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Year 1: Drug Revision > Cardio: Drugs affecting BP > Flashcards

Cardio: Drugs affecting BP Flashcards

1
Q

What effect does nitric oxide have on blood vessels?

A

Vasodilation

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2
Q

Organic nitrates mimic the effect of nitric oxide produced by endothelial cells. What is their effect at low dose?

A

Venorelaxation
Decrease preload
Decrease SV
No change in BP

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3
Q

What is the effect of organic nitrates at high dose?

A

Arteriolar dilation
Decrease arterial pressure
Reduce after load

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4
Q

Give an example of a short acting nitrate

A

GTN

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5
Q

How is GTN administered?

A

Sublingually or IV infusion to avoid first pass metabolism

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6
Q

Give an example of a long acting nitrate

A

Isosorbide mononitrate

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7
Q

How is isosorbide mononitrate administered?

A

Orally- resistant to first pass metabolism

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8
Q

What might repeated administration of nitrates result in?

A

Tolerance (decrease in effectiveness)

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9
Q

What are some of the side effects of nitrates?

A

Headaches

Postural hypotension

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10
Q

Why are nitrates useful in angina?

A

They redirect blood towards the ischaemic zone

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11
Q

Which drugs can be used in the treatment of pulmonary hypertension?

A 
Endothelin antagonists 
(Endothelin released from endothelial cells in response to excess vasodilation causes vasoconstriction of pulmonary arteries)
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12
Q

Give examples of endothelin antagonists

A

Bosentan

Ambrisentan

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13
Q

What do ACE inhibitors block?

A

The conversion of angiotensin I to angiotensin II

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14
Q

ACEi’s inactivate bradykinin metabolism, causing it to build up. What is the adverse effect of this?

A

Dry cough

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15
Q

What do ACEi’s end in?

A

‘pril’

e.g. lisinopril

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16
Q

ACEi’s are first line in the treatment of what condition in caucasian patients under 55?

A

hypertension

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17
Q

In which condition is use of ACEi’s contraindicated?

A

Renal artery stenosis

18
Q

What effects do ACEi’s have on the heart?

A

Decrease preload and after load - decrease BP

19
Q

What conditions are ACEi’s used to treat?

A

Hypertension
Heart failure
Post MI prophylaxis

20
Q

What do ARBs block?

A

Block the agonist action of angiotensin II at angiotensin I receptors in a competitive manner

21
Q

What do ARBs end in?

A

‘Sartan’

e.g losartan

22
Q

When might an ARB be used instead of an ACEi?

A

If a patient has a dry cough

ARBs do not inhibit bradykinin metabolism

23
Q

Which drug acts as a potassium channel openers?

A

Nicorandil

24
Q

What is nicorandil used to treat?

A

Angina

Last resort for hypertension

25
Q

What is the main side effect of nicorandil?

A

Mouth ulcers

26
Q

How do alpha1 adrenoceptor antagonists lower MABP?

A

Cause vasodilation by blocking vascular alpha1 receptors- reduced sympathetic transmission results in decreased MABP

27
Q

What to alpha1 adrenoceptor antagonists end in?

A

‘Zosin’

e.g. prazosin, doxazosin

28
Q

Alpha1 adrenoceptor antagonists are particularly useful in patients with hypertension and what other condition?

A

Benign prostatic hyperplasia

29
Q

What is the main adverse effect of alpha1 adrenoceptor antagonists?

A

Postural hypotension

30
Q

How do diuretics work to lower BP?

A

They promote salt (NaCl) + water excretion by inhibiting reabsorption

31
Q

Where in the kidney do thiazide diuretics act on? Give an example of a thiazide diuretic

A

Distal tubule

Bendroflumethiazide

32
Q

Where in the kidney do loop diuretics act on? Give an example of a loop diuretic

A

Loop of Henle

Furosemide

33
Q

What are the clinical uses of diuretics?

A

Thiazide- Hypertension + mild HF

Loop- acute pulmonary oedema + Chronic HF

34
Q

What are the 4 main side effects of diuretics?

A

Hypokalaemia
Hyperglycaemia
Increased uric acid (gout)
Impotence

35
Q

Which drug is known as a ‘potassium sparing diuretic’

A

Spironolactone

36
Q

Which receptor does spironolactone block?

A

Aldosterone receptor (antagonist)

37
Q

When is spironolactone used?

A

Moderate- severe heart failure

38
Q

What is the main side effect of spironolactone?

A

Gynaecomastia

39
Q

Which drug acts as a renin inhibitor?

A

Aliskiren

40
Q

What is aliskiren used to treat?

A

Hypertension

Year 1: Drug Revision (15 decks)

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