Module 6 - Clincial Considerations In Pharmacology: Cardiovascular Drugs

Question 1

When do we initiate antihypertensive therapy?

Answer 1

BP above 160/100 mmHg (as hypertension increases risk of cardiovascular events such as stroke and myocardial infarction) - used to reach target BP of 140/90 OR 130/80 (diabetes)

Question 2

Describe the mechanism of action of ACE inhibitors

Answer 2

Blocks conversion of angiotensin I to angiotensin II (blood vessels are unable to vasoconstriction therefore BP reduces)

Question 3

What are the common side effects of a ‘-pril’

Answer 3

Dry, irritating cough, light headedness and hyperkalaemia

Question 4

What combination of drugs leads to a triple whammy?

Answer 4

Combination of:
ACE inhibitor/angiotensin II receptor blocker
Diuretic
NSAID

Question 5

What occurs during a triple whammy?

Answer 5

NSAIDs cause afferent arteriole to vasoconstrict (causing drop in glomerular pressure) and ACE inhibitor causes dilation of efferent arteriole (reducing glomerular pressure) = Causes acute renal failure

Question 6

Describe the mechanism of action of Angiotensin II receptor blockers

Answer 6

Prevents dining of angiotensin II to angiotensin I receptor, causing reduction in BP

Question 7

What are the two classes of calcium channel blockers?

Answer 7

Dihydropyridine and non-Dihydropyridine

Question 8

Describe the mechanism of action of Dihydropyridine calcium channel blockers

Answer 8

Acts on arteriolar smooth muscle to decrease peripheral vascular resistance and BP (minimal effect on myocardial cells)

Question 9

Provide an example of a Dihydropyridine calcium channel blocker

Answer 9

Amlodipine

Question 10

Describe the mechanism of action of non-Dihydropyridine calcium channel blockers

Answer 10

Negative chronotropic effect to reduce HR (slows down conduction through AV nodes)

Question 11

Provide an example of a non-Dihydropyridine calcium channel blocker

Answer 11

Verapamil (cannot be taken with beta blocker as it causes severe bradycardia and heart block)

Question 12

Describe the mechanism of action of thiazide diuretics

Answer 12

Lowers BP through vasodilator effect and inhibits reabsorption of sodium and chloride in distal convoluted tubule

Question 13

Provide an example of a thiazide diuretic

Answer 13

Hydrochlorothiazide

Question 14

When are beta blockers used?

Answer 14

When an individual has a comorbidity that will benefit from use of beta blocker