Hypertension - Core Drugs Flashcards
List drug classes for treating hypertension.
ACE inhibitors, calcium channel blockers, thiazide or thiazide like diuretics, angiotensin receptor blockers
Give examples of ACE inhibitors.
ramipril
lisinopril
perindopril
List examples of calcium channel blockers.
amlodipine
felodipine
Give an example of a thiazide.
Bendro-flumethiazide
Give an example of a thiazide-like diuretic.
Indapamide
Give examples of angiotensin receptor blockers.
losartan
irbesartan
candesartan
Describe the mechanism of action of ACE inhibitor.
prevents conversion from angiotensin I to angiotensin II
What are the main side effects of ACE inhibitors?
cough, hypotension, hyperkalaemia, foetal injury, renal failure (in those w/ renal artery stenosis), urticaria/angioedema
Most ACE inhibitors are pro-drugs. What has to occur for them to have therapeutic effects?
hepatic activation to generate the active metabolites
When prescribing ACE inhibitors, what has to be continuously monitored?
K+
What is the mechanism of action of calcium channel blockers?
decrease in calcium influx > inhibit myosin light chain kinase > prevention of cross-bridge formation > vasodilation > reduce peripheral resistance
What is the drug target for calcium channel blockers?
L type calcium channel blockers predominantly on vascular smooth muscle
Side effects of calcium channel blockers
Ankle oedema
Constipation
Palpitations
Flushing/Headaches
Name the other type of calcium channel blocker that has a higher degree of selectivity.
dihydropyridine type calcium channel blockers
What is the drug target of thiazides (like diuretics)?
sodium/chloride co transporter
Side effects of thiazide (like diuretics)
Hypokalemia, hyponatremia, metabolic alkalosis (increased hydrogen ion excretion), hypercalcemia, hyperglycemia (hyperpolarised pancreatic beta cells)., hyperuricemia
Thiazide and thiazide-like diuretics both lose their diuretic effects how long after treatment?
within 1-2 weeks
What is the mechanism of action for angiotensin receptor blockers?
non-competitive antagonists at AT1 receptor (found on kidneys and on the vasculature)
Side effects of angiotensin receptor blockers
Hypotension, hyperkalaemia, foetal injury, renal failure (in patients with renal artery stenosis)
