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Pharmacology 2 > Antihypertensives > Flashcards

Antihypertensives Flashcards

0
Q

Which 3 factors in the body effect BP?

A

Heart
Peripheral resistance
Kidneys

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1
Q

Name 4 types of anti hypertensive drugs

A

Diuretics
Vasodilators
Beta blockers
ACE inhibitors

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2
Q

BP =

A

CO X TPR

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3
Q

How do diuretics act?

A

Reduce plasma volume thus reducing TPR

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4
Q

How do vasodilators work?

A

Directly lower TPR

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5
Q

How do Beta blockers work?

A

Reduce cardiac output and kidney renin secretion

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6
Q

How do ACE Inhibitors work?

A

Inhibit endogenous vasoconstrictor production

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7
Q

How do alpha blockers work?

A

Reduce TPR by inhibiting noradrenaline action

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8
Q

How do angiotensin antagonists work?

A

Reduce TPR by inhibiting angiotensin action

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9
Q

List 4 actions of diuretics

A

Increase sodium excretion
Water loss follows
Reduce plasma volume
Reduce cardiac output

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10
Q

How potent are thiazides?

A

Moderately

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11
Q

Do thiazides reduce systolic or diastolic pressure or both?

A

Both

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12
Q

Are thiazides suitable for most patients?

A

Yes

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13
Q

Where in the nephron do thiazides act?

A

On the distal convoluted tubule

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14
Q

What additional action do thiazides have?

A

Vasodilator

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15
Q

What do thiazides inhibit?

A

Sodium and chloride co-transport

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16
Q

What do thiazides increase the release of?

A

Renin

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17
Q

List 3 thiazides derived from benzothiadiazine

A

Chlorothiazide
Hydrochlorothiazide
Bendrofluazide

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18
Q

Which 2 drugs have a thiazide like structure?

A

Chlorthalidone

Metolazone

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19
Q

What is an adverse effect of thiazides?

A

More frequent urination

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20
Q

How potent are loop diuretics?

A

Very potent

21
Q

Are loop diuretics more effective than thiazides at reducing BP?

A

No

22
Q

Which patients are loop diuretics reserved for?

A

Renal insufficiency, resistant hypertension or heart failure.

23
Q

Where in the nephron do loop diuretics work?

A

The loop of henle

24
Q

Which 3 drugs fall under the category of vasodilators?

A

Calcium antagonists
Alpha blockers
Angiotensin antagonists

25
Q

Where do vasodilators work?

A

Directly on the smooth muscle cells of arteries and arterioles

26
Q

What do vasodilators lower the intracellular concentration of?

A

Calcium

27
Q

How do calcium antagonists work?

A

Block ca2+ entry through voltage operated calcium channels in arterial smooth muscle cells

28
Q

Which group of calcium antagonists are highly selective for smooth muscle but affect most smooth muscle?

A

Dihydropyridines

29
Q

Give three examples of dihydropyridines

A

Nifedipine
Amiodipine
Nicardipine

30
Q

Which calcium antagonist is longer acting and the most commonly used?

A

Amiodipine

31
Q

Which calcium antagonist has some selectivity for cerebral and coronary arteries?

A

Nicardipine

32
Q

Bezothiazipines also block what?

A

Calcium channels in the conducting tissue of the heart

33
Q

What are some adverse effects of ditiazem?

A

Slows heart rate

Potentiates beta block action

34
Q

What are two adverse effects of calcium antagonists?

A

Flushing

Ankle oedema

35
Q

What are two adverse effects of ditiazem?

A

Cardiac depression

Interaction with beta blockers

36
Q

How do alpha blockers work?

A

Prevent noradrenaline from binding to receptor

37
Q

Name 3 alpha blockers

A

Doxazosin
Terazosin
Prazosin

38
Q

What are the adverse effects of alpha blockers?

A

Postural hypotension

Possible severe hypotension after first does

39
Q

Name 2 beta blockers

A

Atenolol

Metoprolol

40
Q

What and where do beta blockers bind to?

A

Beta 1 adrenoceptors in the heart

41
Q

Where exactly are the beta 1 adrenoceptors in the heart?

A

The SA node and ventricular muscle

42
Q

Give 4 examples of ACE inhibitors

A

Captopril
Enalapril
Lisinopril
Ramipril

43
Q

How do ACE inhibitors work?

A

Prevent conversion of angiotensin 1 - angiotensin 2 and stimulates aldosterone secretion which inhibits h20 and salt excretion. Causes vasodilation and reduces plasma volume

44
Q

Give 2 adverse effects of ACE inhibitors

A

Dry cough

Hypotension

45
Q

Name 4 angiotensin 2 receptor antagonists

A

Losartan
Candesartan
Eprosartan
Valsartan

46
Q

How do angiotensin 2 receptor antagonists work?

A

Block the action of angiotensin 2 at its receptors - competes for binding to AT receptors - vasodilation

47
Q

When and why would you use angiotensin 2 receptor antagonists?

A

In combination with an ACE inhibitor as improves mortality and morbidity. Alternative in patients intolerant to ACE inhibitors.

48
Q

What are the choice of drug guidelines for those under 55?

A

A
A+C
A + C +D
A+C+B

49
Q

What would the choice be for those over 55 or Caribbean black origin?

A

C
A+C
A+C+D
A+C+B

Pharmacology 2 (14 decks)

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