HTN and Antihypertensives

Question 1

ACEi
- lisinopril
- ramipril

Answer 1

Question 2

ACEi contraindications
- lisinopril
- ramipril

Answer 2

Question 3

Angiotensin II and receptor antagonists
- candesartan
- losartan

Answer 3

AT1 and AT2 receptors - AT1 important in relation to cardiovascular regulation

No effect on bradykinin

Directly targeting AT1 receptors - more effective at inhibitng Ang-II mediated vasoconstriction than ACEi

Question 4

Angiotensin II and receptor antagonists contraindications
- candesartan
- losartan

Answer 4

Question 5

Calcium channel blockers (CCB)
- dihydropyridines
- non-dihydropyridine
- - phenylalkylamines
- - benzothiazepines

Answer 5

Question 6

CCB - Dihydropyridine class
- amlodipine
- nifedipine
- nimodipine

Answer 6

Amlodipine has long half life others tend to be shorter
Nimodipine selectivity for cerebral vasculature (useful for ischaemic effects of subarachnoid haemorrhage)

Question 7

CCB - Dihydropyridine class contraindications
- amlodipine
- nifedipine
- nimodipine

Answer 7

Question 8

CCB - Phenylalkylamines
Verapamil

Answer 8

Class IV anti-arrhythmic agent
- prolongs the action potential/effective refractory period
Less peripheral vasodilation, negative chronotropic and inotropic effects
Used for arrhythmia, angina, hypertension

Question 9

CCB - Phenylalkylamines contraindications
Verapamil

Answer 9

Question 10

CCB - Benzothiazapines
Diltiazem

Answer 10

Sit between other CCB classes

Question 11

Diuretics - thiazide and thiazide-like
- Bendroflumethiazide
- Indapamide

Answer 11

Inhibit Na+/Cl- co-transporter in distal convoluted tubule
Decrease Na+ and H2O reabsorption

Useful over CCB in oedema

Question 12

Diuretics - thiazide and thiazide-like contraindications
- Bendroflumethiazide
- Indapamide

Answer 12

Question 13

Spironolactone

Answer 13

Used in Step 4 - resistant hypertension
Aldosterone receptor antagonist
Diuretic

Question 14

Spironolactone contraindications

Answer 14

Question 15

β-adrenoceptor blockers
- labetalol
- bisoprolol
- metoprolol

Answer 15

Decrease sympathetic tone by blocking NAd and reducing myocardial contraction resulting in reduced cardiac output
Decrease renin secretion B1

Question 16

β-adrenoceptor blockers contraindications
- labetalol
- bisoprolol
- metoprolol

Answer 16

Question 17

α-adrenoceptor blockers
Doxazosin

Answer 17

Selective antagonism of a-1 adrenoceptors
Reduce peripheral vascular resistance
Urinary tract indluding bladder neck and prostate - bph
Relatively safe in renal disease

Question 18

α-adrenoceptor blockers contraindications
Doxazosin

Answer 18