cardiovascular drugs

Question 1

Regulation of TPR by noradrenaline and RAAS

Answer 1

Noradrenaline -> alpha 1 -> IP3 -> Ca2+ -> constriction

Ang II -> IP3 -> Ca2+ -> constriction

Question 2

How does SNS increase frequency and force of contraction

Answer 2

Via Beta-1 receptors -> cAMP -> increased Ca2+ -> increased rate/force

Question 3

How does PNS decrease frequency

Answer 3

Decrease cAMP via M2 receptors

Question 4

What receptors allow constriction of venules

Answer 4

AT1-R

Question 5

What allows regulation of TRP

Answer 5

Ang II and Noradrenaline (SNS)

Question 6

Who to not give an ACE inhibitor to

Answer 6

> 55 years old (give calcium channel blocker)
African Americans
Those with co-existing diseases

Question 7

Problems with ACE inhibitors

Answer 7

Hyperkalaemia
Renal impairment (ACE inhibitor prevents constriction of efferent arteriole - becomes dilated)
Prevent substance P and bradykinin being down -> coughing

Question 8

Angiotensin receptor blockers ARBs - action (tartan ending drugs)

Answer 8

Block actions of Ang II on AT1-R

Minimal side effects

Question 9

Example of an aldosterone antagonist

Answer 9

Spiralactone

Question 10

What is primary aldosteronism

Answer 10

A hormonal disorder that leads to high blood pressure

Question 11

Mechanism of action of Ca2+ channel blockers

Answer 11

Target L type ca2+ channels on smooth muscle of arterioles and relax them

Question 12

Classes of Ca2+ channel blockers

Answer 12

Dihydropyridines (amlodipine)
Phenylalkylamines (verapamil)
Benzothiazepines (diltiazem)

Question 13

Side effects of Calcium channel blockers

Answer 13

Peripheral Oedema
Flushing and headaches
Grapefruit juice enhances action

Question 14

Mechanism of action of thiazide diuretics

Answer 14

Block sodium chloride co transporter in DCT

Sometimes activation of K(ATP) channels - smooth muscle dilation of arterioles decrease BP

Question 15

Side effects of thiazide diuretics

Answer 15

Hypokalaemia
Increase in urate
Increase in glucose and blood lipids (not used in diabetics)

Question 16

How do thiazide diuretics increase blood glucose

Answer 16

Open K(ATP channels) inhibit opening of Ca2+ channels, preventing release of insulin

Question 17

Side effects of beta blockers

Answer 17

Fatigue
Vasoconstriction of smooth muscle cells
Bronchoconstriction
Hypoglycaemia - low blood glucose activates release of adrenaline - mobilising glucose release from liver

Question 18

Types of beta blocker

Answer 18

Non selective (beta 1 and 2)
Selective (beta 1)

Question 19

Vasodilator example

Answer 19

Alpha-1 antagonists

Question 20

What is alpha 1 antagonists used to treat

Answer 20

Benign prostatic hypertrophy

Question 21

Alpha 1 antagonists mechanism of action

Answer 21

Block the pathway:

NA-> alpha 1 -> IP3 -> Ca2+ -> constriction