2:l&b:2:management Of Htn

Front 1

NICE guidelines for prescribing anti-hypertensives

Back 1

Front 2

ideal blood pressure values to maintain
(and in diabetes/renal disease)

Back 2

<140/90
<130/80

Front 3

lifestyle changes to manage HTN (5)

Back 3

-lose weight if big fat fatty
-exercise
-reduce salt intake
-reduce alcohol intake
-stop smoking(not realated to HTN but is also a major cardiovascular risk)

Front 4

6 main anti-hypertensives

Back 4

-beta-blockers
-alpha-blockers
-diuretics
-ACE-i
-angiotensin II receptor blockers
-calcium channel blockers

Front 5

e.g., action, effect, adverse effects

-BETA-ADRENERGIC RECEPTOR BLOCKERS
-alpha-blockers
-diuretics
-ACE-i
-angiotensin II receptor blockers
-calcium channel blockers

Back 5

-e.g.PROPANOLOL (BETA 1 AND 2), ATENOLOL (BETA 1 SPECIFIC)

-COMPETITIVE REVERSIBLE ANTAGONIST - bind to receptor sites but are silent - prevent access of norad to site

-decrease HR
-decrease contractility
-to lesser extenet decrease RENIN release from kidney

-adverse effects - exacerbate asthma, intolerance to exercise, hypoglycaemia, vivid dreams

Front 6

e.g., action, effect, adverse effects

-beta-blockers
-ALPHA ADRENORECEPTOR BLOCKERS
-diuretics
-ACE-i
-angiotensin II receptor blockers
-calcium channel blockers

Back 6

-e.g. phentolamine (alpha 1 and 2), doxazocin (alpha 1 selective)

-COMPETITIVE REVERSIBLE ANTAGONIST

-reduce sympathetic ton in arterioles
-adverse effects - postural hypotension, reflax tachycardia

Front 7

e.g., action, effect, adverse effects

-beta-blockers
-alpha-blockers
-DIURETICS
-ACE-i
-angiotensin II receptor blockers
-calcium channel blockers

Back 7

-eg BENDROFLUMATHIAZIDE

-reduces renal reabsorption of Na and water
-small vasodilator action too

-adverse effects - hypokalaemia

Front 8

e.g., action, effect, adverse effects

-beta-blockers
-alpha-blockers
-diuretics
-ANGIOTENSIN CONVERTING ENZYME INHIBITOR
-angiotensin II receptor blockers
-calcium channel blockers

Back 8

-eg. captorpil, enalapril, ramopril, perindopril

-reduced formation of angiotensin II vasoconstrictor
-reduced release of aldosterone

-adverse effects - sudden fall in BP with first dose, persistant cough due to reduction of bradykinin breakdown - an peptide that activates sensory nerves in the lungs)

Front 9

e.g., action, effect, adverse effects

-beta-blockers
-alpha-blockers
-diuretics
-ACE-i
-ANGIOTENSIN II RECEPTOR BLOCKERS
-calcium channel blockers

Back 9

-eg LOSARTAN, CANDESARTAN (AT1 blockers)

-there are 2 receptor subtypes AT1 and AT2
-AT1 receptor mediates vasoconstricor action and aldosterone releasing action of angiotensin II

-no cough as with ACE-i

Front 10

e.g., action, effect, adverse effects

-beta-blockers
-alpha-blockers
-diuretics
-ACE-i
-angiotensin II receptor blockers
-CALCIUM CHANNEL BLOCKERS

Back 10

-e.g. - VERAPAMIL, DILTIAZEM, NIFEDIPINE

-act on L-type (long acting) voltage gated calcium channels, decresing Ca entry into smooth and cardiac muscle by
1 - open channel block (veramapril and diltiazem, block channel once opened)
2 - allosteric modulation (nifedipine, binds to allosteric site and reduce probability of it opening)
-relax vascular smooth muscle - vasodialtion
-decrease CO by action on cardiac muscle

-adverse effects - headache, constipation, arrythmias