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Antihyperintensive Drugs Flashcards

0
Q

What condition caused by genetic factors, low birth weight, environmental factors, diabetes, drugs and kidney/cardio disease affects at least 1 in 4 adults?

A

Hypertension

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1
Q

Hypertension is a sustained systolic BP over ? or sustained diastolic BP over ? mmHg

A

140/90

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2
Q

Why would having kidney/cv disease cause hypertension?

A

Can’t maintain electrolyte balance

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3
Q

Why would diabetes cause hypertension?

A

Increase in circulating fats = constricts arteries

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4
Q

Hypertension is high blood pressure, which damages blood vessels. What 3 major things can this result in?
(Think vessels in brain, coronary blood vessels and pain in limbs)

A

Stroke
Ischemic Heart Disease
Peripheral Vascular Disease

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5
Q

Blood Pressure = ? x ?

A

BP = cardiac output x total peripheral resistance

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6
Q

Venous tone (diameter of vein) and blood volume (amount to pump) determines what?

A

Cardiac Output.

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7
Q

What is cardiac output?

A

Heart rate and volume of blood pumped out of heart

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8
Q

What is the initial treatment strategy for hypertension?

A

LIFESTYLE
REDUCE weight, salt, alcohol, smoking, fatty foods, caffiene
MORE exercise, fresh fruit/veg

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9
Q

What part of the brain controls blood pressure?

A

The medulla

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10
Q

What detects how much blood is flowing through the carotid sinus/aortic arch?

A

Baroreceptors

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11
Q

Baroreceptors tell the brainstem/medulla if blood pressure is too high. What does the medulla then do?

A

Tells the peripheral nervous system to dilate arterioles so that more blood can flow through. This reduces cardiac output by reducing TPR - once everything has normalised, the baroreceptors stop firing and everything calms down

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12
Q

Antihyperintensive drugs target the heart, brain and what 2 other targets?

A

Other than the heart and brain,
kidneys
blood vessels

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13
Q

What drugs target the kidneys, blood vessels, heart or brain to control blood pressure?

A

Hypertensive Drugs

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14
Q

Antihypertensive drugs - ABCD: What do they stand for?

A

ACE Inhibitors/Angiotensin Receptor Blockers
Beta Blockers
Calcium Channel Blockers
Diuretics

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15
Q

What does the kidney release as a response to low blood pressure?

A

Renin

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16
Q

What does renin do if it is released?

A

Releases A1. This converts to A2 in the blood stream which causes vasoconstriction and increases blood pressure.

A2 also causes the kidney to absorb more salt and water - this causes the release of aldosterone

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17
Q

What does the renin-angiotensin system want to achieve (in relation to BP)?

A

Vasoconstriction - to increase blood pressure

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18
Q

What is the name of the drug type that contain angiotensin converting enzyme?

A

ACE Inhibitors

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19
Q

What types of drugs are captopril, enalapril, trandolapril, ramipril and lisinopril?

A

ACE Inhibitors
(angiotenisin converting)

APRIL is an ACE month

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20
Q

What do ACE inhibitors do?

A

Block ACE, which causes vasodilation.
(ACE is what converts A1 to A2)

This means they reduce peripheral resistance and therefore blood pressure also reduces

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21
Q

What types of drugs have the side effects of a persistent dry cough, rash, renal problems, possible hypotension and cannot be used in pregnancy?

A

ACE Inhibitors

22
Q

How do Angiotensin Receptor Antagonists work?

A

They selectively block AT1 receptors - so renin does not release A1 and it cannot be converted etc…
Therefore cannot cause constriction

23
Q

Why are angiotensin receptor antagonists better than ACE inhibitors?

A

They have fewer side effects

24
What drugs result in side effects of mild dizziness and hyperkalaemia?
Angiotensin Receptor Antagonists ARTAN - similar to ARA
25
Beta-blockers act on the sympathetic nervous system. What do they usually end in?
LOL
26
How do beta-blockers work as antihypertensives?
They bind to b1 receptors, reducing cardiac output. HEART. They also bind to b2 receptors, so more blood goes to the KIDNEYS and less renin is secreted. They also affect the vasomotor centre in the MEDULLA OBLONGATA, blocking vasoconstriction.
27
Beta-blockers can be used in pregnancy, and act on the heart, kidneys and medulla. What are their side effects?
Remember that Beta-blockers affect the brain so more 'mental'. Lethargy, impaired memory, aching limbs in exercise, erectile dysfunction, aggravation of Raynaud's disease and asthma.
28
What drugs block the action of noradrenaline and adrenaline on both arteriolar and venous vessels so that they can dilate?
A Blockers - A1 antagonists end in osin. Pet shop boys is this o sin??? A blockers? A band? Adrenaline?/Antagonising A1?
29
What is the short acting prazosin and are the longer acting doxazosin and terazosin examples of?
A-blockers
30
What type of antihypertensive drugs have the side effect of postural hypertension?
A-Blockers
31
Which type of hypertensive drug works by decreasing AV node conduction, decreasing myocardial contractility, decreasing arterial tone (vasoconstriction) and decreasing heart rate? (It blocks something that is used for this)
Calcium Channel Blockers
32
There are 2 types of CCB. One of these are more potent on blood vessels than the heart, potentially causing headaches, flushing, dizziness and peripheral oedema. Can you remember some examples of this type?
BLOOD VESSEL CCB = PINE | Nifedipine, amlodipine, nicardipine
33
Verapamil and diltiazem are more potent on the heart than blood vessels, and may cause constipation, heart block and precipitate cardiac failure. What are they?
Calcium Channel Blockers - Antihypertensives Mil loves Zem = heart
34
What type of drug can interact with grapefruit juice resulting in a toxic dose?
Calcium Channel Blockers The interaction stops an enzyme in the liver metabolising the drug
35
What type of hypertensive drugs increase urine output, thereby decreasing blood volume, causing vasodilation and a decrease in blood pressure?
Diuretics
36
Antihypertensive thiazide-like diuretics tend to end in what? What does one of the random ones end in just to throw you?
IDE (thiazide like remember?) Indapamide and Bendroflumethiazide Also chlortalidone - ONE = odd one out
37
What type of antihypertensives have the side effects of hypokalaemia (reduced potassium), reduced insulin release, increased plasma lipids and urate (this leads to gout) and erectile dysfunction?
Thiazide diuretics You are losing things in your urine, which increases acid in the plasma
38
What are amiloride and spironolactone?
Potassium sparing diuretics spiro=sparing?
39
What are indapamide and chlortalidone?
Thiazide like diuretics
40
What type of antihypertensive diuretic is used to treat severe hypertension or oedema?
Loop diuretics severe= loopy
41
Which type of antihypertensive can affect hearing, cause gout and hypokalaemia - and also has a short duration of action?
Loop diuretics
42
What type of diuretic is furosemide?
Loop Diuretic Loopy/furuity??
43
What are hydrazaline, minoxidil and sodium nitroprusside/I.V. nitrates? When are they used?
Vasodilators. Used for hypertension when ABCD haven't worked
44
What is the name of a vasodilator that is short acting and is a non-selective potassium channel opener?
Hydrazaline - a antihypertensive
45
What is the name of a powerful vasodilator that is used for extreme hypertension (and encourages hair growth!)? Begins with M
Minoxidil
46
When do we use I.V. nitrates and sodium nitroprusside as an antihypertensive?
Hospital emergencies
47
What do hydrazaline, minoxidil and I.V. nitrates do to the smooth muscle in blood vessels when used for hypertension?
They cause relaxation of smooth muscle in blood vessels
48
What antihypertensive drugs are first used for over 55 year olds or black patients?
C or D. | Erectile dysfunction and wee don't affect you as much if you're old
49
What antihypertensive drugs are first used for under 55 year olds?
A or B | (not C or D) - more socially acceptable side effects for younger people
50
If A (or C and D) antihypertensive drugs don't work - what happens in stage 2 and 3 of multiple drug therapy?
Step 2 = A and C or A and D so always A and one of the horrible ones Step 3 = A and C and D so far gone you can have all the horrible effects
51
Which antihypertensive reduces heart rate, dilates arteries and reduces renin release?
B-Blockers
52
Which antihypertensive reduces heart rate and dilates arteries but does not affect renin release?
Calcium Channel Blockers
53
What drug increases urine output thereby decreasing blood volume?
Diuretics

Pharmacology (13 decks)

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