CV: Antihypertensive drugs Flashcards
Hydralazine hydrochloride is given by mouth as an adjunct to other antihypertensives for the treatment of ________ ________ but is rarely used; when used alone it causes ______ and ____ _________.
Hydralazine hydrochloride is given by mouth as an adjunct to other antihypertensives for the treatment of resistant hypertension but is rarely used; when used alone it causes tachycardia and fluid retention.
Minoxidil should be reserved for the treatment of _______ hypertension resistant to other drugs. Vasodilatation is accompanied by increased _____ ______ and tachycardia and the patients develop ____ _______.
Minoxidil should be reserved for the treatment of severe hypertension resistant to other drugs. Vasodilatation is accompanied by increased cardiac output and tachycardia and the patients develop fluid retention.
For this reason the addition of a beta-blocker and a diuretic (usually furosemide, in high dosage) are mandatory. Hypertrichosis is troublesome and renders this drug unsuitable for females.
Why is minoxidil unsuitable for females?
Hypertrichosis is troublesome and renders this drug unsuitable for females.
Why are the addition of a beta-blocker and a diuretic to minoxidil therapy mandatory?
Minoxidil causes vasodilation accompanied by increased cardiac output and tachycardia with patients developing fluid retention.
Prazosin, doxazosin, and terazosin have what properties that allows them to be used as antihypertensives?
Prazosin, doxazosin, and terazosin have alpha-blocking and vasodilator properties.
Ambrisentan, bosentan, iloprost, macitentan, sildenafil, and tadalafil are licensed for the treatment of what?
Pulmonary arterial hypertension
Epoprostenol is a prostaglandin and a potent vasodilator which can be used in what patients?
Those with primary pulmonary hypertension resistant to other treatments.
Epoprostenol can be used in patients with primary pulmonary hypertension resistant to other treatments. What other properties does it have?
Epoprostenol is a prostaglandin and a potent vasodilator. It is also a powerful inhibitor of platelet aggregation.
Bosentan is licensed for the treatment of pulmonary arterial hypertension and also what else?
Bosentan is also licensed to reduce the number of new digital ulcers in patients with systemic sclerosis and ongoing digital ulcer disease.
Riociguat is licensed for the treatment of pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension; it should be used under specialist supervision. What is its mechanism of action?
Riociguat is a stimulator of soluble guanylate cyclase (sGC), an enzyme in the cardiopulmonary system and the receptor for nitric oxide (NO). When NO binds to sGC, the enzyme catalyzes synthesis of the signaling molecule cyclic guanosine monophosphate (cGMP).
It is contraindicated in people using sildenafil etc and vice versa
Drugs licensed for pulmonary hypertension include what? (6)
Ambrisentan, bosentan, iloprost, macitentan, sildenafil, and tadalafil are licensed for the treatment of
Methyldopa is a centrally acting antihypertensive. What can it be used for?
Methyldopa is a centrally acting antihypertensive; it may be used for the management of hypertension in pregnancy.
Withdrawal of the centrally acting antihypertensive clonidine hydrochloride can cause what?
Clonidine hydrochloride has the disadvantage that sudden withdrawal of treatment may cause severe rebound hypertension.
Moxonidine, a centrally acting drug, is licensed for what?
Moxonidine, a centrally acting drug, is licensed for mild to moderate essential hypertension. It may have a role when thiazides, calcium-channel blockers, ACE inhibitors, and beta-blockers are not appropriate or have failed to control blood pressure.
Adrenergic neurone blocking drugs prevent the release of noradrenaline from postganglionic adrenergic neurones. For what reason have they largely fallen from use?
Adrenergic neurone blocking drugs prevent the release of noradrenaline from postganglionic adrenergic neurones. These drugs do not control supine blood pressure and may cause postural hypotension. For this reason they have largely fallen from use, but may be necessary with other therapy in resistant hypertension.
