Drugs and the vasculature Flashcards
Which type of blood vessel has the greatest influence on BP?
Arterioles
Recall the meanings of the abbreviations ARB, CCM and TLD
Angiotensin-receptor blocker
Calcium-channel blocker
Thiazide-like duiretic
Recall the options for first-line treatment of hypertension in the <55 and >55 age groups
<55: ACEi or ARB
>55s: CCB or TLD
What must you take into account when treating the afrocaribbean population for hypertension?
Afrocaribbeans have low renin so will be less responsive to ACEi/ARB
Why is anti-hypertensive treatment different for <55s and >55s?
> 55s have low renin
What is the last consideration for anti-hypertensive therapy once the patient has tried combinations of ACEi/ARB/CCB/TLD?
Low dose spironolactone or an alpha/beta blocker
What are the 2 main effects of ACEi on the vasculature?
- Reduces angiotensinogen
2. Reduces bradykinin breakdown
Why is it beneficial to reduce the concentration of angiotensinogen in hypertensive patients?
Decreases renal perfusion pressure so kidney damage risk reduced
Other than hypertension, what can ACEi be used to treat and why?
Heart failure as they reduce salt and water resorption –> decreased venous return –> decreased preload
Recall 2 side effects of ACEis
Cough (due to reduced bradykinin breakdown)
Hypotension
Why are ARBs generally better tolerated than ACEis?
No cough SE
Recall which conditions the following drugs are most useful for treating: ACEi, CCB, TLD
ACEi - heart failure
CCB - stroke
