Antihypertensive Drugs

Front 1

How does amiloride work

Back 1

Blocks ENAC (where aldosterone activates) can’t go to nucleus to increase transcription. No upreg of Na channels in lumen. Less sodium retention and thus less water retention

Front 2

What receptors does ang2 work on to cause vasiconstriction

Back 2

AT1-R

Front 3

How does the sympathetic system cause increase in TPR

Back 3

NA binds to alpha-1 receptors in veins and arterioles

Front 4

Who is ACE inhibitors the choice of drug for?

Back 4

<55 (not black African/American)

Front 5

When are Ca+ channels first line treatment

Back 5

>55 or black/African American

Front 6

If don’t give ACE inhibitor what do you give

Back 6

ARB - AT-1 receptor blocker

Front 7

What counts as treatable high blood pressure

Back 7

150/95

Front 8

If already on 2 drugs (ca2+ blocker and ARB) what would be given as a third

Back 8

Thiazide like diuretics

Front 9

What’s a side effect of Ace inhibitors

Back 9

Dry cough

Front 10

Why does Ace inhibitor cause dry cough

Back 10

Inhibits an enzyme that breaks down substance P/ bradykinin. If this builds up surmounts to dry cough

Front 11

Further Side effects of ACE

Back 11

First dose hypotension

Hyeprkalaemia

Front 12

When are ACE inhibitors contraindicated?

Back 12

Renal impairment more specifically bilateral renal artery stenosis

Front 13

Example of ACE inhibitor

Back 13

Ramipril

Front 14

Eg of angiotensin receptor blocker

Back 14

Losartan

Front 15

Eg of an aldosterone antagonist

Back 15

Spironolactone

Front 16

What’s amlodipine

Back 16

A calcium channel blocker

Front 17

What’s verapamil

Back 17

Ca channel blocker specifically on the heart (IHD)

Front 18

What’s a similar drug to verapamil

Back 18

Diltiazem

Front 19

Side effects of Ca channel blockers

Back 19

Peripheral oedema

Flushing and headaches

Front 20

Why does amlodipine cause peripheral oedema

Back 20

Due to loss of control of precapillary sphincter leads to an increase in hydrostatic pressure and less reabsorption

Front 21

Why can you not have grapefruit juice with amlodipine

Back 21

It enhanves action of CYP3A4 which breaks down ca2+ blockers

Front 22

Example of thiazide like diuretic

Back 22

Indapamide

Front 23

How do thiazide like diuretics work

Back 23

They block reabsorption of Na at the DCT

Also work on smooth muscle of blood vessels - dilation - by hyper-polarisation

Front 24

Side effects thiazide like diuretics

Back 24

Hypokalaemia

Increase in urate

Increase in blood lipids

Front 25

Why are thiazide diuretics used less frequently

Back 25

Increase blood glucose and lipids. Not good if high risk CVD

Front 26

When not to use thiazide like diuretics

Back 26

Diabetes

Front 27

Example of beta blocker

Back 27

Propranolol

Front 28

Example of beta blocker

Back 28

Propranolol

Front 29

Selective b1 antagonist

Back 29

Bisoprolol

Front 30

What are beta blockers mainly used to treat

Back 30

Angina/ IHD

Front 31

Side effects beta blockers

Back 31

TATT - and no reaction to hypoglycaemia/ broncho constriction

Front 32

Alpha 1 antagonist eg

Back 32

Doxazosin

Front 33

Alpha 1 antagonist eg

Back 33

Doxazosin

Front 34

When is doxazosin used

Back 34

BP in men with prostate hypertrophy