13. hypertension ii Flashcards

(31 cards)

1
Q

what is hypokalaemia

A

low potassium levels in the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

major unwanted effect of loop diuretics is what and why does it happen

A

potassium losss
lot more sodium is passed to distal parts of the nephron and is absorbed by orinciple cells of the collecting duct and this lowers the potential of the lumen of the nephron so k+ will move into the lumen. increased flushing due to increased volume of urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

potassium sparing diuretics

A

decrease sodium movement across the principle cells

spironolactone and amiloride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

aldosterone

A

mineralcorticoid nuclear hormone receptor agonist
increases the transcriotion for the gene that codes for Na+/K+ ATPases
can also bind to a protein mediator and directly stimulate na channels non genomically in the luminal membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

spironolactone

A

competitive antagonist of aldosterone

is a potassium sparing antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

amiloride

A

potassium sparing siuretic

blocks sodium channels in the luminal membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

spironolactone uses

A

hyperaldosteronism in
liver cirrhosis - the fialaure to metanbolise aldosterone
conns syndrome - hypersecretion of aldosterone perhaps due to an aldosterone secreting tiumour in the adrenal medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

draw the scheme for RAAS, what does it do to blood pressure

A

renin to angiotensin to aldosterone and vasoconstriction, aldosterone leads to salt and water retention and com ined with vasoconstricition will increase blood pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

describe the generation of the angiotensin hormones

A

renin ( a protease) cleaves angiotensinogen into the inactive decamer angiotensin II.
ACE then cleves angiotensin I to angiotensin II which is an active octamer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

where do angotesin II and III bind

A

to angiotensin II type 1 recptors which are g coupled protein receptors that increase aldosterone secretio and cause vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is renin

A

renin is an enzyme secreted into the bloodstream by cells of the glomerular apparatus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how can the release of renin be stimulated

A

by adrenaline at Beta adrenceptors, prostacyclins and a decreased Na+ conc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

out of renin and ACE whats an example of global control and whats an example of local control

A

renin is global and CE is local

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

ACE inhibitors

A

end in pril

unwanted effects: initial dose hypotension, cough as ACE inhibited so bradykinin not broken down so vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

angiotensin II antagonists

A

compete with angiotensin II at angiotensin II type 1 receptors
hypotension but no cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

angiotensin receptors

A

g protein coupled receptors
angiotensin II type 1 recetpros are for aldosterone release and vascular effects
type 2 is for growth and development

17
Q

adrenergic receptors

A

four types (beta 3 used to breakdown fats)

18
Q

alpha 1 adrenergic receptor function `

A

vasoconstriction and contraction of smooth muscle

coupled with phospholipase c and stimulated by Gq

19
Q

alpha 2

A

coupled to adenlyl cyclase and gi. causes transmitter relase and decrease in insulin release

20
Q

beta 1

A

coupled to gs and adenylate cyclase
heart rateb and force
release of renin

21
Q

beta two

A

coupled to gs and adenylate cyclase

bronchodilation and vasodilation

22
Q

doxazoxin

A

antagonises alpha adrenergic receptors therefpre inhibiting vasoconsstrciton and contraction

23
Q

phenoxybenzamine

A

INSURMOUNTABLE IRREVERSIBLE non competitive inhibitor to all four adrenergic receptors

24
Q

propranolol

A

competive antagonist and is non selective to both beta adrenceptors
lipid soluble so can penetrate CNS

25
atenolol and bisprolol
competitive antagonists beta 1 selectivity bisoprolol then atenolol then propranolol water soluble- poor penetration of CNS
26
beta blockers in hypertension
reduces heart rate and stroke volume reduce release of renin ( b1 anatagonist) can reduce anxiety
27
unwanted effects of beta blocjers
``` big people hate vogue covers brochoconstricition precipitation of heart ailure or heart block hypoglycaemia vivid dreams cold extremities ```
28
diabetic aptients experience what when becoming hypoglycaemic
major sympathetic activation
29
problem with propranolol and diabetes
non selective decreased warning signs of hypoglycaemia problem for type 1 reduced insulin sensitivity problem for type 2
30
treatment for hypotension whats primary if black
calcium channel blocker
31
describe line of treatment for hypertension
aged under 55 years ace inhibitor then ace inhibitor nf a;cium channel blocjer then ace inhibitor calcium channel blocker and du=iuretif and gfinal the atter plus baeta blockers