L6 - Pharmacology Used In Treating Hypertensiom

Question 1

What is the primary goal of hypertension treatment?

Answer 1

To achieve and maintain systolic BP <140 mmHg and diastolic BP <90 mmHg, reducing target organ damage risk.

Question 2

What are first-line lifestyle modifications for hypertension?

Answer 2

• Weight reduction.
• Regular physical exercise.
• DASH eating plan (high fruits/vegetables, low meat).
• Reduced dietary sodium intake.
• Moderation of alcohol consumption.

Question 3

What are the main pharmacological treatments for hypertension?

Answer 3

• Diuretics.
• Sympatholytics.
• RAAS inhibitors (ACE inhibitors, ARBs).
• Calcium channel blockers.
• Direct-acting vasodilators.

Question 4

How do diuretics help in hypertension?

Answer 4

• Prevent water reabsorption by inhibiting sodium reabsorption in kidneys.
• Loop diuretics: Act on Na+/K+/2Cl− co-transporter (e.g., furosemide).
• Thiazides: Inhibit Na+-Cl− transporter in the distal tubule.
• Potassium-sparing diuretics: Inhibit Na+ channels or antagonise aldosterone.

Question 5

What is the mechanism of ACE inhibitors?

Answer 5

• Block the conversion of angiotensin I to angiotensin II.
• Reduce peripheral vascular resistance and blood pressure.
• Promote sodium and water excretion, reducing preload.
• Examples: Captopril, enalapril, lisinopril.

Question 6

What are angiotensin II receptor blockers (ARBs)?

Answer 6

• Block AT1 receptor, preventing angiotensin II action.
• Reduce vasoconstriction and aldosterone secretion.
• Examples: Losartan, valsartan, candesartan.

Question 7

What are the key actions of beta blockers in hypertension?

Answer 7

• Block cardiac beta-1 receptors, reducing heart rate and contractility.
• Decrease renin release, lowering RAAS-mediated effects.
• Long-term use reduces peripheral vascular resistance.

Question 8

What is the difference between dihydropyridine and non-dihydropyridine calcium channel blockers?

Answer 8

• Dihydropyridines (e.g., nifedipine, amlodipine): Dilate peripheral vessels, reduce BP, minimal cardiac effects.
• Non-dihydropyridines (e.g., verapamil, diltiazem): Reduce BP and act on the heart to slow conduction and decrease contractility.

Question 9

What are the reflex effects of nifedipine?

Answer 9

• Reduces BP, activating the baroreceptor reflex.
• Reflex increases heart rate and contractility, which is not desirable in heart disease.
• Lacks direct cardiac suppression, leading to unopposed cardiac stimulation.

Question 10

What are potassium-sparing diuretics?

Answer 10

• Inhibit Na+ channels or antagonise aldosterone.
• Promote sodium and water excretion without potassium loss.
• Examples: Spironolactone, eplerenone.

Question 11

Why is it important to block calcium channels in hypertension?

Answer 11

• Blocks Ca2+ influx in vascular smooth muscle, causing vasodilation.
• Reduces blood pressure and improves coronary perfusion.
• Non-dihydropyridines also slow heart rate and reduce contractility.