Cardiac drugs (Hypertension) Flashcards
What is the first line treatment for hypertension in over 55s or for blacks?
Calcium channel blockers
What is first line treatment for a white under 55
ARB or ACE inhibitor
What is second line treatment?
Calcium channel blocker + ace inhibitor or ARB
What is the third line treatment for hypertension?
ARB or ACE inhibitor Calcium channel blocker + thizides like diuretic
Bendroflumethiazide
Thiazine diuretic
Four types of diuretics?
1) osmotic diuretic (PCT) 2) Loop diuretic (Loop of Henle) 3) thiazides diuretic (DCT) 4) potassium sparing diuretics (collecting duct)
mannitol
Common osmotic diuretic
Furosemide (LASIX) ( I have to pee furiously) Bumetanide
Common loop diuretic
(Loop diuretic - Lasix)
Bendroflumethiazide Indapamide
Thiazides diuretics
Spironolactone (can cause breast enlargement lactose) Amiloride (spiral on lactose)
Potassium sparing
How do ace inhibitors work?
Angiotensin converting enzyme inhibitor stops angiotensin I being converted to angiotensin II which caused vasoconstriction.
How do ARB’s work?
They stop block angiotensin II receptors preventing vasoconstriction.
Ramipril
Lisinopril
Perindopril
Common ACE inhibitors?
Candesartan
Losartan
Candesartan
Losartan
Common ARBs?
Which beta blocker effect which?
beta 1 - heart
beta 2 - lungs
1st generation tend to be non-selective
2nd generation tend to be selective
Bisoprolol
Atenolol
Selective beta blockers?
propranolol (probably going to cause some lung probs)
Non-selective beta blockers?
Calcium channel blockers
Two distinct classes:
1) dihydropyridine
2) non-dihydropyridine
Both are vasodilators but 2 also works directly on the heart as an anti-dysrhythmics.
Nifedipine
Amlodipine
Common dihydropyridines (Ca+ channel blockers)
Diltiazem
Common non-dihydropyridines (Ca+ channel blockers)
What is the difference between the various generations of beta-blockers?
- the 1st generation is non-selective (propranolol, sotalol, etc),
- the 2nd is beta1-selective (“cardioselective”) (metoprolol, bisoprolol, atenolol, etc),
- the 3rd shows additional vasodilating effects (carvedilol, nebivolol, etc), most effective in the decrease of blood pressure.
Where are Alpha-receptors located and what do they do when stimulated?
On the arteries.
When stimulated by epinephrine or norepinephrine ( which act on both A1 and A2 receptors), the arteries constrict = increased blood pressure and increased blood flow returning to the heart.
The blood vessels in skeletal muscles lack alpha-receptors because they need to stay open to utilize the increased blood pumped by the heart
Types of sympathetic receptors?
- Alpha 1
- Alpha 2
- Beta 1 (heart)
- Beta 2 (lungs)
Nitroglycerin
Converts to nitric oxide which acts as a vasoldilator. Can make people dizzy.
