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Pharmacology > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What is hypertension

A

High blood pressure

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2
Q

What is hypotension

A

Low blood pressure

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3
Q

If in a consultation a patient presents high blood pressure, what do you do next

A

Take measurements on both arms if the difference if more than 15 of the recommended.
Take another one then with the highest arm take a 3rd reading

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4
Q

If the clinical blood pressure is between 140/90 - 180/120 what should be carried out

A

Ambulatory ( close monitoring for 24hours) blood pressure monitoring should be carried

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5
Q

What BP is considered as hypertension

A
  • 140/90 or higher (150/90) for adults aged over 80
  • a day time ambulatory blood pressure of 135/85 or higher
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6
Q

What is the ranges of stage 1 hypertension

A

140/90 - 159/99 and subsequent ABPM of 135/85 - 149/94

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7
Q

What is stage 2 hypertension

A

160/100 - 180/120 with an ABPM of 150/95 and higher

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8
Q

What is stage 3 hypertension

A

When the BP is 180/120 and higher

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9
Q

What is accelerated hypertension

A

An accelerated hypertension in which the blood pressure reaches 180/120 and above and also the level this high is associated with progressive organ damage.

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10
Q

What is the name of the hypertension that has no identifiable cause but gradually gets worse over the years

A

Primary/ Essential hypertension

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11
Q

Is hypertension passed on

A

No, thus having someone with hypertension in your family doesn’t mean you’ll also have it

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12
Q

What is secondary hypertension

A

Hypertension that occurs as a result of other health conditions

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13
Q

What is amlodipine

A

Calcium channel blocker 2

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14
Q

How does amlodipine work

A

It acts on the myocardial muscles, myocardial conducting system and the vascular smooth muscle and it worlks by inhibiting Ca2+ influx

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15
Q

What is the bioavailability of amlodipine via the oral route

A

Roughly 60%

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16
Q

What is the half life of amlodipine

A

30-50 hours

17
Q

What is steady-state plasma concentrations

A

The concentration in which the drug concentration consistently stays., the equilibrium in which drug concentration consistency stays.

18
Q

What is angiotensin

A

A hormone that regulates your blood pressure by narrowing blood vessels

19
Q

What are Angiotensin converting enzymes

A

These are enzymes that converts inactive ang I to ang II and degrades active bradykin

20
Q

What are ace inhibitors

A

These are drugs that inhibit ACEnzymes that are used to lower high blood pressure by relaxing veins and arteries

21
Q

What is the mechanism of action for lisinopril

A

It inhibits the angiotensin converting enzyme in the reninangiotensin system.

22
Q

What is the oral bioavailability of lisinopril

A

25%

23
Q

How long does it take for the peak plasma concentration to be reached

A

4-8 hours

24
Q

What is the half life of lisinopril

A

12 hours

25
Q

Is lisinopril water soluble and why is that important

A

Yes and so is not metabolised and so is excreted unchanged

26
Q

What are ARBs

A

Angiotensin receptive blockers. These are selective competitive Blockers of the AT1 (angiotensin II type 1) receptor

27
Q

What are diuretics

A

A drug that increases urination by reducing fluid build up/storage

28
Q

What are thiazides?

A

These are a types of diuretics that are used to treat high blood pressure and heart failure

29
Q

How do the thiazide diuretics work?

A

They inhibit Na+ and cl- reabsorption by blocking the na+, c- symporter.
However should be taken at lower doses to have a more prominent vasodilations effect than a diuretic effect

30
Q

Three examples of ACE inhibitors

A
  • Lisinopril
  • ramipril
  • enalapril
31
Q

What different types of drugs can be administered to treat hypertension

A
  • CCBs ( calcium channel blockers)
  • ACE inhibitors ( angiotensin converting enzyme inhibitors, stops the production of angiotensin)
  • A2RBs (angiotensin II receptor blocker)
  • Thiazide like diuretics
32
Q

What is the first step in the treatment of hypertension under 55 and over 55

A

Under 55
- ACE inhibitors or A2RBs
Over 55 and black
- CCBs

33
Q

What happens in step 2 treatment of hypertension

A

If step 1 is unsuccessful in treating hypertension:
- Offer a CCB in combination with an ACE inhibitor/ A2RB, if CCB not suitable then offer a thiazide like diuretic
- in black people an A2RB should be offered in preference to an ACE inhibitor to have alongside the CCB

34
Q

What happens in step 3 hypertension

A
  • ensure that all the dosages in step 2 are optimal before combing all three meds: A2RB, CCB and ACE inhibitor
35
Q

What is resistant hypertension

A

When a patient is under stage 3 treatments however their BP is still above 140/90.

36
Q

What happens in stage 4 hypertension treatment

A
  • additional diuretics
  • higher dosage of diuretics.
  • using alpha or beta blockers

Pharmacology (17 decks)

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