Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Drugs Used In Hypertension > Flashcards

Drugs Used In Hypertension Flashcards

1
Q

What is the single biggest cause of death worldwide?

A

Hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the first line treatment for hypertension in patients below the age of 55? 2

A
  1. Angiotensin converting enzyme (ACE) inhibitors

2. Angiotensin receptor blockers (ARBs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where is renin produced?

A

Juxtaglomerular cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does renin do?

A

Renin convert angiotensinogen into angiotensin I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where is ACE found?

A

On the surface of the epithelial cells in the capillaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What ACE do?

A

Converts angiotensin I into angiotensin II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the functions of angiotensin II 5

A
  1. Causes vasoconstriction in blood vessels; increases resistance
  2. Stimulates the pituitary gland to release ADH (increasing water reabsorption); increased SV
  3. Stimulates the adrenal gland to release aldosterone (increasing Na reabsorption; increased SV
  4. Increases Na/H2O reabsorption in the kidneys; increased stroke volumes
  5. Increased resistance and increased SV increases BP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why don’t we use ACE inhibitors and ARBs in patients over the age of 55?

A

Over the age of 55 the renin-angiotensin system isn’t as functional. We therefore use calcium channel blockers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the MOA of thiazide and other diuretics? 4

A 
Diuretics cause a decrease in
1. Blood volume
2. Venous return 
3. Cardiac output 
 Which leads to a decrease in blood pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Explain a possible theory for diuretics causing vasodilation 3

A
  1. Diuretics result in the reduction in smooth muscle Na
  2. This may result in a secondary reduction of intracellular Ca
  3. Muscle may therefore be less responsive to vasoconstriction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the side effects of diuretics? 3

A

Diuretics may result in :

  1. Hypokalaemia
  2. Diabetes mellitus
  3. Gout
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Who is thiazide diuretics useful in?

A

Thiazide diuretics is particularly useful in older patients (>55 )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Give two examples of thiazide like diuretics 2

A
  1. Hydrochlorothiazide

2. Indapamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Give an example of a potassium sparing diuretic

A

Amiloride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Explain the effects of β adrenoceptor antagonist 2

A
  1. β blockers initially reduce BP by decreasing CO.
  2. It is also suggested that β blockers, antagonize β1 receptors in the juxtaglomerular cells, inhibiting the release of renin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the disadvantages of β blockers?7

A
  1. Cold hands
  2. Fatigue
  3. Provocation of asthma
  4. Heart failure
  5. Conductance block
  6. Raise serum triglyceride levels
  7. Decrease high density lipoprotein levels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How can some of the side effects of β blockers be prevented?

A

We can use cardio-selective hydrophillic drugs (drugs without liver metabolism or brain penetration) such as atenolol.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How does the body increase BP? 3

A
  1. Stimulation of β1 receptors increases CO
  2. Stimulation of α1 receptors causes vasoconstriction in smooth muscle of blood vessels increasing resistance
  3. Increased renin -> increased angiotensin II -> increased aldosterone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How do α1 blockers reduce BP?3

A
  1. α1 receptors cause vasoconstriction in vascular smooth muscle
  2. Inhibition results in vasodilation
  3. Decreased SVR -> decreased BP
20
Q

Give 2 examples of α1 blockers

A
  1. Doxazosin

2. Prazosin

21
Q

Hoe do selective β blockers decrease BP?

A
  1. β1 receptors in the heart stimulate an increase in heart rate and increase strength of contraction
  2. β1 antagonists would result in decreased CO
  3. Decreased CO -> BP
22
Q

Give 2 examples of selective β blockers

A
  1. Atenolol

2. Bisoprolol

23
Q

Describe how non selective β blockers decrease BP 2

A
  1. Antagonize both β and α receptors

2. Therefore, decrease CO (β) and SVR (kidneys β1; VSM α1)

24
Q

Name a non-selective β adrenoceptor antagonist

A

Propanolol

25
Q

Name a non selective α & β blocker

A

Carvedilol

26
Q

Name an α2 adrenoceptor agonist

A

Methyldopa

27
Q

What is the MOA of methyldopa? 4

A
  1. Methyldopa is converted into methyl epinephrine
  2. Methylepinephrine stimulates α2 receptors in the medulla
  3. Result in decreased sympathetic outflow decreased SVR
  4. Decreased CO and SVR decreases BP
28
Q

What are the 2 classes of calcium channel blockers?

A
  1. Dihydropyridines

2. Non-dihydropyridines

29
Q

What do dihydropyridine calcium channel blocks inhibit?

A

L type calcium channels

30
Q

Discuss how dihydropyridines work 4

A
  1. L type caclium channels allow calcium to enter the cell
  2. When calcium enters the cell, muscle contracts causing vasoconstriction-> increasedSVR
  3. Dihydropyridines selectively block calcium channels on VSM
  4. Blocking the channel results in vasodilation-> decreasing BP
31
Q

Name 2 dihydropyridines

A
  1. Amlodipine

2. Nifedipine

32
Q

What are the side effects of dihydropyridines? 5

A

All side effects are related to systemic vasodilation and include:

  1. Dizziness
  2. Headaches
  3. Flushing
  4. Peripheral oedema
  5. Swelling of gums (gingival hyperplasia)
33
Q

How do non-dihydropyridines work 5

A
  1. No dihydropyridines are non-selective calcium channel blockers
  2. Block calcium channels in VSM and cardiac cells
  3. Decreased AV node and SA node
  4. Decreased contractility, HR and conduction
  5. Anti-arrhythmic properties
34
Q

List 2 non-dihydropyridines

A
  1. Dilitiazem

2. Verapamil

35
Q

What are the side effects of non-dihydropyridines

A
  1. Excessive bradycardia
  2. Cardiac conduction abnormalities
  3. Verapimil can inhibit the calcium channels in the gut leading to constipation
36
Q

Describe the 3 classes of diuretics

A
  1. Loop diuretics
  2. Thiazide diuretics
  3. Potassium sparing diuretics
37
Q

Explain loop diuretics

A
  1. Reduces the reabsorption of sodium chloride in the kidneys
  2. Increased diuresis
  3. Decreased volume is the vascular system results in decreased volume returning to the heart
  4. Decreased BP -> decreased CO
38
Q

Give an example of a loop diuretic

A

Furosemide

39
Q

Explain how thiazide diuretics work 3

A
  1. Reduce sodium reabsorption in the kidneys to a lesser extent than loop diuretics. Decreased sodium reabsorption-> increased diuresis -> decreased CO. Short term effect
  2. Long term effects are thought to be produced by thiazide induced vasodilation
40
Q

Give an example of thiazide diuretics 1

A

Hydrochlorothiazide

41
Q

Explain how potassium sparing diuretics work

A
  1. Interrupts the actions of aldosterone (Na reabsorption and K excretion)
  2. Used in conjunction with loop or thiazide diuretics
42
Q

What do ACE inhibitors do? 3

A
  1. Angiotensin converting enzyme converts angiotensin I into its active form angiotensin II
  2. Inhibition of ACE results in decreased angiotensin II
  3. ACE inhibitors up-regulate bradykinin -> vasodilation
43
Q

Name 2 ACE inibitors

A
  1. Captopril

2. Ramipril

44
Q

How do angiotensin receptors blockers function? 2

A
  1. Angiotensin II binds to angiotensin type I receptors (AT1) which results in vasoconstriction and activation of aldosterone release
  2. ARBs antagonistically bind to AT1 resulting in vasodilation and inhibition of aldosterone release
45
Q

List 2 ARBs

A
  1. Losartan

2. Valsartan

46
Q

List side effects of ACE inhibitors and ARBs

A
  1. Inhibition of aldosterone-> hyperkalaemia
  2. Dry couch
  3. Angiooedema (increased levels of bradykinin and substance P)

Pharmacology (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions