Antihypertensives

Question 0

Which 3 factors in the body effect BP?

Answer 0

Heart
Peripheral resistance
Kidneys

Question 1

Name 4 types of anti hypertensive drugs

Answer 1

Diuretics
Vasodilators
Beta blockers
ACE inhibitors

Question 2

BP =

Answer 2

CO X TPR

Question 3

How do diuretics act?

Answer 3

Reduce plasma volume thus reducing TPR

Question 4

How do vasodilators work?

Answer 4

Directly lower TPR

Question 5

How do Beta blockers work?

Answer 5

Reduce cardiac output and kidney renin secretion

Question 6

How do ACE Inhibitors work?

Answer 6

Inhibit endogenous vasoconstrictor production

Question 7

How do alpha blockers work?

Answer 7

Reduce TPR by inhibiting noradrenaline action

Question 8

How do angiotensin antagonists work?

Answer 8

Reduce TPR by inhibiting angiotensin action

Question 9

List 4 actions of diuretics

Answer 9

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

Question 10

How potent are thiazides?

Answer 10

Moderately

Question 11

Do thiazides reduce systolic or diastolic pressure or both?

Answer 11

Both

Question 12

Are thiazides suitable for most patients?

Answer 12

Yes

Question 13

Where in the nephron do thiazides act?

Answer 13

On the distal convoluted tubule

Question 14

What additional action do thiazides have?

Answer 14

Vasodilator

Question 15

What do thiazides inhibit?

Answer 15

Sodium and chloride co-transport

Question 16

What do thiazides increase the release of?

Answer 16

Renin

Question 17

List 3 thiazides derived from benzothiadiazine

Answer 17

Chlorothiazide
Hydrochlorothiazide
Bendrofluazide

Question 18

Which 2 drugs have a thiazide like structure?

Answer 18

Chlorthalidone

Metolazone

Question 19

What is an adverse effect of thiazides?

Answer 19

More frequent urination

Question 20

How potent are loop diuretics?

Answer 20

Very potent

Question 21

Are loop diuretics more effective than thiazides at reducing BP?

Answer 21

No

Question 22

Which patients are loop diuretics reserved for?

Answer 22

Renal insufficiency, resistant hypertension or heart failure.

Question 23

Where in the nephron do loop diuretics work?

Answer 23

The loop of henle

Question 24

Which 3 drugs fall under the category of vasodilators?

Answer 24

Calcium antagonists Alpha blockers Angiotensin antagonists

Question 25

Where do vasodilators work?

Answer 25

Directly on the smooth muscle cells of arteries and arterioles

Question 26

What do vasodilators lower the intracellular concentration of?

Answer 26

Calcium

Question 27

How do calcium antagonists work?

Answer 27

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

Question 28

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

Answer 28

Dihydropyridines

Question 29

Give three examples of dihydropyridines

Answer 29

Nifedipine Amiodipine Nicardipine

Question 30

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

Answer 30

Amiodipine

Question 31

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

Answer 31

Nicardipine

Question 32

Bezothiazipines also block what?

Answer 32

Calcium channels in the conducting tissue of the heart

Question 33

What are some adverse effects of ditiazem?

Answer 33

Slows heart rate | Potentiates beta block action

Question 34

What are two adverse effects of calcium antagonists?

Answer 34

Flushing | Ankle oedema

Question 35

What are two adverse effects of ditiazem?

Answer 35

Cardiac depression | Interaction with beta blockers

Question 36

How do alpha blockers work?

Answer 36

Prevent noradrenaline from binding to receptor

Question 37

Name 3 alpha blockers

Answer 37

Doxazosin Terazosin Prazosin

Question 38

What are the adverse effects of alpha blockers?

Answer 38

Postural hypotension | Possible severe hypotension after first does

Question 39

Name 2 beta blockers

Answer 39

Atenolol | Metoprolol

Question 40

What and where do beta blockers bind to?

Answer 40

Beta 1 adrenoceptors in the heart

Question 41

Where exactly are the beta 1 adrenoceptors in the heart?

Answer 41

The SA node and ventricular muscle

Question 42

Give 4 examples of ACE inhibitors

Answer 42

Captopril Enalapril Lisinopril Ramipril

Question 43

How do ACE inhibitors work?

Answer 43

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

Question 44

Give 2 adverse effects of ACE inhibitors

Answer 44

Dry cough | Hypotension

Question 45

Name 4 angiotensin 2 receptor antagonists

Answer 45

Losartan Candesartan Eprosartan Valsartan

Question 46

How do angiotensin 2 receptor antagonists work?

Answer 46

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

Question 47

When and why would you use angiotensin 2 receptor antagonists?

Answer 47

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

Question 48

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

Answer 48

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

Question 49

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

Answer 49

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