Hypertension Flashcards
What is the 1st line drug used to treat hypertension in individuals which are older than 55 or black.
ACE inhibitors are used- lisinopril and ramipril.
What is the problem with ACE inhibitors?
So can’t use if there is kidney damage as they can cause AKI.
. BRADYKININ build up (normally broken down by ACE) therefore get a dry cough
. Hyperkalaemia
. Headache/fatigue
What can be used as an alternative to ACE inhibitors, if ACE inhibitors cannot be used due to the intolerance (dry cough)
Angiotensin 2 receptor blockers can be used ie: landesartan and candesartan.
What do they give if the person has high blood pressure and is over 55 years old or black?
Then calcium channel blocker 2ould be used- verapamil.
What class is AMLODIPINE and why does this mean it’s better?
Calcium channel blocker, it is better because it is more specific to the vascular tissue, the non dihydropyridines- verapamil and diltiazem are not as specific and therefore act on the heart and hence are normally used as anti arrhythmics.
What would calcium channel blocker diltiazem be used for?
Angina (chest pain due to lack of blood supply)
What thiazide diuretic should be considered, if the ACEi and CCB aren’t working on their own?
Thiazide diuretics, which act on the DCT- Na-Cl channels.
Examples include: Bendroflumethiazide and Indapamide.
What are the other options for blood pressure after the main ones?
Aldosterone antagonist- spironolactone this is a K+ sparing diuretic, with this you get a risk of hyperkalaemia, this is an ALDOSTERONE antagonist.
Also have bisoprolol, this is a beta blocker which decreases the sympathetic tone, decreases the cardiac output (can’t use this Jin asthmatics though!)
What would you give in a hypertensive emergency?
Labetalol, this is given IV and decreases the sympathetic outflow, it is also safe in pregnancy.
