week 8-hypertension

Question 1

what are some examples of CCB?

Answer 1

Eg: Dihydropyridines:
Amlodipine
Felodipine
Isradipine
Lercanidipine
Nicardipine
Nifedipine
Nisoldipine
Non-dihydropyridines:
Diltiazem
Verapamil

Question 2

NICE FOR CCB?

Answer 2

• Dihydropyridines (E.g. Amlodipine) 1
st line (step 1) choice in >55yrs or Black
African or African Caribbean population of any age (non-diabetic)
• VERAPAMIL must not be used in combination with a beta-BLOCKER due to the risk of
severe bradycardia and heart block

Question 3

what is the mechanism of action for CCB?

Answer 3

• Interfere with the inward displacement of calcium ions through the slow channels of active cell membranes in the peripheral blood vessels and/or heart
• increase peripheral vasodilatation (dihydropyridines)
• increase coronary vasodilatation (all but especially verapamil & diltiazem)
• decrease rate & force of cardiac contraction (verapamil & diltiazem)

Question 4

CHOICE OF DRUG FOR HYPERTENION FIRST LINE?

Answer 4

• CCB= OVER 55 AND BLACK

- ACEi OR ARB= UNDER 55 AND NOT BLACK AND HAVE DIABETES

Question 5

choice of drug for hypertension for 2nd line add on?

Answer 5

• for over 55 and black= add ACEi or thiazide like duiretic

- for under 55 or non black or diabetes= add CCB or thiazide like duiretic

Question 6

whats the 3rd step?

Answer 6

ACEi or ARB +CCB+THIAZIDE LIKE DUIRETIC

Question 7

what are some examples of thiazide like diuretics?

Answer 7

Bendroflumethiazide
Chlortalidone
Cyclopenthiazide
Indapamide
[Metolazone]
Xipamide

2.5mg in the morning

Question 8

what are some examples of ACEi

Answer 8

Captopril
Enalapril
Fosinopril
Imidapril
Lisinopril 10mg od maint 20mg
Moexipril
Perindopril
Quinapril
Ramipril 1.25mg
Trandolapril

Question 9

what are some examples of ARBs?

Answer 9

Candesartan
Eprosartan
Irbesartan
Losartan 50mg daily
Olmesartan
Telmisartan
Valsartan