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Alan's lecture - Pharmacology > CVS 3 > Flashcards

CVS 3 Flashcards

1
Q

what is hypertention?

A
  • Sustained b.p more than 140/90 mm hg
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2
Q

high bp causes organ damage. TRUE OR FALSE?

A

TRUE

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3
Q

what is the treatment goal for hypertention?

A
  • To prevent ischemic heart disease, cerebrovascular disease, heart failure, arrythmias
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4
Q

what are the non-pharmacological treatment options?

A
  • Stop smoking
  • Diet
  • weigth control
  • Exercise
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5
Q

what are the three parameters that control b.p?

A
  • Blood volume
  • cardiac output
  • Vascular resistance
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6
Q

what is cardiac output dependent upon?

A
  • The contractility of the heart and the frequency which the heart beats which is controlled by the sympathetic nervous system - this determines the stroke volume
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7
Q

what is preload?

A
  • The volume of fluid thats returned to the heart
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8
Q

what is preload dependent upon?

A
  • The total blood volume and contractility of the venous capactance vessels returning blood to the heart
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9
Q

the sympathetic nervous system is key to regulating the three parameters that control B.P (blood volume, cardiac output and vascular resistance). TREU OR FALSE?

A

TRUE

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10
Q

what does the equation MAP=CO*TPR stand for?

A
  • Mean arterial pressure = cardiac output * total peripheral reistance
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11
Q

diuretic drusg cannot be used for the treatment of hypertension. TRUE OR FLASE?

A

FALSE

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12
Q

Thiaide like diuretics are most efficacious for treating hypertention e.g metolazone. TRUE OR FALSE?

A

TRUE

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13
Q

How do thiazide like diuretics work as antihypertensive drugs?

A
  • They reduce water volume in blood which leads to a decrease in BP
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14
Q

which of the diuretics are not effective at treating hypertension?

A
  • Loop diuretics
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15
Q

why should K+ sparing diuretics be avoided for treatmet of hypertension? e.g spirinalactone

A
  • Leads to hypokalemia
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16
Q

how do B1 antangonists reduce b.p?

A
  • they reduce heart rate/contractility
  • reduce renal renin secretion
  • inhibits reflex tachycardia caused by vasodilators
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17
Q

B1 anatagonists are contradinicated in heart block and asthma. TRUE OR FALSE?

A

TRUE

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18
Q

Dual a1 and b1 antagonists decrease b.p without bradycardia. TRUE OR FALSE?

A

TRUE

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19
Q

why is gradual withdrawal important for B1 antagonists?

A
  • Can lead to rebound sympathetic stimulation of the heart
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20
Q

B antagonists are not first option except in cases of angina and M.I. TRUE OR FALSE?

A

TRUE

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21
Q

a1 vasoconstrictors important for prevention of posterol hypertension. TRUE OR FALASE?

A

TRUE

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22
Q

B1 antagonists are partial agonists. TREU RO FALSE?

A

TRUE

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23
Q

hwo is reflex tachycardia inhibited?

A
  • By using b1 antagonists
24
Q

why are B antagonist contraindicated in asthma?

A
  • it causes further breathlessnes by causng further bronchoconstriction (blocks B2 receptors)
25
Q

why are B antagonist contraindicated in heart block?

A
  • B receptors control AV node, in heart block AV signals are slowed antagonising this will slow them further
26
Q

how do selective a1 adrenoceptor antagonist work in reducing BP?

A
  • relax arteriolar resistance vessels and dilate venous capacitance
27
Q

selective a1 adrenoceptor antagonist also indicated for prostatic hyperplasia. TRUE OR FALSE?

A

TRUE

28
Q

what are some of the ADRs for selective a1 antagonist?

A
  • reflex tachycardia
  • lethargy
  • postural hypotension
29
Q

what are selective a1 adrenoceptor antagonist drug interations?

A
  • B antagonist

- Diuretics

30
Q

what are a2 adrenergic agonist selective for?

A
  • a2
31
Q

a2 adrenergic agonist avoids sympathomimetic effects. TREU RO FALSE?

A

TRUE

32
Q

how do a2 adrenergic agonist work?

A
  • Inhibit sympathetic output from CNS by inhibiting NE release
33
Q

Methyldopa (a2 adrenergic agonist) is a pro-drug that is metabolised to methylnorepinephrine in CNS. TRUE OR FALSE?

A

TRUE

34
Q

methyldopa has no effect on renal blood flow so can be used in patiets with renal disease. TRUE RO FALSE?

A

TRUE

35
Q

methyldopa does not causes hepatoxicity. TRUE RO FFALSE?

A

FALSE

36
Q

hwo do imidazoline receptor agonist work?

A
  • Inhibit sympathetic output
37
Q

1,4 dihydropyridines is a ca2+ channel blocker that is vascular selective. TRUE OR FLASE?

A

TRUE

38
Q

1,4 dihydropyridines causes arterial vasodilation. TRUE OR FALSE?

A

TRUE

39
Q

verapamil is a ca2+ channel blocker that is less vascular selective. TRUE OR FALSE?

A

TRUE

40
Q

what is negative chronotropic?

A
  • Reduced firing of SA and AV block (Reduced CO)
41
Q

what is a negative inotrop?

A
  • reduced ca2+ influx inhibits contractility (reduced CO)
42
Q

verapimil is contraindicated in patients with cardiac failure. TREU RO FALSE?

A

TRUE

43
Q

How doe ACE inhibitors treat hypertension?

A
  • Reduce angiotensin 2

- Leads to vasoconstriction/ leads to vasodilation

44
Q

give an example prodrug of ACE inhibitors?

A
  • Enalapril (pro-drug)

- Enalaprilat (active)

45
Q

WHta are ACE inhibitors indicated for?

A
  • Hypertention
  • Heart failure (MI)
  • diabetic nepropathy
46
Q

what are some ADRs for ACE inhibitors?

A
  • hypotension
  • Hyerkalemia
  • Coughs
47
Q

what are some drug interactions with ACE inhibitors?

A
  • other drugs that reduce BP
  • K+ sparing diuretics (hyperkalemia)
  • NSAIDS
48
Q

Describe the interaction between k+ sparing diuretics and ACE inhibitor leading to hyperkalemia?

A
  • ACE inhibitors and K+ sparing diuretics both reduces adolsterone production which lead to less K+ being excreted and hence hyperkalemia
49
Q

describe the interactions between NSAIDS and ACE inhibitors?

A
  • ACE inhibitors work on efferent rather afferent, so reduce glomerular pressure and filtration rate
50
Q

Angiotensin 2 receptor antagonists has similar action to ACE inhibitors but no effect on BK metabolism. treu or false?

A

true

51
Q

Losartan is the first angiotensin 2 antangonist to be use dthrapeutically. TREU RO FLASE?

A

TRUE

52
Q

what are some ADRs for angiotensin 2 antagonists?

A
  • hypotension

- lower incidence of coughs compared to ACE inhibitors

53
Q

what are drug intercation of angiotensin 2 antagonists?

A
  • With other bp lowering drugs
  • Hyperkalemia with K+ sparing diuretics
  • NSAIDs antagonise hypotensive effects of angiotensin 2 antagonists
54
Q

What are some of the combination therapy used fpr treatment?

A
  • B antagonist and dihydropyridines ca2+ blockers
  • ACE inhibitors and diuretics
  • ACE inhibitors and ca2+ channel blockers
55
Q

patients with angina, b blockers or ca2+ blockers would be appropriate but not in patients with cardiac failure. TREU RO FALSE?

A

TREU

56
Q

diuretics should be aboided in patients with diabetes and gout. TREU OR FALSE?

A

TRUE

Alan's lecture - Pharmacology (16 decks)

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