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T2: Theme 3: CVS > Lectures 10 and 11: Hypertension > Flashcards

Lectures 10 and 11: Hypertension Flashcards

1
Q

Define hypertension.

A

Persistently higher than normal blood pressure

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2
Q

When should hypertension be treated?

A

When mean BP > 150/95mmHg

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3
Q

What is the equation for BP?

A

BP = CO x TPR

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4
Q

What is the equation for CO?

A

CO = SV x HR

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5
Q

What regulates SV?

A

Ventricles

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6
Q

What regulates the HR?

A

SA node

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7
Q

Where are baroreceptors found?

A

Kidneys, carotid arteries, arch of aorta

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8
Q

What signals are received by medulla?

A

Vagus and glossopharengeal

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9
Q

What receptors in the heart does the sympathetic system act on?

A

beta1

Increases cAMP and calcium to increase rate and force of contraction

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10
Q

What receptors in the heart does the parasympathetic system act on?

A

M2 receptors

Decrease cAMP levels

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11
Q

What receptors in the periphery does the sympathetic system act on?

A

NA –> alpha 1 –> IP3 –> Ca2+ –> constriction

A –> beta 2 –> cAMP –> relaxation

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12
Q

What effects does Ang2 have?

A

Increases sympathetic activity

Increases salt and water retention

Increases aldosterone

Increases ADH

Arteriolar vasoconstriction

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13
Q

What is AT1R the receptor for?

A

Angiotensin 2

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14
Q

How does aldosterone work?

A

Binds cytoplasmic receptors which binds to the nucleus to increase expression of Na channels

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15
Q

What would be the drug of choice for someone under the age of 55 suffering from hypertension?

A

ACE inhibitor or angiotensin receptor blocker

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16
Q

What would be the drug of choice for someone over the age of 55 suffering from hypertension?

A

Calcium channel blocker

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17
Q

What would be the drug of choice for a Black African/American suffering from hypertension?

A

Calcium channel blocker

18
Q

What are the 5 classes of anti-hypertensives?

A

ACE inhibitors and angiotensin receptor blockers

Calcium channel blockers

Diuretics

Beta blockers

Vasodilators

19
Q

What are the side effects of ACE inhibitors?

A

Dry cough
1st dose hypotension
Renal impairment
Hyperkalaemia

20
Q

What kind of drug is ramipril?

A

ACE inhibitor

21
Q

Name an ACE inhibitor.

A

Ramipril

22
Q

What kind of drug is losartan?

A

Angiotensin receptor blocker (ARB)

23
Q

Name an ARB.

A

Losartan

24
Q

What kind of drug is Spironolactone?

A

Aldosterone antagonist

25
Q

What kind of drug is amlodipine?

A

Dihydropyridine (CCB)

26
Q

Name a dihydropyridine.

A

Amlodipine

27
Q

Name a phenylalkylamine.

A

Verapamil

28
Q

Name a benzothiazepine.

A

Diltiazem

29
Q

What are the three main classes of calcium channel antagonist?

A

Dihydropyridines

Phenylalkylamines

Benzothiazepines

30
Q

What kind of drug is verapamil?

A

Phenylalkylamine (CCB)

31
Q

What kind of drug is Diltiazem?

A

Benzothiazepine (CCB)

32
Q

What are the side effects of CCBs?

A

Peripheral oedema

Flushing and headaches

33
Q

What protein metabolises CCBs in the liver?

A

CYP3A4

34
Q

What kind of drug is indapamide?

A

Thiazide (thiazide-like) diuretic

35
Q

How does indapamide work as a diuretic?

A

Opens kATP allowing K to flow out of cell - hyperpolarises smooth muscle cells - Ca channels never activated to open -relaxation/dilation of the arteriole

36
Q

Name a thiazide (thiazide-like) diuretic.

A

Indapamide

37
Q

What are the side effects of diuretics?

A

Hypokalaemia
Increased urate
Increased glucose
Increased blood lipids

38
Q

What condition may make diuretics contraindicated?

A

Diabetes

39
Q

What are the side effects of beta blockers?

A

Fatigue
Vaso/bronchoconstriction
Hypoglycaemia

40
Q

Name a selective b1 antagonist.

A

Bisprolol

41
Q

Name a non-selective (B1 and B2) beta blocker.

A

Propranolol

42
Q

Name a vasodilator.

A

Doxazosin

T2: Theme 3: CVS (18 decks)

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