Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > 4) Hypertension and Heart Failure > Flashcards

4) Hypertension and Heart Failure Flashcards

1
Q

What are Non Pharmacological Treatments of Hypertension ?

A

> Stopping Smoking
Lowering Alcohol Consumption
Reduce Salt Intake
Exercise

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

What is the protocol for pharmacological treatment for Hypertension ?

A

Aged under 50:
A - ACE Inhibitor / ARB
C - Ca2+ Channel Blocker
D - Diuretic

For someone who is >55 / Black person of African / Caribbean Family
> Start with C

If ACD does not work add further diuretic or a / b blocker

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

Give examples of ACE Inhibitors

A

LisoniPRIL

RamiPRIL

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

What is the mechanism of action of ACEi

A

Prevents the conversion of Angiontensin I => Angiotension II

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

What physiological effects do ACEis have ?

A

> Vasodilation - Decrease PVR -> Reduced Afterload
Reduction in Aldosterone release - Na+ + Water excretion
Reduced Vasopressin release - Increase Water excretion
Reduced Cell growth and proliferation`

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

What are some Warnings/Contraindications of ACEi

A 
> Patients with Renal Artery Stenosis 
> AKD => CKD potentially 
> Don't take if pregnant or breast feeding 
> Dry Cough - Bradykinin build up 
> Angio- oedema 
> Hypotension 
> Hyperkalaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some Important interactions of ACEis

A

> Do not use K+ Sparing drugs
Do not use along NSAIDS
Watch out when using with other antihypertenisve drugs

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

Give examples of ARBs

Angiotension Receptor Blockers

A

CandeSARTAN

IoSARTAN

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

What is the mechanism of action of ARBs

A

Block ATII receptor therefore has the same effect as ACEis without having the side effects of BK build up

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

What are some Warnings/Contraindications of ARBs

A

> Patients with Renal Artery Stenosis
AKD => CKD
Pregnant / Breastfeeding

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

What are some important interactions of ARBs

A

> Don’t use along side K+ Sparing Drugs
Don’t use along NSAIDs
Watch out when using other anti hypertensive drugs

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

Give examples of L-Type Ca2+ and Ca2+ Channel Blockers

A

Dihydropyridines:
> AmlodIPINE - Shorter t1/2
> NifedIPINE
> NimoDIPINE (Selectivity for Cerebral Vasculature) Used in sub arachnoid haemorrhage

Non-Dihydropyridines:
Phenylalkymines => Verapamil
Benzothiazapines => Diltiazem

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

What is the mechanism of action of CCBs

A 
Block different sites where VOCC
> Vascular Smooth Muscle Cells 
> Cardiac Myocytes 
> SAN + AVN 
Ultimately relaxes the target site 
e.g. Vasodilation => Reduced preload to the heart
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some warning/contraindications to CCBs (Dihydropyridines)

A

> Unstable Angina

> Severe Aortic Stenosis

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

What are some important interactions of CCBs (Dihydropyridines)

A

> Interaction with Simvastatin => Increases the effect of Statin
Other anti-hypertensive drugs

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

What are some side effects of Dihydropyridines ?

A

> Peripheral Oedema
Headaches
Palpitations => Compensatory Tachycardia

17
Q

What is Verapamil typically used for ?

A

> Anti arrhythmic agent => Prolongs AP / effective refractory period
It is has less peripheral dilation, -ve chrono and inotropic effects
Angina

18
Q

What are some Warnings / Contraindications of Phenylalkylamines ?

A

> Poor LV function

> AV Nodal conduction delay

19
Q

What are some important interactions of Phenylakylamines ?

A

> B blockers

> Don’t use along side other anti hypertensives and anti arrhythmic drugs - It can worsen heart failure

20
Q

What are some side effects of Phenylakylamines ?

A

> Constipation
Bradycardia
Heart Block
Cardiac Failure

21
Q

Give some examples of Diuretics (Thiazides)

A

> Bendroflumenthiazide

> Indapamide

22
Q

What is the mechanism of action of Diuretics (Thiazides)

A

Inhibit NCX in the DCT leading to reduced Na+ Reabsorption so reduced BV

23
Q

What are some warnings/Contraindications of Diuretics (Thiazides)

A

> Hypokalaemia
Hyponatraemia
Gout

24
Q

What some side effects of Thiazides ?

A

> Hyperglycaemia
Hypokalamia - RAAS compensation => Increase K+ secretion
Increased LDL

25
Q

What are some important interactions of Thiazides ?

A

> NSAIDs

> Non K+ Sparing drugs

26
Q

If ACD system fails to treat hyper tension (Resistant Hyper tension) What steps should be taken ?

A

Add :
> Other diuretics => Spironolactone, Amiloride
> Alpha Blockers => DoxazOSIN
> Beta Blockers => IsbetaLOL, MetoproLOL and BisoproLOL

27
Q

What are some warnings/Contraindications to Spironolactone ?

A

> HyperKalaemia

> Addison’s

28
Q

What are some important interactions of Spironolactone ?

A

> K+ Sparing drugs

> ACEis and ARBs

29
Q

What are some warnings/Contraindications of B-Blockers

A

> Asthmatic patients -> Cause bradycardia
COPD
Haemodynamic instability
Hepatic failure

30
Q

What are some important interactions of B-Blockers

A

> Non hydropyridine CCB

=>Asystole

31
Q

What are some side effects of B- Blockers ?

A 
> Bronchospasm 
> Heart block 
> Raynaud's
> Lethargy 
> Impotence
32
Q

What is the mechanism of Alpha Blockers ?

A

Selective antagonism of a1 - adrenoreceptors

> Reduce peripheral vascular resistance

33
Q

What are some side effects of Alpha blockers ?

A

> Postural Hypotension
Syncope
Headache

34
Q

What are the AIMS of managing heart failure ?

A

> Symptomatic improvement
Managed increase exercise tolerance
Address arrhythmias, hyperlipidaemia, diabetes
Decrease Mortality

35
Q

Outline the pharmacological management of Heart Failure

A

1) ACEi/ARB
2) B-Blocker
3) Loop Diuretic
+ if needed
Spironolactone
Digoxin
Statins
2 Antiplatelet drugs

Pharmacology (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions