Anti-hypertensives

Question 1

What are the main classes of anti-hypertensives?

Answer 1

ACEi
ARDs
CCBs
Diuretics

Question 2

What are examples of ACEis?

Answer 2

Ramipril

Lisonpril

Question 3

What are ACEis used for?

Answer 3

Hypertension

Heart failure

Question 4

What is the route of ACEis?

Answer 4

Oral

Question 5

What is the mechanism of ACEis?

Answer 5

Inhibits conversion of angiotensin-1 to angiotensin-2

• vasodilation
• reduced aldosterone release

Acts as a diuretic

Question 6

What are side effects of ACEis?

Answer 6

Dry cough
Angioedema
Renal failure
Hyperkalaemia

Question 7

What causes the dry cough?

Answer 7

Prevention of the breakdown of bradykinin

Question 8

What follow up is needed when starting an ACEi?

Answer 8

U+Es 2 weeks after starting

Question 9

What are examples of ARBs?

Answer 9

Candesartan

Losartan

Question 10

What are ARBs used for?

Answer 10

Hypertension

Heart failure

Question 11

What is the route of administration for ARBs?

Answer 11

Oral

Question 12

What is the mechanism of ARBs?

Answer 12

AT1 receptor antagonist

- vasodilation by inhibiting angiotensin-2 mediated vasoconstriction

Question 13

What are the side effects of ARBs?

Answer 13

Renal failure
Hyperkalaemia
Dizziness
Nausea 
Headaches

Question 14

What are the exmaples of CCB?

Answer 14

Amlodipine
Verapamil
Diltiazem

Question 15

What is the use of amlodipine?

Answer 15

Hypertension

Question 16

What is the route of administration of amlodipine?

Answer 16

Oral

Question 17

What is the mechanism of amlodipine?

Answer 17

Inhibits L-type calcium channels

• vasodilation
• prevent smooth muscle contraction (peripheral vasculature)

Question 18

What are the side effects of amlodipine?

Answer 18

Tachycardia
Palpitations
Flushing
Oedema

Question 19

What are the uses of verapamil?

Answer 19

Hypertension

SVT

Question 20

What are the routes of administration of verapamil?

Answer 20

PO

IV

Question 21

What is the mechanism of verapamil?

Answer 21

Prolongs action potential - prevents smooth muscle contraction

Question 22

What are side effects of verapamil?

Answer 22

Constipation
Risk of bradycardia
Worsen heart failure

Question 23

What are the uses of diltiazem?

Answer 23

Hypertension
Angina
SVT

Question 24

What is the route of administration of diltiazem?

Answer 24

Oral

Question 25

What is the mechanism of diltiazem?

Answer 25

Prolongs action potential Vasodilation Prevent smooth muscle contraction

Question 26

What are the side effects of diltiazem?

Answer 26

Risk of bradycardia | Can worsen heart failure

Question 27

What other drugs are used for hypertension?

Answer 27

Spironolactone | Labetelol

Question 28

When is labetalol used?

Answer 28

Pre-eclampsia | Hypertension in pregnancy

Question 29

What class is labetalol?

Answer 29

Beta adrenoreceptor antagonist

Question 30

What is the route of administration of labetalol?

Answer 30

PO | IV

Question 31

What is the mechanism of labetalol?

Answer 31

Reduce sympathetic outflow - slows HR | Dilate blood vessels - reduce TPR

Question 32

What are the side effects of labetalol?

Answer 32

``` Dizziness Rash Headaches Tingling scalp Dysuria Shortness of breath ```

Question 33

What class is spironolactone?

Answer 33

Aldosterone antagonist

Question 34

What is spironolactone used for?

Answer 34

``` Oedema Ascites Nephrotic syndrome Heart failure Resistant hypertension ```

Question 35

What is the route of administration of spironolactone?

Answer 35

PO

Question 36

What is the mechanism of spironolactone?

Answer 36

Competes with aldosterone at mineralocorticoid receptors Prevents upregulation of ENaC Sodium stays in tubule

Question 37

What are side effects of spironolactone?

Answer 37

Hyperkalaemia Impotence Painful gynaecomastia Refractory hyperaldosteronism

Question 38

What other classes can be used for hypertension?

Answer 38

Alpha-adrenoreceptor blockers | Beta-adrenoreceptor blockers

Question 39

What is an example of an alpha-adrenoreceptor blocker used for hypertension?

Answer 39

Doxazosin

Question 40

What is the route of administration for doxazosin?

Answer 40

Oral

Question 41

What is the mechanism of doxazosin?

Answer 41

Reduces peripheral resistance | Antagonise contractile effects of NA on smooth muscle

Question 42

What are side effects of doxazosin?

Answer 42

Postural hypotension Headache Fatigue Oedema

Question 43

What is an example of a beta-adrenoreceptor blocker used for hypertension?

Answer 43

Bisoprolol

Question 44

What is bisoprolol used for?

Answer 44

Hypertension | Sinus tachy

Question 45

What is the route of administration for bisoprolol?

Answer 45

PO

Question 46

What is the mechanism of bisoprolol?

Answer 46

Reduce CO Slow conduction Decrease sympathetic tone

Question 47

What are side effects of bisoprolol?

Answer 47

Bronchoconstriction Hypotension Bradycardia Raunaud's