Drugs For Hypertension Flashcards
ACE INHIBITORS examples
Ramipril
Lisinopril
ACEi Mechanism of action
Angiotensin becomes angiotensin I, activated by renin
Angiotensin I becomes angiotensin II, causing vasoconstriction, ^ BP AND BV
this conversion is blocked by ACEi
ACEi Clinical indication
Hypertension
Chronic Heart failure
ACEi adverse effects
Dry cough
Hypotension
Hyperkalaemia
NOT FOR PREGNANCY
If ACEi causes adverse effects it can be switched to ____
Angiotensin receptor blocker
Alpha blockers examples
Doxazosin
Alpha blockers mechanism of action
Blocks alpha-1 adrenoceptors
Dilates CVS
Alpha blockers adverse effects
Dizziness on standing
Urinary symptoms
Tachycardia
Oedema
Angiotensin 2 receptor blockers
Examples
Candesartan
Losartan
A2 receptor blocker mechanism of action
Blocks renin which converts ang1 to ang2
A2 receptor blocker
Clinical indication
Hypertension
Heart failure
Diabetic neuropathy
A2 receptor blocker
Adverse effects
Hyperkalaemia
Renal dysfunction
Not for pregnancy
Beta blockers
Examples
Atenolol
Bisoprolol
Beta blockers
Mechanism of action
Inhibits catecholamines used to activate beta 1 adrenoceptors
Reduces cardiac rate and output
Beta blockers
Clinical indication
Hypertension
Heart failure
Coronary artery disease
NOT FOR HB ASTHMA COPD
Beta blockers
adverse effects
Cold peripheries
Impotence
Bradycardia
Heart block
CCB Examples
Amlodipine
Verapamil
CCB mechanism of action
Block voltage gated calcium channels
Used to form bridges between actin and myosin
CCB clinical indication
Hypertension
>55 or of black/Caribbean ethnicity
CCB adverse effects
Ankle oedema
Headaches
Tachycardia
NOT FOR HB OR HF
Thiazide diuretics examples
Bendroflumethiazide
Thiazide diuretics
Mechanism of action
Inhibits Na/Cl transporters
Causes vasodilation
Thiazide diuretics
Site of action
Proximal end of distal convoluted tubules
Thiazide diuretics
Clinical indication
Hypertension
Older patients
Heart failure
Thiazide diuretics
Adverse effects
Hyperglycemia
High urate
gout risk
Impotence
Low sodium
High potassium
Potassium sparing diuretics
Examples
Also known as: mineralcorticoid blockers
Spironolactone, eplerenone
Potassium sparing diuretics
Mechanism of action
Block MC receptors, limits the volume of potassium lost
Potassium sparing diuretics
Site of action
Kidneys
Potassium sparing diuretics
Clinical indication
Hypertension
Heart failure
Diabetic neuropathy
❌ high K+ or MC deficiency
Potassium sparing diuretics
Adverse effects
Hyperkalaemia
Hypertension step 1 of pharmacological management
Under 55 ACEi
Over 55 OR black/Caribbean ethnicity
CCB
What can ACEi be switched to if the patient is unable to tolerate it
Angiotensin receptor blocker
Hypertension step 2 of pharmacological management
If step one has failed
Combine ACEi and CCB
Hypertension step 3 of pharmacological management
Add thiazide diuretic