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HDT 2.2 - Cardiovascular System > Hypertension > Flashcards

Hypertension Flashcards

1
Q

Define hypertension

A

A condition where blood pressure is elevated to an extent that lowering is of clinical benefit

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2
Q

What is stage 1 hypertension?

A

greater than or equal to 140/90 mmHg

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3
Q

What is stage 2 hypertension?

A

greater than or equal to 160/100 mmHg

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4
Q

What are the complications of hypertension?

A
  • myocardial infarction
  • stroke
  • HF
  • Hypertensive encephalopathy
  • Renal Failure
  • Hypertensive nephrosclerosis
  • Peripheral vascular disease
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5
Q

What thiazide diuretics are used?

A

Bendroflumethazide, Chlortaldone, Hydrochlorothiazide, Indapamide

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6
Q

What loop duiretic is used?

A

Furosemide

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7
Q

What Aldosterone antagonist is used?

A

Spironolactone

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8
Q

What ACEi are used?

A

Captopril, ramipril, enalapril, imidapril, lisinopril, perindopril, quinapril

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9
Q

What ARBs used?

A

Candesartan, irbesartan, losartan, temisartan, olmesartan

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10
Q

What renin antagonist is used?

A

Aliskiren

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11
Q

What is the mechanism of Acei?

A

block the conversion of angiotensin I to angiotensin II

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12
Q

What is the mechanism of ARBs?

A

Block the action of angiotensin II at the type 2 receptor

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13
Q

What is the side effect of ACEi?

A

Persistent dry cough

Rash, renal failure, angioedema

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14
Q

What monitoring is required for ACEi?

A
  • Renal function
  • Potassium
  • Blood pressure
  • Creatinine (until required dose is reached then 6-12 months thereafter)
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15
Q

What is the consequence of antagonism of ACE?

A

Leads to vasodilation, potassium retention, inhibition of salt and water.

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16
Q

What are some Beta Blockers?

A

Acebutolol, Atenolol, Bisoprolol, Carvedilol

17
Q

What is the mechanism of beta blockers?

A

They block the beta-adrenoreceptors in the heart, peripheral vasculature, bronchi, pancreas and liver.
Beta-1-receptors are predominant in the heart and kidney whereas Beta-2-receptors are predominant in other organs
Kidney: Blocking the beta-1-receptors causes inhibition of renin from juxtaglomerular cells and thereby reduce the activity of angiotensin-aldosterone system.
Heart: blockade of the beta-1-receptors in the sino-atrial node reduces heart rate and blockade of beta-1-receptors in the myocardium decrease cardiac contractility.
Central and peripheral nervous system: blockade of the beta-receptors in the brainstem and the prejunctional beta-receptors in the periphery inhibits release of neurotransmitters and decreases sympathetic NS activity.

18
Q

What are alpha-adrenoreceptor antagonists

A

Alpha receptors are used as add on drugs to treat hypertension or where other drugs are poorly tolerated.
They act selectively at post-ganglionic alpha-1-receptors which leads to vasodilation and reduction in BP

19
Q

What are the adverse effects of Alpha blockers?

A

First dose postural hypotension

20
Q

What are some of the names of alpha blockers?

A

Doxazosin, Indoramin, Prazosin, Terazosin

21
Q

Name some calcium channel blockers

A

Dihydropyridine derivatives: amlodipine, felodapine, lacidipine, isradipine, nicardipine
Phenylalkylamine: Verapamil
Benzothiazipine derivative: Diltiazem

22
Q

What is the mechanism of calcium channel blockers?

A

They block calcium channels in the peripheral blood vessels/heart. CCBs promote vasodilator activity by reducing calcium influx into vascular smooth muscle cells by interfering with voltage-operated calcium channels in the cell membrane
Dihydro work on L-type calcium channels in peripheral arterioles

23
Q

What are the adverse effects of dihydro derivative CCBs?

A

Headache, flushing, swelling of ankles an hands, gum hypertrophy

24
Q

What are the adverse effects of verapamil? (CCB)

A

Constipation

25
Q

What non-pharmacological interventions can help hypertension?

A
  • Weight reduction
  • Diet changes - whole gain bread, brown rie. 5 a day, low fat foods, low sodium intake, cut alcohol intake
  • Quit smoking
  • Encourage exercise
26
Q

When would you prescribe a loop diuretic for hypertension?

A

When renal function is significantly impaired

27
Q

What are inotropic drugs?

A

Inotropic drugs work on the force of contraction
Positive inotropic drugs increase Ca2+
Negative inotropic drugs decreaseCa2+

28
Q

What are Chonotropic drugs?

A

Work on the heart rate
Positive chronotropic drugs increase heart rate
Negative chronotropic drugs decrease heart rate

29
Q

How does digoxin (positive inotropic) work?

A

Inhibits the cell membrane Na/K ATPase which leads to reversal of Na/Ca2+ exchange
Increased intracellular Ca2+ results in increased strength of contraction
Also affects electrical physiology of the heart by blocking AV conduction and reducing heart rate

30
Q

What are the signs and symptoms of digoxin toxicity?

A
  • Bradycardia
  • Arrythmia
  • Nausea, Vomitting
  • Confusion
  • Visual disturbances
  • Metabolic or electrolyte disturbances
31
Q

What are the sympathomimetics?

A

Acts on B1 receptors causes tachycardia and increased force of contraction
Dopamine and dobutamine

HDT 2.2 - Cardiovascular System (8 decks)

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