Antihypertensives Flashcards
Drug for treating hypertension
ARBs
Vasodilators
calcium channel blockers
ACE inhibitors
Diuretics
Calcium channel blocker MOA
Inhibit influx of calcium ions in myocardial muscle and vascular smooth muscle
Vasodilation
Calcium channel blocker administration
Oral - 60% bioavailability
Calcium channel blocker elimination
Renal - poor renal function does not significantly reduce elimination
Example of ACE inhibitor
Lisinopril
ACE inhibitor MOA
Inhibits angiotensin converting enzyme in RAAS system
Lisinopril administration
Oral - 25% bioavailability
Lisinopril excretion
Unchanged renally
ARB example
Losartan
Losartan MOA
Selective competitive blocker of angiotensin II and AT1 receptor
Losartan administration
Oral - 32% bioavailability
Losartan excretion
Urine and bile - extensive plasma protein binding
Thiazide like diuretic example
Indapamide
Indapamide MOA
Inhibit Na Cl reabsorption from DCT by blocking Na Cl symporter
When is Indapamide taken
Early in the day so diuresis doesn’t affect sleep
Could cause elderly patients to have falls in the night
Indapamide administration
Oral - act between 1 to 2 hours
What is a last resort antihypertensive
Beta blockers
When would beta blockers be given
Young adults
Intolerance to ACEi or ARBs
Increased sympathetic drive
Beta blockers MOA
Bind adrenomuscarinic M2 receptors
Decrease sympathetic signalling
What would someone with hypertension and type 2 diabetes be given (NICE)
ACEi or ARB
What would someone with hypertension, no type 2 diabetes, under 55 and not of African origin be given
ACEi or ARB
What would someone with hypertension with no type 2 diabetes, over 55 be given
CCB
What would someone with hypertension with no type 2 diabetes with African origin be given
CCB
Calcium channel blocker example
Amlodipine
