Prescribing in hypertension Flashcards
How do nitrates work?
Converted to its active form, nitric oxide which leads to coronary vasodilation and therefore increased coronary perfusion
What is the mechanism of Ca channel blockers?
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.
What is Nicorandil?
Potassium channel blocker. Anti anginal and anti ischaemic
What does Ivabradine do?
Lowers the heart rate by inhibiting spontaneous pacemaker activity
Tell me about Ranolazine
Selective inhibitor of the late Na current - anti ischaemic
What is Trimetazidine?
Anti ischaemic metabolic modulator
How does aspirin work?
Switches off the cycloxygenase system - Irreversibly inhibits COX - 1
What does Clopidogrel do?
Blocks ADP receptors - Antagonist of a platelet adenosine disphosphate receptor
What are the side effects of ACE i
Cough, angio oedema, hyperkalaemia
How does ACE i cause hyperkalaemia?
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
Name a dihydropyridine calcium channel blocker
Amlodipine
Name an ACE i
Lisinopril
Name a cardioselective (B1) Beta blocker
Atenolol
Name a Thiazide Diuretic
Bendroflumethiazide
Name an angiotensin receptor blocker
Losartan, Valsartan
Name a loop diuretic and what do they do
Furosemide - prevents reabsorption of Na and water at the loop of Henle
Name a non dihydropyridine Ca channel blocker
Verapamil
Name an alpha adrenoceptor antagonist
Doxazosin
Name a fibrate
Bezafibrate
Name a non cardio selective beta blocker
Propranolol
What are the side effects of Diuretics?
Hypokalaemia Arrhythmias Hyperglycaemia Hyperuricaemia Impotence Fatigue
What are the side effects of beta blockers?
Heart failure (short term)
Cold peripheries
Fatigue
What are the side effects of statins?
Myositis
Rhabdomyolysis
What shouldn’t be prescribed in pregnancy?
Angiotensin II receptor blockers
ACE inhibitors
What is the mechanism behind spironlactone?
Aldosterone antagonist and potassium sparing
Side effects of digoxin
Nausea, vomiting, bradycardia, heart block and any arrhythmia (Paroxysmal atrial tachy)
What is the LVF therapy
Sit up, Oxygen, IV furosemide, IV diamorphine (careful in COPD)
What is the mechanism behind fibrates?
Lowers the blood triglyceride level
