9.2 - Hypertension and HF treatment Flashcards Preview

ESA 5 - Pharmacology > 9.2 - Hypertension and HF treatment > Flashcards

Flashcards in 9.2 - Hypertension and HF treatment Deck (25):
1

How do centrally acting agents work? Give an example

Work by reducing sympathewtic outflow to reduce BP. e.g. Methyldopa

2

How do alpha blockers work? ADRs?

Antagonism of alpha 1 adrenoreceptors

ADR - postural hypotension, dizziness, headaches and fatigue, oedema

3

How do thiazide diuretics work? ADRs?

Act on NaCl symporter in DCT, reducing water reabsorption and blood volume.

ADR - hypokalaemia, hyperuricaemia, hypercalcaemia, ED

4

CCB MoA? What are the 3 types? ADRs?

Bind to L-type calcium channels and reduce Ca entry. Vasodilates arteries.

3 groups:

  1. Dihydropyridines - tachycardia, sweating, flushing, oedema
  2. Phenylalkylamines - constipation, bradycardia
  3. Benzothiazepines - bradycardia, negative ionotropy.

5

What are some ADRs to ACEi?

dry cough, first dose hypotension, renal failure, hyperkalaemia

6

What is classified as a hypertensive emergency? How would you treat?

>220/120mmHg

Treat with IV sodium nitroprusside which acts as an endogenous nitric oxide.

7

Which CCB is the preferred?

Dihydropyridines

8

How would you treat mild, moderate, and severe hypertension?

Mild - Non pharm therapies

Moderate and severe - Pharm therapies

9

What is a pheochromocytoma?

Adrenal catecholamine secreting tumour

10

Describe the treatment plan for <55 yo

1) ACEi

2) +CCBs

3) +diuretics

4) + alpha blockers, beta blockers, centrally acting drugs, or vasodilators 

11

Describe the treatment plan for a black person or a >55yo

1) CCBs

2) +ACEi

3) +diuretics

4) +alpha blockers, beta blockers, centrally acting drugs, or vasodilators

12

How do direct renin inhibitors work?

Bind to renin and prevents cleavage of angiotensinogen to angiotensin I

13

Define mild, moderate, and severe hypertension

Mild - 140-159 s, 90-99 d

Moderate - 160-179 s, 100-109 d

Severe - >180 s, >110 d

14

What antihypertensive drug is used preferably in pregnancy?

Centrally acting agent e.g. methyldopa

15

What are the 3 types of CCBs?

Dihydropyridines, benzothiazepines, phenylakylamines

16

If patient cannot tolerate ACEi, what is the alternative treatment? Name an example and its ADRs.

AG2 receptor blocker

e.g. Losartan. ADR is renal failure, hyperkalaemia

17

How do alpha blockers work?

Antagonise alpha 1 adrenoreceptors to reduce TPR

18

What is the MoA of ACEi? ADRs? Give .e.g

e.g. - ramipril

MoA - prevent AG2 generation by inhibiting ACE. Also prevents bradykinin degradation. This all reduces effect of RAAS system

ADRs - dry cough, first dose hypotension, renal failure and hyperkalaemia.

19

Name an example ACEi

Lisinopril, ramipril

20

How do centrally acting agents work? What drugs does this include? ADRs?

Methylodopa - alpha 2 agonist

Clinidine - alpha 2 agonist

All reduce sympathetic outflow to reduce BP

ADRs - tiredness, lethargy, depression

21

Fill in

22

Define hypertension. What are the 2 causes of hypertension?

>140/90mmHg

Primary - No known cause. 90% of cases

Secondary - known cause.

23

How do direct renin inhibitors work?

Bind to renin and prevent cleavage of angiotensinogen to angiotensin 1. Little effect on BP

24

How do beta blockers work? 

Antagonise beta1 adrenoreceptor, reducing HR and CO. But little effect on BP

25

Define a hypertensive emergency. How would you treat? How does treatment work?

>220/120

IV sodium nitroprusside acts as endogenous N2O