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Pharm > Hypertension > Flashcards

Hypertension Flashcards

1
Q

Describe stepwise treatment for hypertension

A

1: A if <55, C/D if >55 or AfroCaribbean
2: A + C/D
3: A + C + D
4: other diuretics, alpha blocker, beta blocker

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2
Q

Action of ACE inhibitors

A

Inhibit angiotensin converting enzyme so prevent AT2 production
This in turn causes vasodilation, decreased aldosterone secretion, decreased Na reabsorption in kidneys

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3
Q

Side effects of ACEi

A 
Dry cough
Hypotension
Hyperkalaemia
Angiooedema
Renal failure
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4
Q

Benefits of ARBs

A

Better tolerated than ACEi, for example no dry cough

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5
Q

3 classes of Ca channel blockers and an example of each

A

Dihydropyridines - amlodipine
Phenylalkylamines - verapamil
Benzothiazepines - diltiazem

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6
Q

MoA of amlodipine

A

L type Ca channel blocker so causes peripheral vasodilation

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7
Q

Side effects of amlodipine

A 
Ankle swelling
Tachycardia
Palpitations
Sweating
Headache 
Gingival hyperplasia
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8
Q

MoA of verapamil and diltiazem

A

Decrease preload and contractility of heart

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9
Q

Side effects of verapamil

A

Constipation
Bradycardia
Worsen heart failure (contractility)

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10
Q

Side effects of diltiazem

A

Bradycardia

Worsen heart failure (contractility)

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11
Q

Example of alpha blocker

A

Doxazosin

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12
Q

MoA of alpha receptor blockers

A

Block alpha 1 adrenoreceptors in blood vessels so cause vasodilation

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13
Q

Side effects of alpha blockers

A

Postural hypotension
Dizziness
Headache
Oedema

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14
Q

MoA of beta blockers

A

Decrease heart rate and cardiac output which lowers oxygen demand of heart
Inhibits renin release

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15
Q

Side effects of beta blockers

A 
Bradycardia
Cold hands
Impaired glucose tolerance 
Lethargy
Decreased exercise tolerance
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16
Q

Example of renin inhibitor and list its contraindications

A

Aliskiren

Can’t be given with furosemide or to pregnant women

17
Q

Contraindications for beta blockers

A

Asthma

18
Q

Describe aldosterone levels in HF

A

Aldosterone concentration returns to normal despite medication (ACEi/ARBs) which causes endothelial damage, hypokalaemia and myocardial fibrosis.
These can lead to sudden cardiac death however spironolactone improves survival

19
Q

Contraindications for ACEi

A

Renal vascular disease

Severe aortic stenosis

20
Q

First line treatment for heart failure with low ejection fraction

A

ACEi

Beta blockers

21
Q

First line diuretic for hypertension

A

Thiazide like diuretics

E.g. Indapamide, metolazone

Pharm (20 decks)

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