Cardiac drug Therapy Flashcards
What drugs are the first line treatment for hypertension?
Clue: long word
Clue (2): it’s thiazide diuretics
Bendroflumethiazide - stops reabsorbtion of sodium - reducing blood volume
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
Gout
Where do Non selective beta blockers block adrenaline
Beta 1 receptors
Beta 2 receptors
Both
Both
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 ?
That they won’t feel the symptoms of becoming hypoglycaemic since the sympathetic system is blocked the pt will have little warning
What does ace inhibitors do to lower bp?
Think RAAS
Stop the conversion from angio 1 - into 2
How could a patient taking ace-inhibitors reduce the likelyhood of severe hypotension ? 🚿
Drink lots of water
What’s the most powerful hypotensice drug ?
Ramapril
Astrovastatin
Captopril
Linsoprol
Captopril
In as much detail state what Ca+ blockers do to the heart and vessels ?
Limit the amount of ca+ that enters ❤️
The blood vessels dilate, resulting in a fall in bp
Which drug works more better on the heart muscle?
Ramipril
Verapamil
Lisorolol
Nifedipine
Amlodepine
Verapamil
Which calcium channel blockers work on the smooth muscle of the blood vessel ?
Select 2
Ramipril
Verapamil
Lisorolol
Nifedipine
Amlodepine
Nifedipine
Amlodepine
Is nifedipine short half-life or long half-life ?
Short half - life meaning it needs to be taken more frequently
Name one side effect of taking short half lifed drugs on the body
Flushes
Headaches
Long term effects : ankle swelling
What do carbonic anhydride inhibitors do?
Reduce bicarbonate in proxi tubule
How do thiazides work ?
Increase sodium chloride excretion by reducing sodium chloride in the kidneys but 90% is always reabsorbed before reaching distal consulates tubules
They cause vasodilation
What do potassium sparring diuretics do ?
Inhibit sodium reabsorption and prevent K+ excretion
Or blocks the actions of aldosterone
How do furosemide work ?
Reduced sodium chloride in the kidneys leading to significant diuresis
Diuresis = excessive urine output
Bosentan is a diuretic that blocks ?
The action of endothelin-1 leading to vasodilation
What does fenoldapam which is a diuretic stimulate?
Stimulates the Dopamine-1 receptors producing arterial vasodilation
What does minoxidil stimulate ?
Hint: 💪
ATP-activated K+ channels in smooth muscles 💪!! Leading to membrane stability and making vasodilation less likely
4 steps how how baroreceptors initiate sympathetic activity
Baroreceptors ➡️ adrenal medulla ➡️ catecholamines ➡️ increased sympathetic activity ( Activating alpha and beta cells )
The activation of B1 receptors causes what ?
Activation of what system is caused by low BP
RAAS system
Renin is necessary for the production of what? To cause vasoconstriction?
Angiotensin 2 potent vasoconstrictor which activates aldosterone which initiates the sodium and water retention causing increase in BP and volume
Where do alpha 1 blockers work ?
Heart
Or
Smooth muscles
Smooth muscle, reducing SVR
Beta blockers you have the selective and non selective beta blockers
Where do the selective beta blockers work, what organ ?
Heart
Reducing Cardiac Output and BP
Non selective beta blockers inhibit what receptors in which organ?
Non-selective Beta blockers suppresses what from being released by this organ!?
Block beta 1 receptors in the kidneys
Suppress angiotensin 2 & aldosterone
Inhibit b1receptors which causing vasodilation reduces SVR and not retaining water
How can loop diuretics make gout symptoms worse ???
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
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)
Acute onset of Hypovolaemia
Cardiac arrhythmias too
Name the two sub groups of calcium channel blockers
Non-dihydropyridine and dihydropyridine
How do calcium channel blockers work ?
stop calcium from entering the cells of the heart and arteries.
How do non-dihydropyridine work ?
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
Difference between the 2 calcium channel blockers
Dihydropyridines& non-Dihydropyridines
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
