycardia
Palpitations
Flushing
Oedema
What are the uses of verapamil?
Hypertension
SVT
What are the routes of administration of verapamil?
PO
IV
What is the mechanism of verapamil?
Prolongs action potential - prevents smooth muscle contraction
What are side effects of verapamil?
Constipation
Risk of bradycardia
Worsen heart failure
What are the uses of diltiazem?
Hypertension
Angina
SVT
What is the route of administration of diltiazem?
Oral
What is the mechanism of diltiazem?
Prolongs action potential
Vasodilation
Prevent smooth muscle contraction
What are the side effects of diltiazem?
Risk of bradycardia
Can worsen heart failure
What other drugs are used for hypertension?
Spironolactone
Labetelol
When is labetalol used?
Pre-eclampsia
Hypertension in pregnancy
What class is labetalol?
Beta adrenoreceptor antagonist
What is the route of administration of labetalol?
PO
IV
What is the mechanism of labetalol?
Reduce sympathetic outflow - slows HR
Dilate blood vessels - reduce TPR
What are the side effects of labetalol?
Dizziness Rash Headaches Tingling scalp Dysuria Shortness of breath
What class is spironolactone?
Aldosterone antagonist
What is spironolactone used for?
Oedema Ascites Nephrotic syndrome Heart failure Resistant hypertension
What is the route of administration of spironolactone?
PO
What is the mechanism of spironolactone?
Competes with aldosterone at mineralocorticoid receptors
Prevents upregulation of ENaC
Sodium stays in tubule
What are side effects of spironolactone?
Hyperkalaemia
Impotence
Painful gynaecomastia
Refractory hyperaldosteronism
What other classes can be used for hypertension?
Alpha-adrenoreceptor blockers
Beta-adrenoreceptor blockers
What is an example of an alpha-adrenoreceptor blocker used for hypertension?
Doxazosin
What is the route of administration for doxazosin?
Oral
What is the mechanism of doxazosin?
Reduces peripheral resistance
Antagonise contractile effects of NA on smooth muscle
What are side effects of doxazosin?
Postural hypotension
Headache
Fatigue
Oedema
What is an example of a beta-adrenoreceptor blocker used for hypertension?
Bisoprolol
What is bisoprolol used for?
Hypertension
Sinus tachy
What is the route of administration for bisoprolol?
PO
What is the mechanism of bisoprolol?
Reduce CO
Slow conduction
Decrease sympathetic tone
What are side effects of bisoprolol?
Bronchoconstriction
Hypotension
Bradycardia
Raunaud’s
