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pharmacology cardiovascular > antihypertension drugs > Flashcards

antihypertension drugs Flashcards

1
Q

Give some examples of thiazides

A

Hydrochlorothiazide

Bendroflumethiazide

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2
Q

How do thiazides function

A

Blocking the Na+/Cl- symporter in the first part of the Distal convoluted tubule
As less Na+ is absorbed, less water will be reabsorbed leading to diuresis and decreased blood volume and consequential decreased BP

They also have vasodilator action

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3
Q

side effects of thiazides

A

Electrolyte disturbances
Decreased glucose tolerance
Can reduce efficacy of anticoagulants and uricosurics
Can increase LDL and cholestrol

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4
Q

Give examples of drugs that are calcium channel blockers

A

Nifedipine

Amlodipine

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5
Q

What is the mechanism of the calcium channel blockers

A

Dilate peripheral vessels so that:

  • Reduced peripheral resistance
  • Reduced filling pressure
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6
Q

What are the side effects of calcium channel blockers

A

Peripheral oedema

Dizziness

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7
Q

Give some examples of angiotensin converting enzyme (ACE) inhibitors

A

Catopril

Enalapril

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8
Q

What is the mechanism of action of the ACE inhibitors

A

Angiotensin II is a powerful vasoconstrictor normally and activates aldosterone which stimulates thirst and water retention

ACE inhibitors block the conversion of angiotensin I to angiotensin II thus having 2 effects

1) Rapid anti-ANG II effect - prevents vasoconstriction
2) slower effect by reducing blood volume and thirst

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9
Q

what are the side effects of ACE inhibitors

A

Cough in 15% - related to bradykinin
Hyperkalemia - as no K+ excretion as Na+ is not absorbed as much
Taste disturbances
First dose hypotension due to the direct anti-angiotensin II effect (prevents vasoconstriction)

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10
Q

What does the binding to alpha-1 adrenoreceptors cause

A

vasoconstriction

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11
Q

Give examples of drugs that block alpha-1 adrenoreceptors

A

Prazosin

Doxazosin

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12
Q

What is the mechanism of action of alpha-1 adrenoreceptor blockers

A

they antagonise noradrenalie which binds to the alpha-1 receptor with a higher affinity to adrenaline thus blocking vasoconstriction and thus decreasing blood pressure

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13
Q

Side effects of alpha-1 adrenoreceptor blockers

A

Headache
Nausea
Hypotension
Auto-immune problems

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14
Q

Give some examples of angiotensin II receptor blockers

A

Losartan

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15
Q

What is the mechanism of action of angiotensin II receptor blockers

A

It is an angiotensin II antagonist that blocks the AT-1 recpetor
It thus prevents water prevention and thirst causing a decrease in BP

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16
Q

what are the side effects of angiotensin II receptor blockers

A

Hyerkalemia
Diarrhea
Dizziness
Tiredness

17
Q

Give some examples of K+ channel activators

A

Minoxidil

Pinacidl

18
Q

What is the mechanism of action of K+ channel activators

A

As calcium entry into the smooth muscle cell depends on the membrane potential, by allowing more K+ into the cell you are hyperpolarising it and thus inhibiting L-Type Ca2+ channels and the sodium-calcium exchanger preventing vasoconstriction

19
Q

side effects of K+ channel activators

A

Fluid retetntion
May worsen angina
Hirsuitism = increased hair growth

20
Q

What is the mechanism of action of the antihypertensive drug alpha-methyldopa

A

It is converted to methyl-noradrenaline which is not metabolised by MAO and is stored in the synaptic vesiclesI
Its storage in the synaptic vesicles displaces noradrenalin so that when the nerve is stimulated less noradrenaline is released so there is less alpha-1 adrenoceptor activation and less vasoconstriction.
The drug also reduces renin secretion so decrease ANG II levels

21
Q

When is alpha-methyldopa used

A

reserved for hypertension that doesnt respond to other treatments e.g. sever pre-eclampsia

22
Q

Give examples of the gangion blocker drugs (old drugs)

A

Guanethidine

Guanadrel

23
Q

What is the mechanism of action of gangion blocker drugs

A

They target the peripheral adrenergic neuron

Uptake leads to guanadrel substituting fro noradrenaline in secretory granules reducing sympathetic neurotransmission

24
Q

When are ganglion blockers used

A

Reserved for uncontrollable hypertension

pharmacology cardiovascular (9 decks)

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