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Human Diseases > Drug therapies for hypertension and angina > Flashcards

Drug therapies for hypertension and angina Flashcards

1
Q

Hypertension increases your risk of what disease?

A

Cardiovascular disease

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2
Q

What is a greater risk factor for cardiovascular disease?

a) increased systolic BP
b) increased diastolic BP

A

Systolic

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3
Q

What is the difference between systolic and diastolic BP?

A 
Systolic = pressure your heart exerts whilst beating
Diastolic = amount of pressure in your arteries between beats
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4
Q

What are the symptoms of hypertension?

A

usually no symptoms unless very severe = silent killer

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5
Q

What causes hypertension? (5)

A 
Complex interaction of genes and environment
Renal or endocrine disease
Vascular disease (renal artery stenosis)
Drugs (amphetamines)
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6
Q

Describe the renin-angiotensin system?

A

Reduced glomerular filtration leads to reduced sodium in distal tubule.
This cases increased renin release.
Renin converts angiotensinogen to angiotensin I
Angiotensin I converted to Angiotensin II by ACE.
Angiotensin II cuases negative feedback loop to reduce renin release

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7
Q

What is the function of angiotensin II?

A

Peripheral vasoconstriction and aldosterone secretion.

Causes negative feedback loop to reduce renin release

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8
Q

What is the function of aldosterone?

A

Increase peripheral resistance, activate sympathetic nervous system. Increase HR and BP. Stimulates kidneys to retain Na which raises BP

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9
Q

What is the aim of hypertension management?

A

Prevent myocardial infarction and stroke (reduce risk of heart failure)

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10
Q

How is hypertension managed?

A

Lifestyle advice and drug treatment

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11
Q

What is ABPM?

A

Ambulatory blood pressure monitoring

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12
Q

What is HBPM?

A

Home blood pressure monitoring

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13
Q

How can hypertension be classified?

A

Stage 1
Stage 2
Severe

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14
Q

If a patient is diagnosed with stage 1 hypertension what is the course of action?

A

Monitor lifestyle modification and arrange 24 hour monitoring

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15
Q

What is the course of action for stage 2 hypertension?

A

Lifestyle modification fairly urgent 24hours monitoring

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16
Q

What is the course of action for severe hypertension?

A

Treat immediately - emergency

17
Q

What lifestyle changes can be used to manage hypertension?

A 
Lose weight
Exercise
Smoking
Diet - salt
Manage other vascular risk factors e.g. cholesterol, diabetes
18
Q

Function of ACE inhibitors?

A

Inhibit ACE - inhibits formation of angiotensin II. Inhibits aldosterone secretion = no increase in BP

19
Q

What is the bets choice of drug for a patient under 55 with hypertenison?

A

ACE inhibitors

20
Q

What is the choice of drug fro patient over age 55 with hypertension?

A

Calcium-channel blocker

21
Q

Describe the mechanism of action of thiazide like diuretics?

A

Increase excretion of Na and water
More Na reaches the distal tubule
BP lowering related to decreased peripheral reisstance

22
Q

Mechanism of beta blockers?

A

Decrease HR, decrease myocardial contractility, inhibit renin-angiotensin system (reduce peripheral resistance)

23
Q

Adverse effects of beta blockers?

A 
Heart failure
fatigue
Blunting recognition of hypoglycaemia in diabetes
Withdrawal
tooth demineralisation
24
Q

Calcium channel blockers mechanism of action?

A

Block Ca entry into smooth muscle cells, inhibit Ca current in sinus and AV node
Decrease peripheral resistance, decrease HR, decrease coronary vascular resistance

25
Q

Adverse effects of calcium channel blockers?

A

Flushing, headaches, oedema, bradycardia, heart failure

26
Q

Adverse effects of ACE inhibits

A

Renal failure
Cough
Burning mouth syndrome

27
Q

Describe angiotensin receptor blockers mechanism of action?

A

Inhibit action of angiotensin II at receptor

28
Q

Effect of angiotensin receptor blockers?

A

Decrease sympathetic nervous system, vasodilation

29
Q

Mehcanism of action of alpha blockers?

A

Alpha - adrenoreceptor antagonist.
Vasodilation = fall in BP
Increase HR

30
Q

What is the aim of management of angina?

A

Reduce symptoms and reduce risk of MI stroke

31
Q

What risk factors need to be managed for treatment of angina?

A

Vascular risk factors e.g. smoking, cholesterol, diabetes

32
Q

What is the effect of anti-platelet therapy for angina treatment?

A

Reduces risk of NI and stroke

33
Q

Mechanism of action of nitrates for angina teatment?

A

Relax arterial and venous smooth muscle. Venodilation = reduced BP
Redistribution of blood flow to ischaemic myocardium

34
Q

Disadvantages of nitrate therapy to treat angina?

A

Tolerance - decreased effect at given concentration. after repeated doses

35
Q

Effect of catecholamines like adrenaline and noradrenaline on oxygen demand?

A

Increase myocardial oxygen demand during exercise by effecting HR and contractility

36
Q

Effect of B blockers on oxygen demand?

A

Decrease myocardial oxygen demand by decreasing the effects of noradrenaline and adrenaline

37
Q

Effect of B blockers on angina?

A

Reduces effects of adrenaline = reduce oxygen demand during exercise = angina tolerance improved

38
Q

Effect of If channel blockers (in the sinus node)?

A

lowers HR without any other action on cardiac function

Human Diseases (37 decks)

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