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ESA 4 Rev > Hypertension & HF > Flashcards

Hypertension & HF Flashcards

1
Q

Which drugs are indicated for hypertension?

A
  1. ACE-I/ARB or CCB
  2. ACE-I/ARB + CCB
  3. Add thiazide
  4. Spironolactone or other drugs
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2
Q

What is the action or ACE-I?

A

VASODILATION - Inhibit angiotensin II constriction, bradykinin
DECREASED SALT + WATER RETENTION - Inhibit aldosterone synthesis to decrease

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3
Q

What are the side effects of ACE-I?

A

Dry cough
Hyperkalaemia
Renal failure
Angio-oedema

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4
Q

What is the advantage or ARBS vs ACE-I?

A

Better tolerated - no cough as no bradykinin build up

- Still hypokalaemia and renal failure risks

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5
Q

What is the MOA of ARBs?

A

Antagonises angiotensin II AT1 receptor - vasodilation and decreased aldosterone (water and salt retention)
More Ang II binds to AT2 -> NO and vasodilation

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6
Q

What are the 3 groups of CCBs? Give an example and indication of each

A
  1. Dihydropyridine - amiodarone - hypertension
  2. Benzothiazepines - diltiazem - angina
  3. Phenylalkylamines - verapamil - arrythmia
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7
Q

What is the MOA of amlodipine?

A

VSMC relaxation - vasodilation of arterioles.

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8
Q

What are the side effects of amlodipine?

A 
Tachycardia & palpitations (baroreceptor)
Flushing, sweating and headache
Dizziness, hypotension
Oedema 
Gingival hyperplasia
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9
Q

How do thiazide diuretics treat hypertension?

A
  1. Initial decreased in blood volume - returns to normal

2. Vasodilation effect continues - decrease TPR

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10
Q

Which anti-hypertensive is highly protein bound?

A

Amiloride

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11
Q

Which anti-hypertensive has a flat dose-response curve?

A

Thiazide - increasing dose does not improve response.

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12
Q

What are the side effects of thiazide diuretics?

A 
Raised LDL and TAG
Hyperglycaemia
Hyperuriceamia -gout
Hypercalcaemia 
Erectile dysfunction
Hypokalaemia
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13
Q

Why are alpha-blockers rarely used?

A

Postural hypotension and dizziness
headache and fatigue
Oedema

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14
Q

What are side effects of beta blockers?

A

Hypotension
Bradycardia
Fatigue
Insomnia

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15
Q

What is aliskerin and what is its MOA?

A

Renin antagonist - inhibits angiotensin II and causes vasodilation

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16
Q

What is a useful combination of anti-hypertensives?

A

Thiazide + Amiloride

  • K+ effects and glucose effects balance out
  • both reduce BP
17
Q

Which 3 major drugs are used in HF treatment?

A
  1. ACE-I/ARB
  2. Beta blockers
  3. Spironolactone
18
Q

What are the effects of beta blockers in treating heart failure?

A
  1. Decrease HR
  2. Decrease BP
  3. Inhibit deleterious effects of chronic high NA on remodelling and hypertrophy
19
Q

How do aldosterone antagonists treat heart failure?

A

Decrease salt and water retention

Aldosterone contributes to fibrosis of heart

ESA 4 Rev (16 decks)

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