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Applied Pharmacology > Antihypertensives > Flashcards

Antihypertensives Flashcards

1
Q

What are the main aims of Antihypertensive drugs?

A

Reduce BP, Provide 24 hours control (one dose a day - long plasma half life), show dose-effect relationship and have acceptable side effects.

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2
Q

How do Diuretics work in controlling BP?

A

Act on the kidney to increase diuresis.

Increase sodium excretion, Reduce salt re-absorption and plasma volume, causing water loss.

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3
Q

How do Thiazides work in controlling BP?

A

Inhibit sodium chloride co-transport in distal tube.

Increase renin and have a vasodilator action.

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4
Q

Examples of Thiazides…

A 
Chlorothiazide
Hydrochlorothiazide
Bendrofluazide
Benzothiadiazine
Chlorthialidone
Metolazone
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5
Q

What are Loop Diuretics used for?

A

Renal insufficiency
Resistant Hypertension
Heart Failure

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6
Q

How do Vasodilators control BP?

A

Act on smooth muscle cells of arteries/arterioles by lowering intracellular calcium concentration to allow muscle cell relaxation.

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7
Q

Mechanism of Calcium Antagonists…

A

Block calcium entry though voltage-operated calcium channels in arterial smooth muscle cells.

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8
Q

Examples of Calcium Antagonists…

A

Dihydropyridines - smooth muscle selective (Nifedipine/Amlodipine - long acting, Nicardipine - cerebral/coronory arteries)

Benzothiazepine - block calcium channels in conducting heart tissue (Diltiazem, potentiates Blocker action)

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9
Q

Side Effects of Calcium Antagonists…

A

Flushing, Ankle oedema, Cardiac depression and Bblocker interaction.

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10
Q

Mechanism of Alpha Blockers…

A

Selective blockers of A1-adrenoceptors that prevent vasoconstrictor action of endogenous noradrenaline.

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11
Q

Examples of Alpha Blockers

A

Doxazosin, Terazosin and Prozosin (short acting).

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12
Q

Side Effects of Alpha Blockers…

A

Postural hypotension and severe hypertension after 1st dose.

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13
Q

Mechanism of Beta Blockers…

A

Bind to and block B1-adrenoceptors in the heart (sino atrial node/ventricular muscle), blocking noradrenaline action, released from sympathetic nerves/circulating adrenaline and reducing rate/force of heart beat/cardiac output.

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14
Q

Examples of Beta Blockers…

A

Atenolol/Metoprolol

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15
Q

Side Effects of Beta Blockers…

A

Cold hands, fatigue, provoke asthma, heart failure, conduction heart blood and effect blood lipids.

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16
Q

Mechanism of ACE Inhibitors…

A

Prevent conversion of angiotensin I to angiotensin II. Potent vasoconstrictor that stimulates aldosterone secretion, inhibiting H20/salt extortion to reduce plasma volume.

17
Q

Examples of ACE Inhibitors…

A

Catopril, Enalapril, Lisinopril and Ramipril.

18
Q

Side Effects of ACE Inhibitors…

A

Dry cough, hypotension initially when given with a diuretic.

19
Q

Mechanism of Angiotensin II Receptor Antagonists…

A

Block the action of angiotensin II at its receptors, competing for binding to AT receptors.

Used with Ace inhibitors to improve mortality/morbidity.

20
Q

Examples of Angiotensin II Receptor Antagonists…

A

Losartan, Candesartan, Eprosartan and Valsartan.

21
Q

What effects choice in drug to use?

A

Patient Characteristics
Effectiveness at lowering BP
Complications / Adverse effects
Cost Effectiveness

Applied Pharmacology (13 decks)

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