Drugs And Hyperttension Flashcards
True or false, thiazides are the first line treatment for most patients with hypertension
True
A common side effect of calcium channel blockers is swollen ankles, true or false
True
Thiazides reduce systolic BP only, true or false
False
True or false, hypertension is usually treated if a person has a sustained systolic BP of greater than or equal to 140mmHg
False
True or false, thiazides inhibit Na+/Cl- co-transport in the proximal tube
False
True or false, nifedipine and amlodipine are examples of alpha1 blockers
False, they are calcium channel blockers
A common side effect of losartan is a dry, tickly cough, true or false
False
Losartan is an angiotensin II Rs antagonist, ACE inhibitors cause a dry cough
True or false, thiazides release renin
True
Match the following hypertensives with their MOA
- Diuretics. A. Reduce TPR by inhibiting Ndr action
- Vasodilators. B. Reduce CO & renin secretion by the kidney
- B-blockers. C.reduce plasma volume then gradually TPR
- ACE inhibitors. D. Inhibit endogenous vasoconstrictor production
- Alpha-blockers. E. Directly lower TPR
1 - C 2 - E 3 - B 4 - D 5 - A
Beta blockers are not suitable for patients with asthma, true or false
True, they can provoke an asthma attack
Hypertension is treated if there is a sustained systolic BP greater than or equal to 160mmHg, true or false
True
Hypertension is treated if there us a sustained systolic of >90mmHg, true or false
False, treated if sustained diastolic >100mmHg
If known CV disease treated if sustained diastolic 90-99mmHg
BP=
CO x TPR
How can you reduce cardiac output
Reduce heart rate
Reduce stroke volume
Reduce plasma volume
How can you reduce total peripheral resistance
Dilating arteries
Which anti hypertensive drug works by reducing TPR by inhibiting noradrenaline action
Aloha blockers
Which anti hypertensive works by reducing TPR by inhibiting angiotensin action
Angiotensin antagonist
Which anti hypertensive drugs work by inhibiting endogenous vasoconstrictor production
ACE inhibitors
Which anti hypertensive drugs work by reducing cardiac output and kidney renin secretion
B-blockers
Which anti hypertensive drugs work by directly lowering TPR
Vasodilators
Which anti hypertensives work by reducing plasma volume then gradually TPR
Diuretics
Where do thiazides diuretics work
Distal convoluted tubule
True or false, thiazides only reduce systolic BP
False, reduces diastolic and systolic
Which diuretics work by inhibiting NaCl co-transport in the distal tubule
Thiazides
What is a negative of the thiazides diuretics
Increase renin release, which may counteract their effects on BP
Chlorothiazide, hydrochlorothiazide and benrofluazide are all thiazide diuretics derived from what?
Benzothiadiazine
Chlorthalidone and metolazone are what kind of drugs
Thiazide drugs, with thiazide-like structure
Which diuretic is more potent, loop diuretic or thiazide diuretics
Loop diuretics
Which diuretic is more effective at reducing BP, loop or thiazide
Similar
Which diuretic would you use to treat hypertension in patients with renal failure
Loop diuretic
What type of drug is minoxidil
Potassium channel activator, vasodilator, antihypertensive
When is the drug sodium nitroprusside used in hypertension
Hypertensive crisis - IV
How is the drug sodium nitroprusside, which is administered during a hypertensive crisis, administered
IV
Which is the most commonly used vasodilator for hypertension
Calcium antagonist
Minoxidil and hydralazine are only used when?
Severe hypertension
true or false, calcium antagonists used to treat hypertension, work by preventing the movement of calcium into the cardiac and smooth muscle cells when the cells are stimulated
True
Dihydropyridines and benzothiazepine are examples of what kind of antihypertensive
Calcium antagonists
The antihypertensive, calcium antagonist, dihydropyridines are highly selective for what?
Smooth muscle
Nifedipine, amlodipine and nicardipine are examples of what anti hypertensives
Dihydropyridines, calcium antagonists
Which dihydropyridine, calcium antagonist, is longer acting
- Amlodipine
- Nifedipine
- Nicardipine
Amlodipine
Which of the following dihydropyridines, calcium antagonist antihypertensives has some selectivity for cerebral and coronary arteries
- Nifedipine
- Amlodipine
- Nicardipine
Nicardipine
Which calcium antagonists also block calcium channels in the conducting tissue of the heart
Benzothiazepine
Which calcium channel blockers potentiate B-blocker action?
Benzothiazepine, diltiazem
What kind of antihypertensive drug is diltiazem
Benzothiazepine, calcium antagonist
Flushing and ankle oedema are side effects of all calcium antagonists, but what can the drug diltiazem also cause
Cardiac depression
Interaction with B-blockers
Doxazosin, terazosin and prazosin are all examples of what antihypertensive drug
Alpha blockers
How often should the alpha blockers doxazosin and terazosin be taken
Once daily
Which of these alpha blockers is shorter acting and is taken tds
Doxazosin
Terazosin
Prazosin
Prazosin
Alpha blockers drugs used to treat hypertension are selective blockers of what
Alpha 1 adrenoceptors
Which antihypertensives work by preventing vasoconstrictor action of endogenous noradrenaline
Alpha blockers
What is an adverse effect of the antihypertensive alpha blockers, such as doxazosin
Postural hypotension
Atenolol and metoprolol are examples of what type of antihypertensive
B-blockers
True or false, b-blockers bind and block B2 adrenoceptors in the heart
False, bind to b1
Which antihypertensive blocks the action of noradrenaline released from the sympathetic nerves and circulating adrenaline
B-blockers
What is the initial effect of B-blockers
Reduced rate and force if heart best
Decrease cardiac output
What is the effect of B-blockers after continued treatment
CO returns to normal but BP remains low
Name two common side effects of B-blockers
Cold hands
Fatigue
The following less common adverse of effects are from what antihypertensive drug?
Provoke asthma attack in asthmatics, heart failure, conduction block in heart
B-blockers
Captopril, enalapril, lisinopril and ramipril are all examples of what kind of antihypertensive drug
ACE inhibitor
How often should the ACE inhibitor captopril be taken?
2 x daily dose
How often should the ACE inhibitor enalapril be taken
OD
How do ACE inhibitors work?
Prevent conversion of angiotensin I to angiotensin II, this causes vasodilation and causes aldosterone secretion (lowering plasma volume)
Which antihypertensive would you associate the adverse effect of a dry cough
ACE inhibitor
What are the two common side effects of ACE inhibitors
Dry cough
Hypotension
These usually wear off with time
Losartan, candesartan, eprosartan and valsartan are all examples of what antihypertensive drug
Angiotensin II receptor antagonist
Which antihypertensive drugs block the action of angiotensin II at its receptors
Angiotensin II receptor antagonists (losartan, candesartan)
What is the ‘pro’ of using an angiotensin II receptor antagonist in combination with an ACE inhibitor
Improved mortality and morbidity vs. ACE alone
Until recently B-blockers were the drug of choice for hypertension, why are they no longer
Less effective at reducing the risk of stroke
More side effects
Thiazides are the drug of choice for hypertension, if it in ineffective what are the next choices
Add ACE inhibitor or calcium antagonist
