Antihypertensives

Question 1

1st line antihypertensive in someone who is under 55 and is caucasian / brown

Answer 1

ramipril (ACE inhibitor)

Question 2

How does ramipril work

Answer 2

stops conversion of angiotensin one to angiotensin two
no release of aldosterone and less ADH

Question 3

how does aldosterone work

Answer 3

it causes more Na retention
so increases fluid in the body
and so works to increase the blood pressure

Question 4

where does aldosterone work

Answer 4

in the CD

Question 5

a patient is on antihypertensives and is complaining of a dry cough?

Answer 5

ACE inhibitors can cause a buildup of bradykinin

Question 6

if someone isn’t responding that well to ACE inhibitors what can you prescribe instead

Answer 6

Angiotensin 11 receptor antagonist

Question 7

what are some examples of angiotensin 2 receptor blockers

Answer 7

losartan, eprosartan

Question 8

what is a pro of using AT2RB

Answer 8

they dont cause a build up of bradykinin so no dry cough

Question 9

which is better at vasoconstriction ACEi or AT2RB

Answer 9

AT2RB as the target the receptor directly

Question 10

if someone is not responding well to both ACE I and AT2RB what other medication could you prescribe

Answer 10

thiazide

Question 11

how do thiazide diuretics work

Answer 11

they are Na/Cl receptor blockers so prevent reabsorption in the DT

Question 12

what is BP is stage one of hypertension

Answer 12

140/90

Question 13

what BP is stage two of hypertension

Answer 13

160/100

Question 14

what BP is stage three of hypertension

Answer 14

180/110 (120)

Question 15

if the three main drugs dont work what is the final drug to resort to

Answer 15

spironolactone

Question 16

what drug class is spironolactone

Answer 16

aldosterone receptor blocker

Question 17

How does aldosterone receptor blocker work

Answer 17

it blocks aldosterone at the collecting duct
it increases the Na and H20 excretion

Question 18

what are some side effects of spironolactone

Answer 18

gynaecomastia
hyperkalemia

Question 19

what drug class is amlodipine

Answer 19

dihydropyridine

Question 20

how does amlodipine work

Answer 20

it is a calcium channel blocker and works across all peripheral vasculature

Question 21

what are three side effects of amlodipine

Answer 21

facial flushing
swelling in legs
headaches

Question 22

what class of drug is verapamil

Answer 22

it is a non dihydropyridine
Ca channel blocker

Question 23

how does verapamil work

Answer 23

it is a calcium channel blocker that slows the electrical activity of the heart and decreases the force of contraction

Question 24

what are some side effects of verapamil

Answer 24

• risk of bradycardia
• worsen heart failure as it slows AV conduction and can delay LV function

Question 25

in people of afro- Caribbean descent what would you prescribe

Answer 25

calcium channel blocker first because they are said to have low renin levels so dont want to give ACE inhibitor

Question 26

apart from verapamil what is another calcium channel blocker that could be used when treating hypertension

Answer 26

diltiazem

Question 27

what is another thiazide diuretic that you can give to people

Answer 27

bendroflumethiazide

Question 28

amiloride can be used as an antihypertensive what class of drug is it and where does it act

Answer 28

K sparing diuretic that acts on the DCT

Question 29

what are some drugs you should be cautious of when prescribing amiloride

Answer 29

ramipril trimethoprim (hyperkalemia) furosemide (hyponatremia)

Question 30

Doxazosin is also used as an antihypertensive medication what class of drug is it

Answer 30

alpha adrenoreceptor blocker

Question 31

how does doxazosin work

Answer 31

it is a selective antagonist at the post synaptic a1 adrenoreceptors and antagonises the contractile effects of NA on smooth muscle and reduces TPR

Question 32

bisoprolol can be used to treat hypertension what is its drug class and how does it work

Answer 32

b blocker reduces sympathetic tone by blocking NAD and reducing myocardial contraction reduces CO, slows HR

Question 33

what are some side effects of bisoprolol

Answer 33

raynauds bradycardia

Question 34

who should you be careful about when prescribing B BLOCKERS

Answer 34

asthmatics as it can cause bronchoconsyrictoon

Question 35

what would prescribe when someone is suffering from heart failure

Answer 35

furosemide