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Cardiovascular System > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

How many times a day do we aim to take an anti hypertensive drug?

A

Once a day

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2
Q

What are the 4 types of anti hypertensive drugs?

A
  • Beta blockers
  • Diuretics
  • Vasodilators
  • Inhibitors of renin -angiotensin-aldosterone axis
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3
Q

What are beta blockers competing with?

A
  • Noradrenaline
  • Adrenaline
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4
Q

What do NAdr and Adr stimulate when they bind to the beta receptors?

A

Sympathetic nervous system

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5
Q

Are the beta blockers used for hypertension selective or non-selective?

A

Selective for the beta 1 receptors

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6
Q

Why is important that the beta blockers are selective?

A

This minimises the side effects of the drugs

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7
Q

Give two of the common side effect that you will experience with beta blockers?

A

Cold hands and fatigue

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8
Q

Give two of the less common side effects of beta blockers

A

Cardiac depression and bronchospasm

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9
Q

What’s the basis of the diuretic drugs?

A

To reduce salt and water reabsorption from the glomerulus and increase excretion of sodium and water.

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10
Q

Where do the diuretics take action in the nephron?

A

Loop of Henle and distal convoluted tubule

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11
Q

What areas of the nephron are permeable to water?

A

Descending limb and distal convoluted tubule

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12
Q

What areas of the nephron are impermeable to water?

A

Thick ascending limb

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13
Q

Where do the loop diuretics take action?

A

In the ascending limb, and they block the Na/K/Cl transporter

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14
Q

Where are the basolateral Na/K pumps?

A

In the distal convoluted tubule

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15
Q

How do you increase the expression of basolateral Na/K pumps and their activity

A

You have to activate the mineralcorticoid receptors by aldosterone binding to it

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16
Q

What does spironolactone block?

A

Aldosterone binding to the mineralcorticoid receptors

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17
Q

How do K sparing drugs work?

A

Block aldosterone from binding to the MR which increases the excretion of Na and H2O while preserving K in the circulation

18
Q

What are the three different types of diuretics?

A

Loop diuretics, thiazide diuretics and aldosterone antagonists

19
Q

What type of diuretics have the highest diuretic potency?

A

Loop diuretics

20
Q

What diuretics have the lowest diuretic potency?

A

Aldosterone antagonists

21
Q

What diuretic drug could cause fatal hyperkaelemia?

A

Aldosterone antagonist

22
Q

What levels should you monitor for patients that are on diuretics?

A

Serum electrolyte and creatinine levels

23
Q

What’s the overall mechanism of the vasodilators?

A

They dilate arteries and arterioles to reduce the role peripheral resistance

24
Q

Is calcium needed to maintain muscle constriction or not?

A

No it’s not needed to maintain it, but it’s needed to activate it

25
Q

What are the two GPCRs that are involved with vasodilator drugs?

A

Alpha adrenoceptor and angiotensin 1 receptors

26
Q

When the GPCRs get activated in the smooth muscle (to cause muscle constriction) and activate PLC, what does the PLC release?

A

IP3 and DAG

27
Q

What channels on the membrane can allow calcium to enter the cell?

A

Chloride channels, K channels, voltage operated Ca channels (VOCC)

28
Q

Are alpha adrenorecptor blockers used as first line vasodilators or not?

A

No, but they do work well in combination with other drugs

29
Q

What are the 2 most commonly prescribed alpha adrenorecptor blockers?

A

Doxazosin and terazosin

30
Q

What’s the main side effect of alpha adrenorecptor blocker?

A

Postural hypotension

31
Q

What are the 3 types of calcium antagonists?

A

Dihydropyridines, phenylalkylamines and benzothiazepines

32
Q

Where do Dihydropyridines selectively bind?

A

Smooth muscles

33
Q

Where do phenylalkylamines selectively bind?

A

Cardiac muscles

34
Q

Where do benzothiazepines selectively bind?

A

They poorly discriminate between cardiac and smooth muscle channels

35
Q

What’s the first line treatment for patients under 55 who are not of black African or black Caribbean origin?

A

Angiotensin 1 receptor blockers

36
Q

What’s ACE inhibitors biggest side effects?

A

Persistent dry cough

37
Q

What is a side effect of ACE inhibitors that will wear off over time?

A

Hypotension

38
Q

When ACE inhibitors are administered with diuretics what’s the side effect?

A

Severe hypotension

39
Q

What should be monitored when your patient is on renin-angiotensin-aldosterone blocking drugs?

A

Creatinine levels, to check for renal damage

40
Q

What do ACE inhibitors block?

A

The conversion of angiotensin 1 to angiotensin 2

Cardiovascular System (8 decks)

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