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HTN Flashcards

1
Q

Thiazide diuretics

A

Bendroflumethiazide
Chlortalidone
Indapamide
Metolazone

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2
Q

Bendroflumethiazide drug class

A

Thiazide diuretic

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3
Q

Bendroflumethiazide targets

A

Na+ Cl

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4
Q

where is Bendroflumethiazides target (what part of the kidney)

A

DCT

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5
Q

Bendroflumethiazide moa

A

Inhibits sodium and chloride reabsorption = Natriuresis and reduction in blood volume and pressure

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6
Q

Bendroflumethiazide important side effects

A

electrolyte imbalance

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7
Q

Bendroflumethiazide causes the excretion of

A

sodium, chloride, and water

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8
Q

Bendroflumethiazide may inhibit

A

carbonic anhydrases in the smooth muscle

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9
Q

what does Chlortalidone inhibit

A

odium ion transport across the renal tubular epithelium

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10
Q

where does Chlortalidone work

A

ascending limb of the loop of Henle

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11
Q

what else does Chlortalidone decrease

A

potassium

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12
Q

Chlortalidone class

A

thiazide-like diuretics

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13
Q

Chlortalidone stimulates synthesis of

A

hypotensive prostaglandin PGE2

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14
Q

Chlortalidone blocks

A

rectifier potassium current

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15
Q

Metolazone class

A

thiazide-like diuretics

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16
Q

Metolazone length of action

A

long

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17
Q

Metolazone actions

A

lower BP

potassium loss

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18
Q

Metolazone inhibits

A

sodium reabsorption

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19
Q

where does Metolazone work

A

cortical diluting site

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20
Q

Loop diuretics

A

Furosemide

Bumetanide

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21
Q

Furosemide target

A

Na+ K+ 2Cl symporter

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22
Q

where is Furosemides target in the kidney

A

thick ascending limb of the loop of Henlé

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23
Q

Furosemide moa

A

Prevents the transport of sodium from the lumen of the loop of Henle into the basolateral interstitium. Consequently, the lumen becomes more hypertonic while the interstitium becomes less hypertonic, which in turn diminishes the osmotic gradient for water reabsorption throughout the nephron

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24
Q

important adverse effects of Furosemide

A

Electrolyte distubances
Metabolic disturbances
Ototoxicity; Nephrotoxicity; Hepatic encephalopathy

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25
Q

which part does Furosemide bind to

A

Chloride binding site

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26
Q

Bumetanide drug class

A

loop D

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27
Q

Potassium-sparing diuretics

A

Amiloride

Spironolactone

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28
Q

amiloride moa

A

inhibits sodium reabsorption predominantly in the collecting ducts

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29
Q

how strong is spironolactone

A

weak

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30
Q

spironolactone moa

A

competing for intracellular aldosterone receptor

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31
Q

where in the kidney does spironolactone work

A

DCT

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32
Q

difference between propanolol and atenolol

A

atenolol does not have a negative inotropic effect

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33
Q

high dose atenolol can do what

A

competitively block beta(2)-adrenergic responses in the bronchial and vascular smooth muscles

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34
Q

describe propanolol

A

non-cardioselective beta-adrenergic antagonist

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35
Q

Calcium channel blockers

A

Amlodipine
Felodipine
Diltiazem
Verapamil

36
Q

amlodipine target

A

L-type calcium channels (Dihydropyridines favour depolarised closed Ca++)

37
Q

amlodipine moa

A

Inhibit influx of calcium ions into vascular smooth muscle cells through L-type calcium channels = Decreased arterial smooth muscle contratility leading to vasodilatation

38
Q

common adverse effects of amlodipine

A

Headache; Tachycardia; Peripheral oedema

39
Q

bad side effect of amlodipine

A

Heart failure in patients with poor left ventricular function

40
Q

where are depolarised closed Ca++ commonly found

A

vascular smooth muscle cells

41
Q

Verapamil class

A

Class IV anti-arrhythmia agent

42
Q

Verapamil inhibits

A

voltage-dependent calcium channels

43
Q

what happens when Verapamil blocks L type calcium channels

A

reduction in ionotropy and chronotropy, reducing heart rate and blood pressure

44
Q

how is Verapamil given

45
Q

first line ACE

46
Q

what does ACE do

A

converts angiotensin I to angiotensin II

47
Q

how does angiotensin II work

A

Stimulation of secretion of aldosterone from the adrenal cortex
Stimulation of Vasopression secretion from the posterior pituitary gland.
Through direct arterial vasoconstriction

48
Q

angiotensin II affect of hypothalamus

A

stimulates hypothalamic neurons = thirst

49
Q

what does ACE deactivate

A

bradykinin

50
Q

ACE side effect

51
Q

Losartan class

A

angiotensin II receptor blocker

52
Q

good thing about ARBs to ACEi

A

do not affect bradykinin = no cough

53
Q

Doxazosin class

A

alpha-adrenergic blocking agent

54
Q

Doxazosin inhibits

A

selective inhibitor of the α1-adrenoceptors

55
Q

where is Doxazosin target

A

smooth muscle

56
Q

Spironolactone drug class

A

Aldosterone-dependent potassium sparing diuretics

57
Q

Spironolactone target

A

Intracellular aldosterone receptors (mineralocortocoid receptors (MR)) in the renal tubules

58
Q

Spironolactone important adverse effect

A

Hyperkalaemia
Gynaecomastia/hypogonadism, impotence in males, menstrual irregularities
AKI

59
Q

when to stop Spironolactone

A

V and D - dehydration

60
Q

bisoprolol moa

A

Inhibits binding of noradrenaline, this inhibits activation of adenylyl cyclase enzymes leading to reduced cyclic AMP. This in turn leads to reduced intracellular calcium levels.

61
Q

bisoprolol overall aim on the heart

A

Reduce contractility, reduce heart rate, reduce blood pressure, reduce cardiac

62
Q

bisoprolol important side effects

A 
Hypotension
Bronchoconstriction
Bradycardia and heart block 
Hypoglycaemia
Peripheral vasoconstriction = intermittent claudication and Raynaud’s phenomenon
63
Q

bisoprolol in diabetics risk

A

may mask hypo symptoms

64
Q

what does cardioselective mean

65
Q

examples of cardioselective BB

A

Atenolol, Metoprolol

66
Q

examples of non cardio selective BB

67
Q

noradrenaline is released from

A

released from sympathetic adrenergic neurones

68
Q

Reduced contractility proper name

A

negative intropy

69
Q

reduce heart rate proper name

A

negative chronotropy

70
Q

diltiazem drug class

A

Rate-limiting calcium channel blocker

71
Q

diltiazem target

A

L-type calcium channels

72
Q

diltiazem moa

A

Inhibit influx of calcium ions into cardiomyocytes through L-type calcium channels

73
Q

diltiazem affect on heart

A

Negative inotropic effect – decreases cardiac contractility

74
Q

diltiazem risks

A

Sino-atrial and AV block

75
Q

ramipril moa

A

Inhibits synthesis of angiotensin II leading to vascular smooth muscle relaxation and vasodilatation

76
Q

common side effects of ramipril

A

Persistent dry cough

(First dose) hypotension

77
Q

bad side effects of ramipril

A

Acute renal failure
Hyperkalaemia
Angioedema, hypersensitivity reactions

78
Q

what to do if ramipril acuses a cough

A

swap to ARB

79
Q

when to take first ramipril

80
Q

1st line drug in those below 55

81
Q

sartan target

A

Angiotensin II AT1 receptor

82
Q

sartan side effects

A

1st dose hypotension

83
Q

sartan bad side effects

A

Hyperkalaemia

Acute renal failure

84
Q

doxazosin drug class

A

α1 specific Alpha blockers

85
Q

doxazosin target

A

Alpha adrenoceptor

86
Q

doxazosin moa

A

inhibits binding of noradrenaline
This inhibits activation of phospholipase-C enzyme leading to reduced inositol triphosphate; this in turn blocks the downstream phosphorylation cascade.

87
Q

doxazosin bad side effect

A

Postural hypotension

cardioresp drugs (13 decks)

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