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RBF: 1) Drugs > Lecture 15 - Antihypertensive drugs > Flashcards

Lecture 15 - Antihypertensive drugs Flashcards

1
Q

Define hypertension?

A

BP >140/90mmHg.

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2
Q

What is ideal BP?

A

120/80mmHg.

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3
Q

What is hypertension and major risk factor for?

A
  1. Stroke.
  2. Coronary artery disease.
  3. Renal disease.
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4
Q

What is the general treatment for hypertension?

A
  1. Lifestyle changes - change in diet, weight loss and exercise.
  2. Drug therapy - typically multiple drugs.
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5
Q

Is there a cure for hypertension?

A

There is no cure for hypertension, it is lifetime, however treatment does help to manage the symptoms of hypertension and to try and prevent other diseases from occurring.

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6
Q

List the therapy drugs for hypertension?

A
  1. ACE inhibtiors/Angiotensin II antagonists.
  2. Beta blockers.
  3. Calcium channel blockers.
  4. Diuretics.
  5. Alpha blockers.
  6. Miscellaneous.
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7
Q

What is the most effective drug combination for hypertension?

A

ACEi + Diuretic + Vasodilator.

e.g. Cilazapril + Bendrofluazide + Felodipine.

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8
Q

What is the mechanism of action for thiazide diuretics?

A

They inhibit sodium/chloride channels in the distal convoluted channel - basically they stop sodium being reabsorbed hence water from being reabsorbed back into the blood.

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9
Q

Describe bendrofluazide?

A

Thiazide diuretic that inhibits Na/Cl channels in the distal convoluted tubule - stops Na+ and water being reabsorbed.

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10
Q

What is bendrofluazide used for?

A
  1. Oedema.

2. Hypertension.

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11
Q

Why do patients not take bendrofluazide?

A

They do not take if they have the following:

  1. Refractory hypokalaemia.
  2. Hyponatraemia.
  3. Hypercalcaemia.
  4. Addison’s disease.
  5. Severe renal impairment.
  6. Hepatic impairment.
  7. Pregnancy.
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12
Q

What are the adverse effects of bendrofluazide?

A
  1. Gi disturbances.
  2. Postural hypotension.
  3. Hypokalaemia.
  4. Hyponatraemia.
  5. Hypercalcaemia.
  6. Gout.
  7. Headache.
  8. Arrhythmias.
  9. Dizziness.
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13
Q

What is the mechanism of action of loop diuretics?

A

They inhibit Na/K/Cl cotransporter in the ascending loop of henle. They stop sodium being reabsorbed, hence water.

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14
Q

Describe frusemide?

A

Loop diuretic that inhibits the reabsorption of sodium and water.

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15
Q

What is frusemide used for?

A
  1. Oedema.

2. Resistant hypertension.

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16
Q

Why do patients not take frusemide?

A

They do not take if they have the following:

  1. Severe hypokalaemia.
  2. Severe hyponatraemia.
  3. Anuria (no urine).
  4. Renal impairment.
  5. Hepatic impairment.
  6. Pregnancy.
17
Q

What are the adverse effects of frusemide?

A
  1. GI disturbances.
  2. Pancreatitis.
  3. Intrahepatic cholestasis.
  4. Postural hypotension.
  5. Hyperglycaemia.
  6. Metabolic alkalosis.
18
Q

What is the mechanism of action of potassium-sparing diuretics?

A

They are aldosterone antagonists that bind to the mineralocorticoid receptor (where aldosterone binds to) stopping sodium being reabsorbed and water, but it also stops potassium being excreted.

19
Q

Describe spironolactone?

A

Potassium sparing diuretic that acts as an aldosterone antagonist. It stops K+ being excreted and Na+ being reabsorbed.

20
Q

What is spironolactone used for?

A
  1. Oedema.
  2. Ascites in cirrhosis.
  3. Nephrotic syndrome.
  4. Oedema in congestive heart failure.
  5. Resistant hypertension.
  6. Primary hyperaldosteronism.
21
Q

Why do patients not take spironolactone?

A

They do not take if they have the following:

  1. Hyperkalaemia.
  2. Hyponatraemia.
  3. Addison’s disease (decrease in aldosterone).
  4. Anuria.
  5. Renal impairment.
  6. Pregnancy.
22
Q

What are the adverse effects of spirononlactone?

A
  1. GI disturbances.
  2. Hepatotoxicity.
  3. Malaise.
  4. Confusion.
  5. Drowsiness.
  6. Dizziness.
  7. Gynaecomastia.
  8. Breast pain.
  9. Menstrual disturbances.
  10. Leucopenia.
23
Q

What are ACE inhibitors used for?

A
  1. Hypertension.

2. Heart failure.

24
Q

What are beta blockers used for?

A
  1. Hypertension.
  2. Angina.
  3. Chronic heart failure.
25
Q

What are diuretics used for?

A
  1. Hypertension.

2. Heart failure.

26
Q

What are alpha blockers used for?

A
  1. Hypertension.

2. Prostatism.

RBF: 1) Drugs (8 decks)

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