Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharmacology > Hypertension > Flashcards

Hypertension Flashcards

1
Q

First line treatment

A

ABCD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Second line

A

Central alpha2 agonists
VDs
Alpha blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Diuretics

A

Diuretic action decreasing BV and CO
VD properties: k opener, depletion of Na and Prostaglandin
Indapamide (thiazide analogue that’s actually a CCB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Thiazide; Hydrochlorothiazide, chlorthalidone and indapamide

A

Mild and moderate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Loop
Furosemide Torsemide Ethacrynic acid Bumetanide

A

Severe HT
Ht emergencies
HT with renal insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Potassium Retaining
Spironolactone eplerenone amiloride triametrene

A

In combination with others to correct hypokalemia
Resistant hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

ACE Inhibitors

A

Inhibit VC and produce VD through kininase inhibition (directly through increase bradykinin and indirectly through PGs and NO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hypertrophy and Cardiac Remodelling

A

Decreased by ACEis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pharmacological actions of ACEis

A

Mixed Arterio > Venous VD
This decrease Cardiac work making ACEi ideal for HF angina as well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Venous VD

A

Decreased VR then EDV then Preload then BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Arterial VD

A

Decreased TPR then BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Increase Renal Blood Flow with decreased GFR

A

ACEi because of EFFERENT VD not afferent decreasing Glomerular HT
*doesn’t affect metabolites metabolism (including uric acid secretion) unlike diuretics do

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

No postural hypotension in ACEi

A

Less venodilation
*unlike nitrates with their postural hypotension and reflex tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Decreased baroreceptor reflex and sympathetic activity

A

No reflex tachycardia with ACEi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Dry irritant cough

A

Bradykinin and prostaglandin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Classification of ACEIs

A

S H containing - captopril
Non S H containing- active: lisinopril and pro drug: ramipril
* Fusinopril excreted in bile not urine so it’s dose doesn’t need to be readjusted with renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Captopril
*Active
*Angio edema side effect

A

Oral absorption affected by meal so take 1 - 2 hrs before
No BBB
50% liver and 50% unchanged in urine
Short acting so give 2 - 3 times per day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Posses less side effects between cptopril and non SH

A

Non SH
*Absorption not even affected by meals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Active non S H

A

Lisinopril - NOat metabolised longest t1/2 so used once daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Prodrugs
FERPBQ
ferbeque

A

Enalapril - enalaprilat
Ramipril - ramiprilat
Perindopril - perindoprilat
Benazepril - benazeprilat
Quinapril
Fosinopril - excreted in bile not urine so impaired renal function doesn’t cause toxicity and stuff like that

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

First dose hypotension especially in

A

Na Depletes patients by diuretics
- treat with saline and stop diuretics before the ACEI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Take in patients with k Retaining diuretics or NSAIDS

A

Hyperkalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

ACEIs are contraindicated jn bilateral renal artery stenosis

A

ACRIs cause EFFERENT not affer3nt VD which won’t help this situation at all

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

ACEI are only helpful in treatment of diabetes nephropathy with their efferent VD property

A

As with 1 you have BD arteries that need to be counterbalanced and with 2 the arteries are of normal diameter so no need

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Decreased taste - disgeusia
ACEI side effect
26
ACEI s lush NSAIDS
Aspirins partially antagonise the hypotensive effects blocking PGs synthesis
27
ACEI plus anatcid
Poor absorption as they are week acids that require basic media
28
AT1receptor blockers *compete with Ang for it's receptors *Two mechanisms :decreased VC and release prostacyclin(VD)
Losartan Valsartan Candesartan Talmisartan Irbesartan
29
30
Presynaptic AT1 receptors exists
Blocked by AT1 RB decreasing Noradrenaline release
31
Cause efferent DVD decreasing Glomerular Glomerular hypertension
AT1
32
ATI RB plus diuretics
With diuretics because k Retaining Mild uricosic *therapeutic uses andside effects like ACEI minus dry irritant cough
33
Dysgeusia neutropenia proteinuria
Side effects of ACE and AT1 Blockers
34
Direct renin inhibitors
Aliskiren *Better results (refmduced systolic and diastolic BP) with hydrochlorothiazide and AT1
35
Adverse effects of Aliskiren
Headache fatigue dizziness diarrhea Be careful moderate renal dysfunction patients because chymase takes over
36
Sympathetic depressants as another line of treatment
37
What are ganglion blockers?
Trimethaphan
38
What are combined alpha- and beta-adrenergic blockers?
Examples include labetalol.
39
What are beta adrenergic blockers?
Examples include propranolol.
40
What are alpha adrenergic blockers?
Example includes Phentolamine.
41
What are adrenergic neuron blockers?
Reserpine & Guanethidine.
42
What are centrally acting sympathetic depressants?
Agonists such as Methyldopa & imidazoline.
43
What is the use of sympathetic depressants?
They are used in the treatment of hypertension.
44
Alpha 2 agonists inhibit NA release by stimulating the receptors in
The brain stem - decreasing flow from CNS The kidney - decreasing renin The adrenergic ending - decreasing NA *plus they decrease renal vascular resistance so used in hypertension with renal failure
45
Alpha methyldopa
BBB so a risk in pregnancy ĵ really
46
Alpha methyl dopa inhibits NA through
Same general mechanisms plus inhibition of dopa decarboxylase and Serotonin biosynthesis
47
Alpha methyl dopa fights with dopa for its Dopamine forming receptors
Giving methyl Noradrenaline (a false tesnsmitter) and not Noradrenaline with *plus BBB
48
Adrenergic blockers: Selective al0ha
Two mechanisms As an alpha blocker And phosphodiesterase inhibi
49
Uses of prazosin 3Hs
Hypertension Heart Failure - mixed dilator Benign prostatic Hyperplasia
50
Beta blockers as adrenergic receptor blockers in HF
Can cause hypotension on Prolonged use
51
Beta blockers in The usual places
CNS Kidney Presynaptic endings Heart Baroreceptor - sensitivity BV - PG and decreased PR Plus VD beta blockers like celiprolol nebivolol carvedilol labetalol
52
Beta and alpha blockers in treatment of hypertension
Labetalol Beta : alpha - 3 : 1 No effect on CO plus no ISA like propranolol No tachycardia- blocks both receptors
53
Labetaproduces quick drop in bp because
Alpha 1 blocking Anti renin *so used in emergencies
54
Combined Alpha and beta blockers are perfect for
Pheochromocytoma And hypertension 😕: orally or IV in severe (emergency or toxemia(pre-eclampsia)) hypertension
55
Carvedilol
Like labetalol but with antioxidant action apparently
56
Calcium Channel Blockers
Also used in hypertension
57
Vaso Ds as antihypertensives
Direct : Veno - nitrates Arterio - hydralazine minoxidil CCB Mixed Na nitroprusside nesiritide Others - affect endogenous mediators: raas antagonists autocoids sympathomimetics sympathetic depressants
58
Special VD
Hydralazine - arterial through NO Minoxidil Diazoxide Na nitroprusside
59
Hydralazine
Coronary Renal - increased RBF Splanchnic Decreased Diastolic more than systolic
60
There can be slow acetylation of hydralazine
Peripheral neuritis(idiosyncracy) - treat with vit B6
61
Decreased bp increased sympathetic reflex tachycardia *Hydralazine
Contraindicated in angina Contraindicated in kidney desease
62
Anti hypertensive(maye with beta blockers or diuretics) drugs also used in
HF
63
Minoxidil, another arterio is a
Prodrug(K channel causing hyper p) - active minoxidil sulphate
64
Potent Oral Long acting Direct Arterio D
Minoxidil
65
Added disadvantage of minoxidil
Together with decreased BP Hypertrichosis - All the hair growth
66
Added therapeutic use of minoxidi
Topically in alopecia Together with sever Hyper t and resistant HF
67
Diazoxide
Two mechanisms: Hyperpolarisation Direct ArterioD
68
Added disadvantage
It's related to thiazide diuretics so can cause hyperglycaemia and hyperuricemia
69
Therapeutic uses of diazoxide
Hypertension Oral hypoglycemic in insulinomas
70
Specia case of Diazoxide
Boud to plasma proteins so if to be used in emergencies: Rapid IV of large doses Repeated Iv of small doses till saturation of plasma proteins then IV infusion
71
Na Nitroprusside- mixed VD plues inhibit platelet aggregation
RBCs and endothelium uptake the stuff then release NO which stimulates granulated cyclase and gives cGMP
72
Na Nitroprusside
Arterio VD Veno VD Maintained CO because decreased TPR
73
Na Nitroprusside
Taken IV: Onset 0.5 minutes Peak 2 minutes Duration 3 minutes Metabolised by Rhodanese enzyme - thiocyanate which is excerpted in urine
74
Increase cyanide especially in old age
Acidosis and arrhythmia Death
75
Large doses of Na nitroprusside
Severe hypotension Shock *Teratogenic
76
Don't stop Na nitroprusside sudden
Rebound hyper t.
77
Uses of Na nitroprusside *Only by IV 0.5 to 10micrograms * fresh *cover with foil because photosensitive *continuous monitoring *never stop suddenly
Emergency HF HT Controlled hypotension during some operations In aortic Aneurysm together with Beta blockers
78
Used in hypertension, heart failure and MI
ACEIs
79
1st dose hypotension with K depleting diuretics
ACEIs
80
Uses of alpha methyl dopa
Category B - non teratogenic orally in Hypertension with pregnancy Even with renal insufficiency as alpha 2 agonist decrease renal vascular resistance Category C - is kind of teratogenic paranterally
81
Adverse effects alpha methyl dopa ON CNS
Sedation Night mares Less than reserpine- depression and parkinsonism
82
Alphabet methyl dopa - leaves parasympathetic to roam free so:
All the bradycardia Diarrhea Postural hypotension with large doses unlike guanethedine Nasal stuffiness
83
Other alpha methyl dopa adverse effects
Edema Liver toxicity Bine marrow depression Salt and water retention due to the reduced blood pressure
84
Clonidine - alpha 2 agonist, Imidazoline as well
Hypertension tension by central and peripheral action
85
Central clonidine
On alpha and imida in brainstem decreasing vasomotor and sympathetic flow causing VD
86
Peripheral clonidine on nerve endings and kidney
Presynaptic alpha stimulation Anti renin
87
Used in morphine withdrawal(as there's reverse effect - sympathetic hyperactive?
Clonidine
88
Combined with morphine in caudal anaesthesia
Clonidine
89
Rebound hypertension with clonidine treated with
Phentolamine
90
Clonidine also causes bradycardia because of the reduced sympathetic activi
Plus drowsiness and dry mouth
91
Decreases effect of clonidine
Tricyclic Antidepressants
92
More selective with longer durations and less side effects than morphine
Guanfacjnr and guanabenz

Pharmacology (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions