Pharmacological Treatment of Hypertension Flashcards
what must be tried first before drug treatment?
lifestyle interventions
What is drug treatment if under 55?
A then A+C then A+C+D
What is the recommended drug treatment if over 55 or black origin?
C then C+A then C+A+D
What is the main aim for drug treatment?
do decrease the mean arterial blood pressure into a safe working range
what is the equation for MABP?
MABP= TPR x CO
What determines peripheral resistance?
vascular structure and function and this is what is modified by drugs
What is the effect of renin released from the kidneys?
renin release converts angiotensinogens into angiotensin 1 then converted into 2 in the lungs
what does angiotensin 2 do?
- broken down or binds to receptors
- induces release of aldosterone
- salt retention effecting constriction of arteries supplying the glomerulus
- vasoconstriction in smooth muscle
How do ARBs work?
they are angiotensin 2 receptor blockers hence prevent angiotensin 2 binding to receptors and bringing about their responses
how do ACE inhibitors work?
angiotensin converting enzyme inhibitors prevent the formation of angiotensin 1 to 2 in the lung
What are 2 examples of ACE inhibitors used?
- ramipril
- Lisinopril
what is an example of an ARB?
losartan
what are 2 examples of calcium antagonists used to treat hypertension?
- amlodipine
- lercanidipine
what type of diuretics are used? what are 2 examples of these diuretics?
- thiazide like diuretics
- indapamide and bendroflumethiazide
what is the mechanism of action of thiazide like diuretics?
- acto on a channel in the distal tubule preventing reabsorption of sodium and chloride ions
- hence more urine output= decreased blood volume therefore decreased blood pressure
what is an example of an aldosterone antagonist?
spironolactone
what os the mechanism of action of spironolactone?
- channel in the collecting tubule which lets sodium into the body
- spironolactone binds instead and hence prevents opening of channel
what is an example of a alpha adrenoreceptor blocker? what is its mechanism of action?
- doxazosin
- alpha 1 receptors are associated with constricting smooth muscle and regulating vascular tone so blocking these causes relaxation
what are the side affects of ACE?
- persistent dry cough
- dizziness and tiredness
- headaches
what is the side effects of ARBs?
- dizziness
- headaches
- back and leg pain
what are the side effects of thiazide like diuretics?
- raise blood potassium and sugar levels
- need to be careful with diabetic patients
