Drugs for Hypertension and Heart Failure Flashcards Preview

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Flashcards in Drugs for Hypertension and Heart Failure Deck (19)
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1
Q

Name the types of drugs used to treat hypertension

A

ACE inhibitors

Angiotensin-II antagonists and ARBs

Calcium channel blockers

Alpha receptor blockers

Beta receptor blockers

2
Q

What are the effects of an ACEi

A

Vasodilation

Reduced aldosterone release

Reduced ADH release

Reduced cell growth and proliferation

3
Q

Name some ACEi

A

End with suffix -pril

Catopril

Enalapril

Lisinopril

Ramipril

4
Q

Name some common side effects of ACEi

A

Persistant dry cough

Angioedema

Renal failure

Hyperkalaemia

5
Q

Name some ARBs

A

End with the suffix -sartan

Losartan

Candesartan

Eprosartan

Irbesartan

6
Q

Name some side effects of ARBs

A

Renal failure

Hyperkalaemia

7
Q

What are the type of CCBs ,and where and how do they act

A

Dihydropyridines - selective for peripheral vasculature. Cause vasodilation

Phenylalkylamines - affect myocardium. Depress SA node and slow AV condution. Cause -ve inotropy and -ve chronotropy

Benzothiazepines - affect vasculature and myocardium

8
Q

Name some dihydropyridines

A

Named using suffix -ipine

Amlodipine

Nifedipine

Nicardipine

9
Q

What are the adverse effects of dihydropyridines

A

SNS activation and tachycardia

Palpitations

Flushing

Sweating

Throbbing headache

Oedema

Interaction with amlopidine and simvastatin causes an increased plasma concentration of simvastatin

10
Q

Name a phenylalkylamine and name some adverse effects

A

Verapamil

Adverse effects:

Constipation

Risk of bradycardia

Negative inotropic effect can worsen HF

11
Q

Name a benzothiazepine and name some adverse effects of the drug

A

Diltiazem

Adverse effects:

Bradycardia

Negative inotropy which can worsen HF

12
Q

Why should a patient of African or Caribbean origin with hypertension be treated with CCBs or a thiazide-like diuretic first instead of being treated with an ACEi/ARB

A

Patients with an African or Caribbean origin have lower levels of renin activity so use the CCBs or thiazide-like diuretics first instead of ARBs/ACEi

13
Q

How do alpha-adrenoreceptor blockers work and give an example of one

A

Alpha-receptor blockers work by antagnoising alpha-1 receptors and antagonise contractile effects of NA on vascular SM

Example is doxazosin

14
Q

Name some adverse effects of alpha-receptor blockers

A

Postural hypotension

Headache and fatigue

Oedema

15
Q

How do beta-receptor blockers work and give an example of one

A

Beta-receptors blockers work by decreasing sympathetic tone by blocking NA and reducing myocardial contraction -> decrease CO

Are an add on in hypertension

E.g. bisoprolol

16
Q

Name some adverse effects of beta-receptor blockers

A

Bronchoconstriction

Mask tachycardia

Lethargy and imparied concentration

Decreased exercise tolerance

Bradycardia

Raynaud’s - cold hands

17
Q

Name some inherited and acquired causes of heart failure

A

Inherited - congenital hypertrophic CM, arrhythmogenic RV CM

Acquired - ischaemic CM, pressure overload, valve disease, infection, inflammation, alcohol

18
Q

What are the aims of heart failure treatment

A

To reduce symptoms

Managed increase in exercise tolerance

Decreased mortality

Address arrhythmias, hyperlipidaemia and diabetes

19
Q

What drugs can be used to treat HF

A

ACEi and ARBs - ACEi mainly but if they cannot be tolerated, then give ARB

Give spironolactone (aldosterone antagonist) if patient has hyperaldosteronism or as an adjunct along with ACEi and diuretic

Beta-receptor blocker for all patients with stable HF, unless contraindicated or not tolerated. Introduce once ACEi or ARB is initiated

May use digoxin - produces symptomatic benefits