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Yr 3 - Pharmacology > Prescribing Antihypertensives > Flashcards

Prescribing Antihypertensives Flashcards

1
Q

What class of drug is ramipril?

A

ACE inhibitor

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2
Q

What class of drug is amlodipine?

A

Calcium channel blocker

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3
Q

What class of drug is indapamide?

A

Thiazide-like diuretic

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4
Q

What class of drug is losartan?

A

ARB

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5
Q

What 3 factors about the patient is important to consider when prescribing antihypertensives?

A

1) What is the patient’s age?
2) What is the patient’s ethnicity?
3) Does the patient have type 2 diabetes?

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6
Q

Why may an ACEi not be tolerated?

A

Due to cough

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7
Q

If an ACEi is not tolerated, what should be offered instead?

A

ARB

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8
Q

Of the 4 main antihypertensive drugs, which 2 CANNOT be used in combination?

A

ACEi + ARB

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9
Q

In patients of Black African or African-Caribbean origin, are ARBs or ACEi preferred?

A

ARBs

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10
Q

If a patient has oedema, which class of antihypertensives is NOT tolerated?

A

Calcium channel blockers

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11
Q

If a patient has heart failure, which class of antihypertensives is NOT tolerated?

A

Calcium channel blockers

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12
Q

Does the treatment for isolated systolic hypertension (>160 mmHg) differ from the treatment for patients with both raised systolic and diastolic blood pressure?

A

No, treatment is the same

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13
Q

If a CCB is not tolerated, what should be offered instead?

A

Thiazide-like diuretic

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14
Q

A white patient aged 50 presents to the clinic with hypertension. They are not on any antihypertensives and do not have a history of type 2 diabetes.

What is the first line antihypertensive?

A

ACEi

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15
Q

A white patient aged 60 presents to the clinic with hypertension. They are not on any antihypertensives and do not have a history of type 2 diabetes.

What is the first line antihypertensive?

A

Calcium channel blocker

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16
Q

Patients of any age and any origin presenting with hypertension with type 2 diabetes are prescribed which 1st line antihypertensive?

A

ACEi (or ARB - consider if Black African/African-Caribbean or cough)

17
Q

Black African/African-Caribbean patients of any age are prescribed which 1ary antihypertensive if they do not have type 2 diabetes?

A

Calcium channel blocker

18
Q

Antihypertensives prescribing chart:

A
19
Q

Describe the step-wise approach to prescribing antihypertensives in patients aged <55 y/o and not of Black African

A
  1. ACEi (or ARB)
  2. ACEi + CCB or thiazide-like diuretic
  3. ACEi + CCB + thiazide-like diuretic
20
Q

Describe the step-wise approach to prescribing antihypertensives in all patients with type 2 diabetes (all ages and origins)

A
  1. ACEi (or ARB)
  2. ACEi + CCB or thiazide-like diuretic
  3. ACEi + CCB + thiazide-like diuretic
21
Q

Describe the step-wise approach to prescribing antihypertensives in all patients of Black African or African-Caribbean origin without type 2 diabetes

A
  1. Calcium channel blocker (e.g. amlodipine)
  2. Calcium channel blocker + ACEi (or ARB) or thiazide-like diuretic (e.g. indapamide) → N.B. ARBs are preferred in patients from Black African or African-Caribbean descent
  3. Calcium channel blocker + ACEi (or ARB) and thiazide-like diuretic
22
Q

Describe the step-wise approach to prescribing antihypertensives in patients aged 55 years or older (without type 2 diabetes)

A
  1. Calcium channel blocker (e.g. amlodipine)
  2. Calcium channel blocker + ACEi (or ARB) or thiazide-like diuretic (e.g. indapamide)
    1. N.B. ARBs are preferred in patients from Black African or African-Caribbean descent
  3. Calcium channel blocker + ACEi (or ARB) and thiazide-like diuretic
23
Q

What is resistant hypertension?

A

Patients whose blood pressure is not adequately controlled after a combination of 3 antihypertensives.

24
Q

In resistant hypertension, what does management then depend on?

A

Serum potassium

25
Q

In resistant hypertension, if a patient has a serum potassium or 4.5 mmol/l or less, what drug is offered?

A

Low dose spironolactone

26
Q

In resistant hypertension, if a patient has a serum potassium of more than 4.5 mmol/l, what drug is offered?

A

Alpha blocker or beta blocker

27
Q

What class of drug is doxazosin?

A

Alpha blocker

Yr 3 - Pharmacology (18 decks)

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