Hypertension

Question 0

What do you ACE inhibitors do?

Answer 0

Decrease angiotensin II 
Act as vasodilators
Inhibit aldosterone
Potentiates bradykinin
Decreases BP
Decreased cardiac load

Question 1

What are the drugs used for hypertension?

Answer 1

ACE inhibitors/ARB
Calcium Channel blockers
Diuretics (thiazide)

Question 2

Where do you ACE inhibitors act?

Answer 2

Heart
Kidney
Brain

Question 3

What are ACE inhibitors used for?

Answer 3

MI
Hypertension
Cardiac failure
Diabetic nephropathy
IHD risk

Question 4

What are the ADR’s of ACE inhibitors?

Answer 4

Dry cough
Angio oedema
Renal failure
Hyperkalaemia
Hypotension

Question 5

Name two examples of ACE inhibitors

Answer 5

Lisinopril

Ramapril

Question 6

What do you angiotensin II receptor blockers do?

Answer 6

Inhibit vasoconstriction

Inhibit aldosterone

Question 7

What are ARB’s is used for?

Answer 7

Young hypertensive patients
Diabetic hypertensive patients
LVH hypertensive patients
Heart failure
Diabetic nephropathy

Question 8

What are the ADR’s ours of a ARB’s?

Answer 8

Teratogenic
Renal failure
Hyperkalaemia

Question 9

Name two ARB’s

Answer 9

Losartan

Valsartan

Question 10

What do calcium channel blockers do?

Answer 10

Vasodilates peripheral, coronary and pulmonary arteries by binding to L-type calcium channels

Question 11

What are the three types of calcium channel blockers?

Answer 11

Dihydropyridines
Phenylalkylamines
Benzothiazepines

Question 12

What is the pk of dihydropyridines?

Answer 12

Highly protein bound over 90%
Metabolised by the liver
Good oral absorption

Question 13

What are the ADRs of dihydropyridine?

Answer 13

Sympathetic nervous system activation leading to tachycardia and palpitations, flushing, sweating, throbbing headache
Oedema
Gingival hyperplasia

Question 14

What do you phenylalkylamines do?

Answer 14

Impede calcium transport across myocardial and vascular smooth muscle cell membrane
Prolongs action potential
Peripheral vasodilation and decreases cardiac preload and myocardial contractility

Question 15

Give an example of Phenylalkylamine

Answer 15

Verapamil

Question 16

What are the ADRs of Phenylalkylamines?

Answer 16

Constipation
Bradycardia
Decrease myocardial contractility

Question 17

What do Benzothiazepines do?

Answer 17

Same as verapamil
Less aggressive
Less effect on AV node

Question 18

What are the ADRs of benzodiazepines?

Answer 18

Bradycardia

Less negative inotropic effect than verapamil

Question 19

Give an example of a Benzothiazepine

Answer 19

Disulfiram

Question 20

What do thiazide diuretics do?

Answer 20

Reduce distal tubular sodium reabsorption

Reduce BP initially by decreasing blood volume later by decreasing TPR

Question 21

What are the ADRs of thiazide diuretics?

Answer 21

Gout
Impotence
Impaired glucose tolerance
Hypokalaemia
Increased cholesterol

Question 22

What are the nice guidelines for hypertension?

Answer 22

Under 55 is ace inhibitor or angiotensin receptor blocker
Over 55 then give calcium channel blocker or diuretic
If these don’t work combine therapy

Question 23

What other drugs can be used for hypertension?

Answer 23

Alpha blockers
Direct renin inhibitors
Beta-blockers

Question 24

What is the aetiology of heart failure?

Answer 24

Ischaemic heart disease
Hypertension
Cardiomyopathy
Valve disease

Question 25

What drugs are used in heart failure?

Answer 25

Spirinolactone
Beta blocker
Statins