Drugs And Hyperttension Flashcards by Alice Caporn | Brainscape

Q

True or false, thiazides are the first line treatment for most patients with hypertension

A

True

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Q

A common side effect of calcium channel blockers is swollen ankles, true or false

A

True

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Q

Thiazides reduce systolic BP only, true or false

A

False

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Q

True or false, hypertension is usually treated if a person has a sustained systolic BP of greater than or equal to 140mmHg

A

False

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Q

True or false, thiazides inhibit Na+/Cl- co-transport in the proximal tube

A

False

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Q

True or false, nifedipine and amlodipine are examples of alpha1 blockers

A

False, they are calcium channel blockers

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Q

A common side effect of losartan is a dry, tickly cough, true or false

A

False

Losartan is an angiotensin II Rs antagonist, ACE inhibitors cause a dry cough

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Q

True or false, thiazides release renin

A

True

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Q

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

A

1 - C 
2 - E
3 - B 
4 - D 
5 - A

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Q

Beta blockers are not suitable for patients with asthma, true or false

A

True, they can provoke an asthma attack

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Q

Hypertension is treated if there is a sustained systolic BP greater than or equal to 160mmHg, true or false

A

True

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Q

Hypertension is treated if there us a sustained systolic of >90mmHg, true or false

A

False, treated if sustained diastolic >100mmHg

If known CV disease treated if sustained diastolic 90-99mmHg

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Q

BP=

A

CO x TPR

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Q

How can you reduce cardiac output

A

Reduce heart rate
Reduce stroke volume
Reduce plasma volume

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Q

How can you reduce total peripheral resistance

A

Dilating arteries

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Q

Which anti hypertensive drug works by reducing TPR by inhibiting noradrenaline action

A

Aloha blockers

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Q

Which anti hypertensive works by reducing TPR by inhibiting angiotensin action

A

Angiotensin antagonist

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Q

Which anti hypertensive drugs work by inhibiting endogenous vasoconstrictor production

A

ACE inhibitors

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Q

Which anti hypertensive drugs work by reducing cardiac output and kidney renin secretion

A

B-blockers

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Q

Which anti hypertensive drugs work by directly lowering TPR

A

Vasodilators

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Q

Which anti hypertensives work by reducing plasma volume then gradually TPR

A

Diuretics

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Q

Where do thiazides diuretics work

A

Distal convoluted tubule

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Q

True or false, thiazides only reduce systolic BP

A

False, reduces diastolic and systolic

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Q

Which diuretics work by inhibiting NaCl co-transport in the distal tubule

A

Thiazides

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Q

What is a negative of the thiazides diuretics

A

Increase renin release, which may counteract their effects on BP

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Q

Chlorothiazide, hydrochlorothiazide and benrofluazide are all thiazide diuretics derived from what?

A

Benzothiadiazine

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Q

Chlorthalidone and metolazone are what kind of drugs

A

Thiazide drugs, with thiazide-like structure

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Q

Which diuretic is more potent, loop diuretic or thiazide diuretics

A

Loop diuretics

Q

Which diuretic is more effective at reducing BP, loop or thiazide

A

Similar

Q

Which diuretic would you use to treat hypertension in patients with renal failure

A

Loop diuretic

Q

What type of drug is minoxidil

A

Potassium channel activator, vasodilator, antihypertensive

Q

When is the drug sodium nitroprusside used in hypertension

A

Hypertensive crisis - IV

Q

How is the drug sodium nitroprusside, which is administered during a hypertensive crisis, administered

A

IV

Q

Which is the most commonly used vasodilator for hypertension

A

Calcium antagonist

Q

Minoxidil and hydralazine are only used when?

A

Severe hypertension

Q

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

A

True

Q

Dihydropyridines and benzothiazepine are examples of what kind of antihypertensive

A

Calcium antagonists

Q

The antihypertensive, calcium antagonist, dihydropyridines are highly selective for what?

A

Smooth muscle

Q

Nifedipine, amlodipine and nicardipine are examples of what anti hypertensives

A

Dihydropyridines, calcium antagonists

Q

Which dihydropyridine, calcium antagonist, is longer acting

Amlodipine
Nifedipine
Nicardipine

A

Amlodipine

Q

Which of the following dihydropyridines, calcium antagonist antihypertensives has some selectivity for cerebral and coronary arteries

Nifedipine
Amlodipine
Nicardipine

A

Nicardipine

Q

Which calcium antagonists also block calcium channels in the conducting tissue of the heart

A

Benzothiazepine

Q

Which calcium channel blockers potentiate B-blocker action?

A

Benzothiazepine, diltiazem

Q

What kind of antihypertensive drug is diltiazem

A

Benzothiazepine, calcium antagonist

Q

Flushing and ankle oedema are side effects of all calcium antagonists, but what can the drug diltiazem also cause

A

Cardiac depression

Interaction with B-blockers

Q

Doxazosin, terazosin and prazosin are all examples of what antihypertensive drug

A

Alpha blockers

Q

How often should the alpha blockers doxazosin and terazosin be taken

A

Once daily

Q

Which of these alpha blockers is shorter acting and is taken tds
Doxazosin
Terazosin
Prazosin

A

Prazosin

Q

Alpha blockers drugs used to treat hypertension are selective blockers of what

A

Alpha 1 adrenoceptors

Q

Which antihypertensives work by preventing vasoconstrictor action of endogenous noradrenaline

A

Alpha blockers

Q

What is an adverse effect of the antihypertensive alpha blockers, such as doxazosin

A

Postural hypotension

Q

Atenolol and metoprolol are examples of what type of antihypertensive

A

B-blockers

Q

True or false, b-blockers bind and block B2 adrenoceptors in the heart

A

False, bind to b1

Q

Which antihypertensive blocks the action of noradrenaline released from the sympathetic nerves and circulating adrenaline

A

B-blockers

Q

What is the initial effect of B-blockers

A

Reduced rate and force if heart best

Decrease cardiac output

Q

What is the effect of B-blockers after continued treatment

A

CO returns to normal but BP remains low

Q

Name two common side effects of B-blockers

A

Cold hands

Fatigue

Q

The following less common adverse of effects are from what antihypertensive drug?
Provoke asthma attack in asthmatics, heart failure, conduction block in heart

A

B-blockers

Q

Captopril, enalapril, lisinopril and ramipril are all examples of what kind of antihypertensive drug

A

ACE inhibitor

Q

How often should the ACE inhibitor captopril be taken?

A

2 x daily dose

Q

How often should the ACE inhibitor enalapril be taken

A

OD

Q

How do ACE inhibitors work?

A

Prevent conversion of angiotensin I to angiotensin II, this causes vasodilation and causes aldosterone secretion (lowering plasma volume)

Q

Which antihypertensive would you associate the adverse effect of a dry cough

A

ACE inhibitor

Q

What are the two common side effects of ACE inhibitors

A

Dry cough
Hypotension

These usually wear off with time

Q

Losartan, candesartan, eprosartan and valsartan are all examples of what antihypertensive drug

A

Angiotensin II receptor antagonist

Q

Which antihypertensive drugs block the action of angiotensin II at its receptors

A

Angiotensin II receptor antagonists (losartan, candesartan)

Q

What is the ‘pro’ of using an angiotensin II receptor antagonist in combination with an ACE inhibitor

A

Improved mortality and morbidity vs. ACE alone

Q

Until recently B-blockers were the drug of choice for hypertension, why are they no longer

A

Less effective at reducing the risk of stroke

More side effects

Q

Thiazides are the drug of choice for hypertension, if it in ineffective what are the next choices

A

Add ACE inhibitor or calcium antagonist