Hypetension, Hypotension and Therapeutic Intervention NOT FINISHED

Question 1

What can we influence to treat hypertension?

Answer 1

Baroreceptor reflex 
Autonomic nervous system
- heart (PNS/SNS) 
- blood vessels (SNS)
RAAS
- kidneys --> alter blood volume (slow)
- vessels (fast)

Question 2

Describe ‘drug A’
Give examples
What is the mechanism of action?
What are the side effects?

Answer 2

Angiotensin Converting Enzyme inhibitors
e.g. lisinopril, enalapril
Mechanism:
- decreases angiotensin II –> decreases TPR/CO
- decreases degradation of vasodilator kinins e.g. bradykinin
Side effects:
- dry cough - due to effect on kinins, irratate lung receptors
- can get severe sudden hypotension if taken with diuretics

Question 3

Describe the second ‘drug A’
Give examples
What is the mechanism of action?
What are the side effects? How is it used clinically?

Answer 3

Angiotensin (AT1) receptor antagonists
e.g. losartan, irbesartan
Mechanism:
- decrease vasoconstriction - ATII cannot bind to AT1 receptor –> decrease TPR/CO
Clinically
- no common major adverse effects reported yet
- no affect on kinins - used if ACEi gives them cough

Question 4

Describe ‘drug C’
Give examples
What is the mechanism of action?
What are the side effects?

Answer 4

Calcium Channel Blockers
e.g. amplodipine
Mechanism of action
- block calcium channels –> decreases TPR and CO
Side Effects
- don’t directly affect heart!
- decrease other smooth muscle activity e.g. GIT

Question 5

Describe ‘drug D’
Give example
Describe their biphasic

Answer 5

diuretics
e.g. thiazides, furosemide etc.
Biphasic mechanism
1. increase water and Na+ absorption from kidneys, decrease blood volume and therefore BP
- however this is mostly compensated for by other mechanisms
2. affects on arterial dilation? –> decreases TPR
Side effects
- clinically