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Cardio > treating hypertension > Flashcards

treating hypertension Flashcards

1
Q

what would you use to first treat an over 55 or of afro caribbean origin for hypertension

A

CCB

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2
Q

what would you use to first treat an under 55 patient for hypertension

A

ACE

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3
Q

what would you do if a patient on ACE develops a cough

A

take off ACE put on ARBs

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4
Q

if a patient also has angina and hypertension what medication would you put them on?

A

BB

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5
Q

Examples of rate limiting CCB

A

verapamil and diltiazem

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6
Q

what’s xanthelasma

A

the deposit of cholesterol under the skin

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7
Q

what is a sign of hyperlipidaemia

A

xanthelasma

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8
Q

what medication blocks HCN channels?

A

ivabradine

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9
Q

what are the two types of ccb

A

dihydropyridine and non dihydropyridine (non selective )

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10
Q

example of dihydropyridine ccb

A

amlodipine and nifedipine

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11
Q

example of non dihydropyridine (non selective ) ccb

A

verapamil and diltiazem

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12
Q

how do calcium channel blockers work?

A

usually the alpha 1 adrenoceptors stimulate the L-type ca2+ channels in the vascular smooth tissue, increasing Ca2+ influx, causing muscle contraction. CCB block the L-type ca2+ channels, decreasing the influx of calcium , decreasing TPR and MABP. Also causing coronary vasodilation

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13
Q

why one of the calcium channel blockers is best for angina and hypertension and why?

A

amlodipine because it’s a dyhydropyridine and so unlike the non- dyhidropyridines targets the L-type channels in the vascular smooth muscle instead of both the vascular smooth muscle and the cardiac muscle, meaning there’s less chance of having unwanted effects on cardiac muscle

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14
Q

side effects of CCB

A

ankle oedema, hypotension, dizziness, flushing

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15
Q

what are the warnings for dihydropyridines and non dihydropyridines?

A

non dihydropyridines should not be used with beta antagonists whereas dihydropyridines are usually given with beta antagonists

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16
Q

example of an ACE inhibitor

A

lisinopril

17
Q

how do ACE inhibitors work?

A

they block the conversion of angiotensin I to angiotensin II, causing venous dilatation (decreasing preload) and arterial dilatation (decreasing after load and TPR) decreasing arterial blood pressure in cardiac load

18
Q

side effects of ACE inhibitors

A

dry cough, hypotension (especially in patients on diuretics) , hyperkalemia and angiodema

19
Q

when should ACE inhibitors not be used?

A

during pregnancy or in bilateral renal artery stenosis

20
Q

example of ARBs

A

losartan

21
Q

how to ARBs work

A

AT1 receptor antagonists - competitively block the action of angiotensin II at the AT1 receptors causing venous dilatation (decreasing preload) and arterial dilatation (decreasing after load and TPR) decreasing MABP

22
Q

when should ARBs not be used

A

during pregnancy and bilateral renal artery stenosis

23
Q

examples of alpha blockers

A

prazosin and doxazosin

24
Q

how do alpha blockers work

A

alpha blockers block vascular adreno1-receptors causing vasodilation , decreasing MABP and TPR

25
Q

side effects of alpha blockers ?

A

postural hypotension

26
Q

examples of casio selective beta blockers

A

atenolol, bisoprolol

27
Q

examples of non selective beta blockers

A

propanolol and carvidilol

28
Q

how do cardio selective beta blockers work

A

only block the Beta1 receptors- beta 1 adrenoceptors stimulate Gs to increase conversion of ATP to cAMP, increasing PKa

29
Q

what are the side effects of beta blockers

A

tiredness , cold peripheries, can cause heart failure in the long term, bradycardia

30
Q

when should beta blockers not be used

A

in asthma as can cause bronchospasms

31
Q

what are the 2 types of diuretics

A

thiazide and loop diuretics

32
Q

examples of thiazide diuretics

A

bendrofluazide

33
Q

examples of loop diuretics

A

furosemide

34
Q

how do diuretics work?

A

they promote sodium water excretion from the kidneys by inhibiting réabsorption in the loop of Henle or distal tube

35
Q

what are thiazide and loop diuretics used for

A

loop (stronger) - heart failure thiazide (weaker) - hypertension

36
Q

side effects of diuretics

A

hypokalaemia, arrhythmias, hyperglycaemia, diabetes, increase uris acid (gout), impotence

37
Q

what is given to type 2 diabetic?

A

ACEI (regardless of age)

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