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Hypertension Flashcards

1
Q

CO X TPR =

A

MAP

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2
Q

SV x HR =

A

CO

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3
Q

What 2 systems regulate blood pressure

A

Sympathetic and Renin-angiotensin-aldosterone system

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4
Q

What type of adrenoceptors are on heart

A

B1

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5
Q

What type of adrenoceptors are on the smooth muscle

A

A1

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6
Q

What vascular changes can occur as a result of hypertension?

A

Remodelling, thickening, hypertrophy

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7
Q

What can local salt sensitivity cause?

A

Vascular remodelling

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8
Q

In hypertension, there is an increase in which vasoactive substances?

A

ET-1
NAd
Ang2

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9
Q

Hypertension can cause end organ damage such as…

A

Renal, peripheral vascular, aneurysm, vascular dementia, retinal disease

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10
Q

What figure does NICE recommend as the boundary of hypertension?

A

140/90mmHg

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11
Q

What blood pressure reading indicates emergency treatment is required?

A

> 180/120 + clinical signs

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12
Q

How would you treat prehypertension?

A 
Promote regular exercise
Modify diet
Reduce stress
Increase relaxation
Limit alcohol 
Limit caffeine
Smoking cessation
Reduce dietary sodium
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13
Q

What are CCB’s?

A

Calcium channel blockers

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14
Q

What are ARB’s?

A

Angiotensin receptor blockers

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15
Q

What are ACEi?

A

ACE inhibitors

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16
Q

Thiazides and Thiazide like are subsets of which drug class?

A

Diuretics

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17
Q

Where in the body is ACE made?

A

Surface of pulmonary and renal endothelium

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18
Q

Angiotensin 2 is a?

A

Vasoconstrictor

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19
Q

Angiotensin 2 acts on AT1 receptors to elicit what responses?

A

Vasoconstriction
Stimulation of aldosterone
Cardiac and vascular muscle cell growth
Vasopressin

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20
Q

Where in the body is vasopressin (ADH) produced?

A

Posterior pituitary

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21
Q

ACEi’s cause vasodilation, how does this help treat hypertension?

A

Decrease in peripheral vascular resistance which decreases afterload

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22
Q

How does a reduction in aldosterone release help treat hypertension?

A

Increase in water and Na+ excretion

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23
Q

Name 2 ACEi

A

Lisinopril

Ramipril

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24
Q

Lisinopril and Ramipril are examples of what type of drug?

A

ACEi

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25
ACEi’s do what to bradykinin?
Potential it
26
What are the side effects of ACE inhibitors?
Hypotension Dry cough due to bradykinin association Hyperkalaemia - low aldosterone = increase K+ Renal failure
27
Angioedema due to ACEi is more common in which population?
Black population
28
What warnings and contraindications are associated with ACEi’s?
Renal artery stenosis AKD Pregnancy Breast feeding
29
What important interactions should you be aware of when prescribing ACEi’s?
Drugs that increase K+ NSAIDs Other antihypertensives
30
Candesartan and Losartan are examples of what class of antihypertensives?
ARBs
31
Why are ARBs not associated with a dry cough and angioedema?
No effect on bradykinin
32
ARBs are less affective in what type of hypertensive
Low renin hypertensive
33
ARBs that directly target AT1 receptors are more effective at inhibiting what effect
Angiotensin2 mediated vasoconstriction via chymase production
34
What are the warnings and contraindications associated with ARBs
Renal artery stenosis AKD Pregnancy Breastfeeding
35
What interactions are important to consider when prescribing ARBs?
Drugs that increase K+ NSAIDs Other antihypertensives
36
What 2 types of drugs target calcium movement?
LTCC - L-type calcium channels | CCB - calcium channel blockers
37
LTCC’s allow the flux of calcium ions in which direction?
Inwards
38
LTCCs are an example of what type of ion channel?
Voltage operated calcium channel
39
What is the target of CCBs?
They target calcium initiated smooth muscle contraction
40
What drug class does Amlodipine belong to?
Dihydropyridine
41
The vasodilation caused by dihydropyridines causes what side effects?
Ankle swelling, flushing and headache
42
What are the warnings and contraindications associated with dihydropyridines?
Unstable angina, severe aortic stenosis
43
Why is Amlodipine + Simvastatin not adviced?
Increased effect of the statin
44
Verapamil belongs to which drug class?
``` Phenylalkylamines A class 4 anti-arrhythmic agent ```
45
When might the phenylalkylamine Verapamil be contraindicated or warned against?
If the patient has poor LV function or AV nodal conduction delay
46
Diltiazem belongs to which drug class?
Benzothiazapines
47
What type of drug is Bendroflumethiazide?
A thiazide diuretic
48
How do thiazide diuretics such as bendroflumethiazide elicit their action?
Inhibit sodium resorption at the distal convoluted tubules
49
Indapamide belongs to which drug class
A thiazide-like diuretic
50
What are the warnings and contraindications of Bendroflumethiazide?
Hypokalaemia Hyponatraemia Gout
51
What is the two pronged approach to treating primary hypertension?
Decrease blood pressure and dilation of the efferent glomerular arteriole to reduce intraglomerular pressure which is good for type 2 diabetes
52
What is Spironolactone?
Aldosterone receptor antagonist
53
When is Spironolactone warned against/contraindicated?
In hyperkalaemia and Addisons
54
What is Addison’s disease?
Adrenal insufficiency - so too little cortisol and aldosterone
55
What interactions should be considered when prescribing Spironolactone?
Drugs that increase K+ including ACEi and ARBs
56
How do beta-blockers reduce cardiac output?
Decrease sympathetic tone by blocking NAd and reducing myocardial contraction
57
Renin secretion is reduced when beta blockers act on which adrenoceptors?
B1
58
When are beta blockers warned against/contraindicated?
Asthma haemodynamic instability, hepatic failure
59
Why is it a problem that beta blockers can mask tachycardia?
Tachycardia is a sign of insulin induced hypoglycaemia
60
What drugs have interactions with beta blockers?
Non-dihydropyridine CCB: verapamil and diltiazem - asystole
61
Name 2 beta blockers
Labetalol Bisoprolol Metoprolol
62
Give an example of an Alpha-1 adrenoceptor?
Doxazosin
63
What are the possible side effects of the a-adrenoceptor Doxazosin?
Postural hypotension Dizziness Headache Fatigue

Pharmacology (11 decks)

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