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Case 6 Sem 2 > Hypertension > Flashcards

Hypertension Flashcards

1
Q

Diuretic potency of loop diuretics

A

High - loss of fluid can be dramatic

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2
Q

Anti hypertensive effect of loop diuretics

A

No more effective than thiazides at reducing BP

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3
Q

Clinical use of loop diuretics

A

Reserved for patients with pulmonary oedema, heart failure, renal insufficiency, resistant hypertension
Reduces oedema
Daily oral tablet but IV transfusion gives rapid effect

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4
Q

Side effects of loop diuretics

A

Excessive loss of Sodium and water resulting in hypovolaemia and hypotension
Potassium loss resulting in hypokalaemia
Metabolic alkalosis

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5
Q

Examples of loop diuretics

A

Furosemide
Bumetanide
Terasemide

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6
Q

Diuretic potency of thiazide diuretics

A

Moderate

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7
Q

Anti hypertensive effect of thiazide diuretics

A

Reduce systolic and diastolic pressure in hypertensive patients and risk of cardiovascular complications
Have additional vasodilator action: BP falls initially due to renal action, reduced blood volume stimulates renal secretion and limits effect on BP, vasodilation maintains antihypertensive effect

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8
Q

Clinical use of thiazide diuretics

A

Usually given as an add on if drugs not sufficient on own
Thiazides potentials effects of other hypertensive drugs
Daily oral tablet

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9
Q

Thiazide side effects

A

Safe drugs
More frequent urination
Hypokalaemia
Erectile dysfunction (could relate to vasodilator action)

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10
Q

Examples of (original) thiazide drugs

A

Chlorothiazide
Hydrochlorothiazide
Bendroflumethiazide

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11
Q

Examples of (newer thiazide-like - same action) thiazide drugs

A

Indapamide (preferred)
Chlorthalidone (preferred)
Metolazone

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12
Q

Diuretic potency of aldosterone antagonists

A

Weak

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13
Q

Anti hypertensive effect of aldosterone antagonists

A

Marked anti hypertensive effect
Spieonolactone prolonged syrvival in patients with heart failure

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14
Q

Clinical use of aldosterone antagonists

A

Used in treatment of heart failure, hyperaldosteronism, resistant hypertension (esp. with low renin)
Prevents hypokalaemia when given with loop or thiazide diuretic
Daily oral tablet

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15
Q

Side effects of aldosterone antagonist

A

Potentially fatal hyperkalaemia
GI upset
Gynaecomastia, menstrual disorders and testicular atrophy due to actions at other steroid receptors

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16
Q

Examples of aldosterone antagonist

A

Spironolactone
Eplerenone

17
Q

Side effects of all diuretics

A

Disturb plasma electrolyte balance (potassium a particular concern)
Loss of renal function as consequence of hypovolaemia
Therefore serum electrolyte and creatinine levels monitored

18
Q

Dihydropyridines (calcium antagonist) examples

A

Amlodipine
Felodipine
Nimodipine

19
Q

Dihydropyridines (calcium antagonist) cardiovascular selectivity

A

Smooth muscle selective
Inhibit calcium channels in vascular smooth muscle with little effect on heart
Nimodipine acts preferentially on cerebral arteries

20
Q

Therapeutic use of Dihydropyridines (calcium antagonist)

A

First line anti hypertensive drugs
Nimodipine used for vasospasm after cerebral haemorrhage

21
Q

Phenylalkylamines (calcium antagonsist) example

A

Verapamil

22
Q

Phenylalkylamines (calcium antagonist) cardiovascular selectivity

A

Cardiac selective
At doses inhibiting cardiac channels, little effect on smooth muscle

23
Q

Phenylalkylamines (calcium antagonist) therapeutic use

A

Used to treat cardiac arythmias and angina

24
Q

Benzothiazepines (calcium antagonist) example

A

Diltiazem

25
Q

Benzothiazepine (calcium antagonist) cardiovascular selectivity

A

Discriminate poorly between cardiac and smooth muscle channels

26
Q

Benzothiazepines (calcium antagonist) therapeutic use

A

Used for angina that is resistant to B blockers

27
Q

How many people in UK smoke?

A

6.6 million (13.3%)

28
Q

How many deaths attributable to smoking?

A

74,600

29
Q

3 biggest causes of preventable death in UK

A

Tobacco, obesity and alcohol

30
Q

How many lifelong smokers die of smoking related cause?

A

2/3
Half a million smoking related hospital admissions each year

31
Q

How much does smoking cost the NHS

A

2.4 billion

32
Q

Dahlgren and whitehead determinants of health model and smoking

A

Health decisions made in context of wider influences on health
Education
Work environment: routine and manual workers more likely to smoke
Unemployment
Children with parents/siblings that smoke
Friends who smoke
Mental health conditions

Case 6 Sem 2 (1 decks)

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