Therapeutics Of ⬆️BP Flashcards
Why endothelium factors affect BP?
Endothelin
NO
…
BP=
CO x TPR
What happens to systolic pressure with ⬆️ age?
⬆️
What happens to diastolic pressure with ⬆️ age?
Rises, plateaus at 50, can even ⬇️ slightly
Causes of secondary ⬆️BP?
Renal Endocrine Genetic CoA (coarctation of aorta) eg Turner's Mediations Poisons
What drugs can cause ⬆️BP?
NSAIDs
Oral contraceptive pill
Cyclosporins
What poisoning can give ⬆️BP?
Lead poisoning
Alternative medicines
Main endocrine syndromes that cause ⬆️BP?
PCC
Conn’s (⬆️ aldosterone)- tumour or hypertrophy of fireball glands
Cushing’s (⬆️ glucocorticoids)
Acromegaly (⬆️ GH)
What genetic conditions cause ⬆️BP?
CAH (congenital adrenal hyperplasia)
GRA (glucocorticoid remediable aldosteronism)
AME (apparent mineralocorticoid excess)
Liddle’s syndrome - ENac channel
Gordon’s syndrome
What happens to the aorta in Turner’s syndrome?
CoA
Coarctation of aorta
Target organ damage in ⬆️BP
Micro vascular disease
Atherosclerosis
LVF
Renal disease
AAA - rarer
-more common in men
What microvascular conditions can ⬆️BP cause?
Hypertensive renal disease
Retinopathy
Cerebral microaneurysms
What drug are recommended for under 55s with ⬆️BP?
ACE inhibitors
What’s the issue of giving ACE inhibitors to women of child baring age?
ACE inhibitors are highly teratogenic in the first trimester
Side effects if ACE inhibitors
Cough (10%) ⬆️kalaemia ARF Skin rash Angioedema (⬆️ bradykinin) Hepatotoxicity Teratogenic
What are he 3 types I Ca channel blockers?
Dihydropyridines (amlodipine) - ankle swelling
Benzothiazepines
ADR of thiazides
⬇️natreamia
…
What can increase in patients taking a-blockers?
CCF
Name a central a-blocker
Clonidine
Sedation
Name a common aldosterone antagonist
Spirinolactone
Gynaecomastia
Define a hypertensive emergency?
> 180/110 mmHg
Acute damage to target organs
Requires intravenous therapy
What is hypertensive urgency?
180/110 mmHg
No acute target organ damage
Requires GRADUAL reduction
Acute LVF Ureania with volume overload CVA/SHA SOL Encephalitis Drugs & toxins Hypercalcaemia
If a women BP is over … /… mm Hg medicate them
150/110 mmHg
