drugs affecting vasculature and blood

Question 1

nitrates use

Answer 1

angina

acute coronary syndrome

Question 2

nitrates main effect

Answer 2

venorelaxation but arterial dilation at higher doses

Question 3

nitrates mechanism

Answer 3

formation of NO, which inc intracellular cGMP, which activates PKG causing relaxation

Question 4

nitrates AE

Answer 4

headache
hypotension 
fainting 
reflex tachycardia 
tolerance

Question 5

nitrates - control side effect of reflex tachycardia

Answer 5

prescribe with beta blockers

Question 6

antagonists of endothelia

Answer 6

bosentan and ambrisentan

Question 7

what are endothelia antagonists used in

Answer 7

pulmonary hypertension

Question 8

renin inhibitor

Answer 8

aliskiren

Question 9

ACE inhibitor

Answer 9

lisinoPRIL

Question 10

what do ACE inhibitors block

Answer 10

conversion of AGT1 to AGT2

Question 11

ARB

Answer 11

loSARTAN

Question 12

ACE effect

Answer 12

cause venous dilation - dec preload

and cause arteriolar dilation - dec afterload

Question 13

ACE - what can happen on first dose

Answer 13

steep fall in BP

Question 14

ACE - specific AE

Answer 14

dry cough - inc in bradykinin

Question 15

ACE - AE

Answer 15

renal failure
angioedema
hyperkalaemia

Question 16

ARB effect

Answer 16

similar to ACE but don’t cause dry cough

Question 17

ACE and ARB contraindicated in

Answer 17

pregnancy - where hypertension is common

Question 18

clinical use of ACE and ARB

Answer 18

hypertension

heart failure following MI

Question 19

Ca channel blocker action

Answer 19

inhibit L type Ca channels in SM causing relaxation and vasodilation by blocking entry of Ca into cell

in the myocardium they also produce a negative inotropic effect b reducing calcium influx in phase 2 of the actin potential

Question 20

dihydropiridines

Answer 20

amlodipine

Question 21

amlodipine AE

Answer 21

ankle oedema and headache

Question 22

amlodipine affinity

Answer 22

vascular muscle

Question 23

rate limiting

Answer 23

verapamil and diltiazem

Question 24

verapamil selectivity

Answer 24

cardiac L type channels

Question 25

verapamil effect

Answer 25

slows conduction of the AV node | negative inotropic effect

Question 26

what shouldnt one use Ca blockers with

Answer 26

beta blockers

Question 27

clinical uses of calcium channel blockers

Answer 27

hypertension arrhythmias angina

Question 28

what must you avoid using verapamil in

Answer 28

heart failure

Question 29

adverse effects of calcium channel blockers

Answer 29

AV block tachycardia verapamil - constipation excessive vasodilation - hypotension, dizzy, flashing, ankle oedema

Question 30

K channel openers

Answer 30

minoxidil and nicorandil

Question 31

minoxidil use

Answer 31

severe hypertension - last resort

Question 32

minoxidil AE

Answer 32

``` reflex tachycardia (B blocker prevents) and salt and water retention inc hair growth ```

Question 33

nicorandil use

Answer 33

angina resistant to other treatments

Question 34

K channel openers AE

Answer 34

mouth gut ulcers

Question 35

A1-Adrenoceptor Receptor Antagonists

Answer 35

prazosin and doxazosin

Question 36

a1 ADR A use

Answer 36

hypertension | benign prostatic hyperplasia

Question 37

a1 ADR A AE

Answer 37

postural hypotension

Question 38

diuretics effect

Answer 38

inc excretion Na, CL and H2O

Question 39

thiazides act on

Answer 39

distal tubule - inhibit NaCl reabsorption

Question 40

which produce a stronger diuresis

Answer 40

loop agents

Question 41

diuretics cause an undesirable loss of what

Answer 41

K | leads to hypokalaemia - tired, stimulus for cardiac arrhythmias, metabolic alkalosis

Question 42

diuretics AE

Answer 42

hyperglycaemia - diabetes impotence inc uric acid - gout

Question 43

loop diuretics can cause what

Answer 43

hyponatraemia

Question 44

what are thiazides used in

Answer 44

mild heart failure and hypertension

Question 45

what are loop diuretics used in

Answer 45

acute pulmonary oedema, peripheral oedema and chronic heart failure good in LVF

Question 46

K sparing diuretics

Answer 46

spironolactone

Question 47

spironolactone clinical use

Answer 47

severe chronic heart failure resistant hypertension ascites due to cirrhosis

Question 48

spironolactone AE

Answer 48

hyperekalaemia, gynaecomastia and renal dysfunction

Question 49

spironolactone suitable alternative

Answer 49

amiloride