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Drugs > Hypertension > Flashcards

Hypertension Flashcards

1
Q

ACE inhibitors end in

A

pril

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2
Q

Angiotensin receptor antagonists (ARBs) end in

A

artan (ARb)

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3
Q

Calcium channel blockers end in

A

ipine

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4
Q

Example of an ACE inhibitor

A

lisinopril

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5
Q

Example of an angiotensin receptor antagonist (ARB)

A

losartan

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6
Q

Example of a calcium channel blocker

A

amlodipine

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7
Q

Arguably the worst side effect of ACE inhibitors and why

A

dry cough

kinins (eg bradykinin) not degraded –> irritate sensory receptors in lungs

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8
Q

Common side effects of ARBs

A

No common side effects reported (yet)

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9
Q

Common side effects of calcium channel blockers

A

Amlodipine & nifedipine - ankle swelling, flushing, headache, palpitations due to vasodilation & compensatory tachycardia
Decreased GIT activity - constipation - common with vermapamil

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10
Q

Most serious side effect of diuretics

A

hypokalaemia ( –> basis for arrhythmia)

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11
Q

How do diuretics affect blood volume

A

decrease it

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12
Q

Beta blockers end in

A

olol

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13
Q

Example of a beta blocker

A

propanolol

bisoprolol

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14
Q

Common side effects of beta blockers

A 
cold extremities 
fatigue (lower HR)
headache
GI disturbance (nausea)
bronchospasm 
exercise intolerance
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15
Q

Why NICE recommends avoiding beta blockers in newly diagnosed patients

A

correlation between people who have taken beta blockers and people developing type II diabetes (seems they alter pancreatic cell function)

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16
Q

An newly diagnosed hypertensive patient who is white, and under 55 would be started on which class of drug?

A

ACE inhibitor (pril)

17
Q

An newly diagnosed hypertensive patient who is African/Caribbean would be started on which class of drug?

A

Calcium channel blockers (ipine)

18
Q

An newly diagnosed hypertensive patient who is over 55 would be started on which class of drug?

A

Calcium channel blockers (ipine)

19
Q

If a patients hypertension is worsening why do we respond with combination therapy?

A
  • lower doses can be used - less toxic side effects

- more chance of successful therapy as 2 different routes acted on

20
Q

Furosemide is what kind if drug?

A

loop diuretic

21
Q

What does digoxin do?

A

from foxgloves
increases the force of myocardial contraction (by causing Ca accumulation in cells) and reduces HR (by increasing parasympathetic innervation and
sop reducing conductivity at the AVN)

22
Q

What may digoxin be given for

A

atrial flutter or fibrillation

HF

23
Q

Beta blocker MoA

A
  • Block B1 receptors on heart - reduce contractility and HR
  • Block B1 receptors on kidneys - reduce renin secretion (mediated by B1R)
  • Prolong refractory period at AVN
24
Q

ACE Inhibitor MoA

A

Blocks angiotensin II production

  • causes vasodilation particularly of the efferent glomerular arteriole
  • reduces aldosterone levels (angio II stimulates aldosterone secretion) lowering blood volume
25
Q

Ca channel blocker MoA

A

Decreases Ca entry into cardiac and vascular cells

  • Arterial smooth muscle relaxes and vasodilates
  • Reduce contractility of the heart
  • Suppress conduction at the AVN - slow ventricular rate
26
Q

Common side effects of ACE inhibitors

A

CAPTOPRIL
Cough (bradykinin not degraded)
Angioedma (rare)
Proteinuria (improves it!)
Taste disturbance/Teratogenic in 1st trimester
Other (fatigue, headache)
Potassium increase (aldosterone not secreted)
Renal impairment (glomerular efferent arteriole dilates)
Itch
Low BP

27
Q

Important side effects for ARBs

A

hyperkalemia and renal failure
same reasons as ACE inhibitors - ARB dilates glomerular efferent arteriole - so patients most at risk are those with renal artery stenosis who rely on efferent construction for GFR
hyperkalemia as aldosterone not secreted

28
Q

Ca channel blockers selective for vascular Ca channels are called…and end in…

A

dihydropyridines

end in ipine

Drugs (8 decks)

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