Session 3.1 - Hypertension

Question 1

Ramipril

Lisinopril

Answer 1

Drug Class: ACEi

Mechanism of Action: Inhibit ACE, Limits conversion of Agl to Agll

Common Indicators: Hypertension

ADRs: Dry cough, Hyperkalaemia, Hypotension, Worsen renal failure

Important drug-drug rxns: K+ increasing drugs (ACEi, Amiloride), NSAIDs, Antihypertensive agents

Question 2

Candesartan

Losartan

Answer 2

Drug Class: Angiotensin ll Receptor Blockers

Mechanism of Action: Directly target AT1 receptors ==> more effective at inhibiting Agll

Common Indicators: Hypertension

ADRs: Hyperkalaemia, Hypotension, Worsen renal failure

Important drug-drug rxns: K+ increasing drugs (ACEi, Amiloride), NSAIDs

Question 3

Amlodipine

Answer 3

Drug Class: CCB, Dihydropyridine

Mechanism of Action: Block Ca2+ channels in peripheral vasculature, Inhibiting Ca2+ influx, Stopping contraction of vascular smooth muscle

Common Indicators: Hypertension, Angina pectoris

ADRs: Hypotension + Headaches due to vasodilation, Palpitations (compensatory tachycardia)

Important drug-drug rxns: Amlodipine + Simvastatin (increases statin effects), Grapefruit juice increases effect

Question 4

Verapamil

Answer 4

Drug Class: CCBs, Phenylalkylamine

Mechanism of Action: Blocks L-type voltage-gated Ca2+ channels in SA/AV node, Prolongs action potential & ERP

Common Indicators: Hypertension, Arrythmias, Supraventricular tachycardias

ADRs: Heart block, Bradycardia, Constipation

Important drug-drug rxns: B-blockers, Other antiarrhythmics, Other antihypertensives

Question 5

Spironolactone

Answer 5

Drug Class: Mineralocorticoid receptor antagonist

Mechanism of Action: Blocks aldosterone receptor

Common Indicators: Hypertension, Oedema, Ascites, CCF (to counterbalance hypokalaemic effect of Furosemide)

ADRs: Hyperkalaemia, Gynaecomastia (painful from drug)

Important drug-drug rxns: K+ increasing drugs (ACEi, Amiloride), Pregnancy