Hypertension, HFrEF + arrhythmias

Question 1

Beta-1 antagonists for hypertension + what differentiates them

Answer 1

• atenolol (selective)
• propanolol (non-selective)

Question 2

Atenolol MOA/adverse effects

Answer 2

• blocks B-1 receptors in heart thus preventing effect of increase HR, contractility etc.
• block effects of B-1 receptors at different respiratory, CNS, CV etc.
• postural hypotension

Question 3

Propanolol MOA/adverse effects

Answer 3

• blocks B-1 + B-2 receptors at heart (more broad) to decrease HR + contractility + decrease hypertension
• block beta receptors in other places
  cold extremities as vasodilation receptors blocked
• postural hypotension

Question 4

Calcium channel blockers for hypertension and their classes

Answer 4

• dihydropyridines
  
  • Nifedipine
• non-dihydropyridines
  
  • verapimil
  • dilitazem

Question 5

Nifedipine MOA/adverse effects

Answer 5

• blocks L type calcium channels in heart therefore blocking calcium current into cell thus decreasing Q, conduction, and increasing vasodilation of arteries
• dyspepsia
• bradycardia

Question 6

Verapimil MOA/adverse effects

Answer 6

• blocks L type calcium channels into heart therefore blocking calcium current into cell thus decreasing Q, conduction, and increasing vasodilation of arteries
• dyspepsia
• bradycardia

Question 7

Dilitazem MOA/adverse effects

Answer 7

• blocks L type calcium channels into heart therefore blocking calcium current into cell thus decreasing Q, conduction

Question 8

ACE inhibitors for hypertension

Answer 8

perindopril

Question 9

perindopril MOA/adverse effects

Answer 9

• binds to ACE enzyme + inhibits it therefore stopping conversion of angiotensin I to angiotensin II in RAAS cascade. Stops effectors so increases vasodilation + decreases symp. activity, ADH + aldosterone secretion
• hypotension, hyperkalemia
• increased bradykinin -> dry cough

Question 10

Alpha-1 antagonist for hypertension

Answer 10

Prazosin

Question 11

Prazosin MOA/adverse effects

Answer 11

• Inhibit a1 on vascular smooth muscle therefore causes vasodilation in veins + arteries -> decreases SVR + venous return to decrease BP
• postural hypotension
• lightheadedness

Question 12

AT1 receptor antagonists/angiotension receptor blockers for hypertension

Answer 12

Sartans eg. candesartan

Question 13

Candesartan MOA/adverse effects

Answer 13

• stop angiotensin II binding to AT1 receptor therefore causing vasodilation of blood vessels, decreased sympathetic activity, ADH + aldosterone secretion

Question 14

Replacement of ACE inhibitor in HFrEF

Answer 14

Salcubitril (with valsartan)

Question 15

Salcubitril + valsartan MOA/adverse effects

Answer 15

• inhibits neprilysin so causes vasodilation + increased GFR + bradykinin / decreases sympathetic tone + aldosterone release

Question 16

Digoxin MOA/adverse effects

Answer 16

• inhibits Na/K/ATpase pump in myocardial cell therefore increases EF + Q
• arrhythmia, kidney issues

Question 17

Ivabradine MOA/adverse effects

Answer 17

• inhibits a current regulating the interval b/t depolarisation of the SA node to decrease HR and therefore the cardiac workload of the heart

Question 18

Potassium channel blockers for arrythmia’s

Answer 18

• Flecainide
• Sotalol
• Amiodarone

Question 19

Flecainide MOA/adverse effects

Answer 19

• inhibits Na+ channels to slow automaticity of SA node
• bradycardia

Question 20

Sotalol MOA/adverse effects

Answer 20

• blocks beta-receptors in SA + AV node to decrease automaticity + conduction velocity to prolong AP
• risk of torsades de pointes

Question 21

Amiodarone MOA/adverse effects

Answer 21

• inhibit efflux of K+ to prolong repolarisation + increase refractory period therefore treats re-entry circuits
• phototoxicity, weight loss, anorexia