Drugs used for treatment of Hypertension 2

Question 1

List the chemical derivates for selective CCB with mainly vascular effects

Answer 1

Dihydropyridine derivates

Question 2

List the drugs for selective CCB with mainly vascular effects

Answer 2

Drug name
Amlodipine*
Felodipine
Lecanidipine
Nifedipine*
Nimodipine

Question 3

list the chemical derivates for selective CCB with direct cardiac effects

Answer 3

Phenylalkylamine derivates
Benzothiazepine derivates

Question 4

List the drugs for phenylalkylamine derivates

Answer 4

Verapimil

Question 5

List the drugs for Benzothiazepine derivates

Answer 5

Diltiazem

Question 6

explain the MoA of Calcium channel blockers

Answer 6

L-type calcium channels
Block cellular entry of Ca2+,through calcium channels rather than
preventing its intracellular actions

Question 7

Many calcium channel antagonist show properties of?

Answer 7

Many calcium channel antagonists show properties of:
* Use dependence, the most active calcium channels are more
effectively blocked
* Voltage-dependent blocking, blocking is stronger when the
membrane is depolarised, causing calcium channel opening and
inactivation

Question 8

explain the cardiac action for calcium channel blockers: physiological actions

Answer 8

Cardiac actions
* Cardio-selective: Verapamil
(diltiazem intermediate
selectivity)
* Antiarrhythmic affects (AV block
and cardiac slowing)
* Negative ionotropic effect
(contra-indicated in CCF)

Question 9

Explain what calcium channel blockers do on vascular smooth muscle

Answer 9

Vascular smooth muscle
* Selective for smooth muscle:
Dihydropyridines – amlodipine
* Reflex tachycardia due to
vasodilator action
* Reduce blood pressure
* Can be used in CCF
* Coronary vasodilation use in
variant angina (cause by
vasospasm)
* Other smooth muscles are also
relaxed: biliary, urinary, uterine

Question 10

Inidcation for calcium channel blockers

Answer 10

Hypertension: shown beneficial effects on cardiovascular morbidity
and mortality

Question 11

explain the pharmacokinectis for calcium channel blockers

Answer 11

• Mostly given oral with good bioavailability, iv , e.g. nimodipine for
  special indication (subarachnoid haemorrhage)
• Extensively metabolised
• Amlodipine long elimination half-life (once daily dosing)
• Nifedipine, verapamil, diltiazem, short half-lives (formulations for
  once daily dosing available)

Question 12

What are adverse effects for short acting dihydrpyridine

Answer 12

Headache and flushing

Question 13

list the adverse effects for chronic use of CCB

Answer 13

ankle swelling (pedal oedema) – vasodilation and
increased permeability

Question 14

List adverse effects of verapamil

Answer 14

constipation, heart block, worsening heart failure

Question 15

Name 2 classes of low-ceiling diuretics

Answer 15

Thiazides
Excluding thiazides

Question 16

Give one agent that is a Thiazide

Answer 16

hydrochlorothiazide

Question 17

Name one agent that is excluding thiazides

Answer 17

Indapamide

Question 18

Name the class and the drugs under High-ceiling diuretics

Answer 18

LOOP
Furosemide*
Bumetanide
Torasemide

Question 19

Name the classes for potassium-sparing diuretics and the drugs

Answer 19

Aldosterone antagonists
Spironolactone*

Eplerenone

Other potassium-sparing (epithelial sodium channel blocker
Amiloride
Triamterene

Question 20

FOR INTEREST

LIST DRUGS FOR
1. Carbonic anhydrase inhibitors
2. Osmotic
3. Antidiuretic hormone antagonist

Answer 20

1. Acetazolamide
   Dorzolamide
2. Mannitol
   Glycerol
3. Conivaptan
   Tolvaptan