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Pharmacology > Hypertension > Flashcards

Hypertension Flashcards

1
Q

Give an example of angiotension converting enzyme inhibitor (ACE inhibitors)

A

ramipril
lisinopril
perindopril

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2
Q

Which class of drug does ramipril belong to?

A

ACE inhibitor

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3
Q

What is the mechanism of action of ACE inhibitors?

A

inhibits angiotensin converting enzymes, preventing the conversion of angiotensin 1 to angiotensin 2 by ACE

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4
Q

What is the drug target of ACE inhibitors?

A

angiotensin converting enzyme

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5
Q

What are the main side effects of ACE inhibitors?

A

cough, hypotension, hyperkalaemia, foetal injury, renal failure, uritcaria angioedema

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6
Q

Which ACE inhibitor is NOT a pro drug?

A

lisinopril

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7
Q

What is meant by pro drug (ACE inhibitors)?

A

require hepatic activation to generate the active metabolites required for therapeutic effects

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8
Q

Should ACE inhibitors be avoided in pregnant people?

A

Yes, they can cause foetal injury

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9
Q

What two levels should be monitored when prescribing ACE inhibitors?

A

eGFR and serum potassium

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10
Q

Why is eGFR and serum potassium monitored in a patient on ACE inhibitors?

A

ace inhibitors are associated with renal failure and hyperkalaemia

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11
Q

Give an example of a calcium channel blocker

A

amlodipine, felodipine

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12
Q

Which class of drug does amlodipine belong to?

A

calcium channel blocker

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13
Q

What is the mechanism of action of calcium channel blockers?

A

blocks L type calcium channel on predominantly vascular smooth muscle which results in a decrease in calcium influx, with downstream inhibition of myosin light chain kinase and prevention of cross bridge action - resultant vasodilation reduces peripheral resistance

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14
Q

What is the drug target of calcium channel blockers?

A

L type calcium channel

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15
Q

What are the side effects of calcium channel blockers?

A

ankle oedema, constipation, palpitations, flushing, headaches

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16
Q

Give examples of thiazide/ thiazide like diuretics

A

bendroflumethiazide (thiazide)

indapamide (thiazide like)

17
Q

What is the mechanism of action of thiazide/ thiazide like diuretics?

A

block sodium chloride transporter in the DISTAL CONVOLUTED TUBULE , inhibiting sodium and chloride reabsorption. the osmolarity of tubular fluid increases, decreasing the osmotic gradient for water reabsorption in the COLLECTING DUCT

18
Q

What is the drug target of thiazide/thiazide like diuretics?

A

sodium chloride cotransporter

19
Q

What are the side effects of thiazide/thiazide like diuretics?

A

hypokalaemia
hyponatremia
metabolic alkalosis (from the increased hydrogenation excretion) ,
hypercalcemia, hyperglycaemia (hyperpolarised pancreatic beta cells) hyperuricemia

20
Q

How long does it take for thiazide and thiazide like diuretics to lose diuretic effects?

A

1-2 weeks of treatment

21
Q

How do thiazides and thiazide like diuretics continue to have antihypertensive effects past two weeks?

A

vasodilating properties, which are more pronounced for the thiazide like diuretics

22
Q

Give examples of angiotensin receptor blockers?

A

losartan, irbesartan, candesartan

23
Q

What is the mechanism of action of angiotensin receptor blockers?

A

agents act as a non competitive antagonist at the AT1 receptor found on kidneys and vasculature

24
Q

What is the drug target for angiotensin receptor blockers?

A

angiotension receptor AT1 on kidneys and vasculature

25
Q

What are the side effects of angiotensin receptor blockers?

A

hypotension, hyperkalaemia, foetal injury, renal failure

26
Q

Are ACE inhibitors more effective than angiotensin receptor blockers?

A

ACE inhibitors are more effective antihypertensives than angiotensin receptor blockers

27
Q

Which angiotensin receptor blockers are pro drugs?

A

losartan and candesartan

Pharmacology (8 decks)

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