Cardiac drug Therapy

Question 1

What drugs are the first line treatment for hypertension?

Clue: long word

Clue (2): it’s thiazide diuretics

Answer 1

Bendroflumethiazide - stops reabsorbtion of sodium - reducing blood volume

Question 2

What condition should say a patient be suffering from where they need to avoid Bendroflumethiazide ?

Hint: it increasss the amount of a certain acid in the plasma !

Sickle cell
Gout
Rheumatoid arthritis

Answer 2

Gout

Question 3

Where do Non selective beta blockers block adrenaline

Beta 1 receptors
Beta 2 receptors
Both

Answer 3

Both

Question 4

It’s with diabetes who take beta blockers what’s one thing they should be warned about ?

Hint: what will they not have the symptoms of ?

Answer 4

That they won’t feel the symptoms of becoming hypoglycaemic since the sympathetic system is blocked the pt will have little warning

Question 5

What does ace inhibitors do to lower bp?

Think RAAS

Answer 5

Stop the conversion from angio 1 - into 2

Question 6

How could a patient taking ace-inhibitors reduce the likelyhood of severe hypotension ? 🚿

Answer 6

Drink lots of water

Question 7

What’s the most powerful hypotensice drug ?

Ramapril
Astrovastatin
Captopril
Linsoprol

Answer 7

Captopril

Question 8

In as much detail state what Ca+ blockers do to the heart and vessels ?

Answer 8

Limit the amount of ca+ that enters ❤️
The blood vessels dilate, resulting in a fall in bp

Question 9

Which drug works more better on the heart muscle?

Ramipril
Verapamil
Lisorolol
Nifedipine
Amlodepine

Answer 9

Verapamil

Question 10

Which calcium channel blockers work on the smooth muscle of the blood vessel ?

Select 2

Ramipril
Verapamil
Lisorolol
Nifedipine
Amlodepine

Answer 10

Nifedipine
Amlodepine

Question 11

Is nifedipine short half-life or long half-life ?

Answer 11

Short half - life meaning it needs to be taken more frequently

Question 12

Name one side effect of taking short half lifed drugs on the body

Answer 12

Flushes
Headaches
Long term effects : ankle swelling

Question 13

What do carbonic anhydride inhibitors do?

Answer 13

Reduce bicarbonate in proxi tubule

Question 14

How do thiazides work ?

Answer 14

Increase sodium chloride excretion by reducing sodium chloride in the kidneys but 90% is always reabsorbed before reaching distal consulates tubules

They cause vasodilation

Question 15

What do potassium sparring diuretics do ?

Answer 15

Inhibit sodium reabsorption and prevent K+ excretion

Or blocks the actions of aldosterone

Question 16

How do furosemide work ?

Answer 16

Reduced sodium chloride in the kidneys leading to significant diuresis

Diuresis = excessive urine output

Question 17

Bosentan is a diuretic that blocks ?

Answer 17

The action of endothelin-1 leading to vasodilation

Question 18

What does fenoldapam which is a diuretic stimulate?

Answer 18

Stimulates the Dopamine-1 receptors producing arterial vasodilation

Question 19

What does minoxidil stimulate ?
Hint: 💪

Answer 19

ATP-activated K+ channels in smooth muscles 💪!! Leading to membrane stability and making vasodilation less likely

Question 20

4 steps how how baroreceptors initiate sympathetic activity

Answer 20

Baroreceptors ➡️ adrenal medulla ➡️ catecholamines ➡️ increased sympathetic activity ( Activating alpha and beta cells )

Question 21

The activation of B1 receptors causes what ?

Answer 21

Question 22

Activation of what system is caused by low BP

Answer 22

RAAS system

Question 23

Renin is necessary for the production of what? To cause vasoconstriction?

Answer 23

Angiotensin 2 potent vasoconstrictor which activates aldosterone which initiates the sodium and water retention causing increase in BP and volume

Question 24

Where do alpha 1 blockers work ?

Heart
Or
Smooth muscles

Answer 24

Smooth muscle, reducing SVR

Question 25

Beta blockers you have the selective and non selective beta blockers

Where do the selective beta blockers work, what organ ?

Answer 25

Heart
Reducing Cardiac Output and BP

Question 26

Non selective beta blockers inhibit what receptors in which organ?

Non-selective Beta blockers suppresses what from being released by this organ!?

Answer 26

Block beta 1 receptors in the kidneys

Suppress angiotensin 2 & aldosterone

Inhibit b1receptors which causing vasodilation reduces SVR and not retaining water

Question 27

How can loop diuretics make gout symptoms worse ???

Answer 27

Loop diuretics excrete sodium and water
This causes reduced blood flow to kidneys
This causes kidneys to want to reabsorb Uric acid = lvls increase causing hyperuricemia

Question 28

Since loop diuretics cause sodium and water to leave the body what can this cause the body to go through.

Hint in the question
(2 answers)

Answer 28

Acute onset of Hypovolaemia
Cardiac arrhythmias too

Question 29

Name the two sub groups of calcium channel blockers

Answer 29

Non-dihydropyridine and dihydropyridine

Question 30

How do calcium channel blockers work ?

Answer 30

stop calcium from entering the cells of the heart and arteries.

Question 31

How do non-dihydropyridine work ?

Answer 31

They work by blocking the calcium channels present in the heart muscle and reduce the influx of calcium into cardiac muscle cells (myocytes), leading to a decrease in the heart rate and contractions of the heart muscle

Question 32

Difference between the 2 calcium channel blockers

Dihydropyridines& non-Dihydropyridines

Answer 32

Dihydropyridines (DHPs) have greater selectivity for vascular smooth muscle with little direct effect on the myocardium; non- dihydropyridines (non-DHPs) have less selective vasodilator activity and have a direct effect on the myocardium