Pharmacology of hypertension Flashcards
What are the treatments for hypertension?
-ACE inhibitor
-Calcium channel blockers
-Thiazide/thiazide like diuretics
-Angiotensin receptor blockers
What is the primary mechanism of action of ACE inhibitors?
-Inhibits ACE
-Prevents conversion of angiotensin I to angiotensin II
What is the drug target of ACE inhibitors?
ACE
What are examples of ACE inhibitors?
-Ramipril
-Lisinopril
-Perindopril
What are the main side effects of ACE inhibitors?
-Cough
-Hypotension
-Hyperkalaemia
-Foetal injury= teratogenic
-Renal failure
-Urticaria/angioedema (swelling under skin)
What type of drugs are most ACE inhibitors (apart from lisinopril)?
Prodrugs so require hepatic activation to have effect
What is the primary mechanism of action of calcium channel blockers?
-Block L type calcium channels mainly on vascular smooth muscle
-Prevents cross bridge formation as out decreases calcium influx
What is the therapeutic effect of calcium channel blocker?
Vasodilation reduces peripheral resistance
What is the drug target of calcium channel blockers?
L type calcium channel
What are examples of calcium channel blockers?
-Amlodipine
-Felodipine
What are the main side effects of calcium channel blockers?
-Ankle oedema
-Constipation
-Palpitations
-Flushing/headache
Why are dihydropyridine calcium channel blockers good?
Higher degree of vascular selectivity
What is the primary mechanism of action of thiazide/thiazide like diuretics?
-Block Na+Cl- cotransporter in early DCT
-Na+Cl- reabsorption inhibited
-Osmolality of tubular fluid increases which decreases somatic gradient for water reabsorption in collecting duct
What is the drug target of thiazide/thiazide like diuretics?
Na+Cl- cotransporters
What are examples of thiazide/thiazide like diuretics?
-Bendro flumethiazide (thiazide)
-Indapamide (thiazide like)
