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Cardio Pharmacology > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What is the function of an ACE inhibitor?

A

It inhibits angiotensin converting enzyme, and thus the production of angiotensin II.

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2
Q

Give an example of an ACE inhibitor.

A

Ramipril

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3
Q

Main adverse effects of ACE-I related to reduced angiotensin II production.

A
  • Hypotension
  • Acute renal failure
  • Hyperkalaemia
  • Teratogenic effects
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4
Q

What causes cough in ACE-I use?

A

ACE normally breaks down bradykinin, inhibition of ACE increases bradykinin levels leading to cough.

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5
Q

Give an example of angiotensin II receptor blocker (ARB).

A

Ends in -sartan e.g Candesartan, Losartan

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6
Q

What receptor does ARB work on?

A

AT-1

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7
Q

Main adverse effects of ARB?

A
  • Hypotension
  • Hyperkalaemia
  • Rash
  • contraindicated in pregnancy
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8
Q

Which calcium channel blockers don’t end in -pine?

A
  • Diltiazem

- Verapamil

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9
Q

Give examples of CCB.

A
  • Amlodipine

- Felodipine

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10
Q

How do CCB act?

A

Block L-type calcium channels

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11
Q

Adverse effects of CCB.

A
  • headache, oedema, palpitations (peripheral vasodilation)
  • Bradycardia (conduction tissue)
  • Constipation (by verapamil)
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12
Q

Give examples of three Beta blockers.

A
  • Bisoprolol
  • Atenolol
  • Propanolol
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13
Q

Why is it better to say beta-1 selective rather than ‘cardioselective’ beta blockers?

A

Because half the beta adrenoceptors in the heart are beta-2.

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14
Q

Adverse effects of beta blockers.

A
  • fatigue, headache, sleep disturbance

- Bradycardia, hypotension, cold peripheries, erectile dysfunction

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15
Q

What conditions can be worsened by use of beta blockers? i.e. contraindications.

A
  • Asthma and COPD
  • Peripheral vascular disease
  • Heart failure
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16
Q

Give an example of a thiazide (distal tubule diuretic).

A

bendroflumethiazide

17
Q

Give an example of a loop diuretic.

A

furosemide/ bumetanide

18
Q

Main adverse effects of diuretics.

A
  • Hypovalaemia
  • Hypotension
  • Low serum K+, Na+, Ca2+, Mg2+
  • Raised uric acid
  • Erectile dysfunction
19
Q

Give an example of an alpha-1-adrenoceptor.

A

Doxazosin

20
Q

Give an example of a direct renin inhibitor.

A

Aliskiren

21
Q

What is the first line of therapy for a patient with hypertension (<55y)?

A

ACE-I or ARB

22
Q

What is the first line of therapy for a patient with hypertension (>55y or afro-carribean of any age)?

A

CCB

23
Q

What is the second line of therapy for hypertension (any age)?

A

Combine ACE-I/ARB with CCB

24
Q

What is the third line of therapy for a patient with hypertension (if steps 1 and 2 fail to work)?

A

ACE-I/ARB + CCB + thiazide-like diuretic

25
Q

What is the final step of treating ‘resistant hypertension’?

A

Consider addition of spironolactone, high dose thiazide-like diuretic, alpha blocker, beta blocker.

Cardio Pharmacology (1 decks)

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