Prescribing + Pharmacology 25/5/20 Flashcards
antihypertensive effects of ACEIs
1) . vascular resistance reduced
2) . ECF volume reduced (reduced sodium reabsorption & reduced aldosterone)
3) . Bradykinin elevated (lead to dry cough)
ACEI side effects
- dry cough
- hypotension
- angioedema (face/tongue/throat)
- hyperkalaemia (do not use with K+sparing diuretics
- congenital malformation in pregnancy (give labetalol)
ARB side effects
- hypotension
- hyperkalaemia
- congenital malformation in pregnancy (give labetalol)
CCB (NON-DIHYDROPYRIDINES - eg. verapamil) CIs
- bradycardia
- heart failure (HFREF)
- Wolff-Parkinson-White/sick sinus/sino-atrial block
CCB (DIHYDROPYRIDINES - eg. amlodipine) CIs
- significant aortic stenosis
- unstable angina
SEs of CCBs
- bradycardia
- reflex tachycardia (nifedipine)
- hypotension (esp. verapamil)
- abdo discomfort
- flushing
- palpitations
indications for CCBs
Dihydropyridines (eg. amlodipine = vascular targetting mostly)
- angina prophylaxis (amlodipine)
- antihypertensive
- Raynaud’s (nifedipine)
- post-SA haemorrhage prevention of vasospasms (nimodipine)
NON-dihydropyridines (eg. verapamil = cardiac targetting mostly)
- supraventricular arrhythmias
- angina
- antihypertensive
where do osmotic diuretics (eg. mannitol) and carbonic anhydrases act?
proximal convoluted tubule
where do loop diuretics (eg. furosemide) act?
Loop of Henle/thick ascending limb
where do thiazide diuretics (eg. bendroflumethiazide) act?
distal convoluted tubule
where do potassium-sparing diuretics (eg. spironolactone/amiloride) act?
collecting duct
- principal cells = amiloride
- intercalated cells = spironolactone
total blood volume calcs for neonate, child and adult
neonate = 90ml/kg child = 80ml/kg adult = 70ml/kg
osmolality vs osmolarity
osmolality = osmoles per kg solvent osmolarity = osmoles per litre
deficit calcs (paeds)
% deficit x 10 x weight = deficit fluids in ml/kg/day
maintenance fluids (paeds) over 24hrs
first 10kg = 100ml/kg/day
next 10kg = 50ml/kg/day
thereafter = 20ml/kg/day
