Prescribing in hypertension

Question 1

How do nitrates work?

Answer 1

Converted to its active form, nitric oxide which leads to coronary vasodilation and therefore increased coronary perfusion

Question 2

What is the mechanism of Ca channel blockers?

Answer 2

Prevents Ca moving into the cells, reducing myocaridal contractility and chronotrophy.
In vascular smooth muscle leads to vasodilation, reduced peripheral arterial pressure and reduced after load.

Question 3

What is Nicorandil?

Answer 3

Potassium channel blocker. Anti anginal and anti ischaemic

Question 4

What does Ivabradine do?

Answer 4

Lowers the heart rate by inhibiting spontaneous pacemaker activity

Question 5

Tell me about Ranolazine

Answer 5

Selective inhibitor of the late Na current - anti ischaemic

Question 6

What is Trimetazidine?

Answer 6

Anti ischaemic metabolic modulator

Question 7

How does aspirin work?

Answer 7

Switches off the cycloxygenase system - Irreversibly inhibits COX - 1

Question 8

What does Clopidogrel do?

Answer 8

Blocks ADP receptors - Antagonist of a platelet adenosine disphosphate receptor

Question 9

What are the side effects of ACE i

Answer 9

Cough, angio oedema, hyperkalaemia

Question 10

How does ACE i cause hyperkalaemia?

Answer 10

Due to the stopping of the conversion of Angiotensin I to Angiotensin II, there is a decrease in the availability in Angiotensin II which can stimulate the production of aldosterone from the adrenal cortex which then affects the Na/K ATPase
Angiotensin II causes your blood vessels to become narrower and retains fluid

Question 11

Name a dihydropyridine calcium channel blocker

Answer 11

Amlodipine

Question 12

Name an ACE i

Answer 12

Lisinopril

Question 13

Name a cardioselective (B1) Beta blocker

Answer 13

Atenolol

Question 14

Name a Thiazide Diuretic

Answer 14

Bendroflumethiazide

Question 15

Name an angiotensin receptor blocker

Answer 15

Losartan, Valsartan

Question 16

Name a loop diuretic and what do they do

Answer 16

Furosemide - prevents reabsorption of Na and water at the loop of Henle

Question 17

Name a non dihydropyridine Ca channel blocker

Answer 17

Verapamil

Question 18

Name an alpha adrenoceptor antagonist

Answer 18

Doxazosin

Question 19

Name a fibrate

Answer 19

Bezafibrate

Question 20

Name a non cardio selective beta blocker

Answer 20

Propranolol

Question 21

What are the side effects of Diuretics?

Answer 21

Hypokalaemia
Arrhythmias
Hyperglycaemia
Hyperuricaemia 
Impotence 
Fatigue

Question 22

What are the side effects of beta blockers?

Answer 22

Heart failure (short term)
Cold peripheries
Fatigue

Question 23

What are the side effects of statins?

Answer 23

Myositis

Rhabdomyolysis

Question 24

What shouldn’t be prescribed in pregnancy?

Answer 24

Angiotensin II receptor blockers

ACE inhibitors

Question 25

What is the mechanism behind spironlactone?

Answer 25

Aldosterone antagonist and potassium sparing

Question 26

Side effects of digoxin

Answer 26

Nausea, vomiting, bradycardia, heart block and any arrhythmia (Paroxysmal atrial tachy)

Question 27

What is the LVF therapy

Answer 27

Sit up, Oxygen, IV furosemide, IV diamorphine (careful in COPD)

Question 28

What is the mechanism behind fibrates?

Answer 28

Lowers the blood triglyceride level