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Pharmacology Y2 > High Blood Pressure > Flashcards

High Blood Pressure Flashcards

(66 cards)

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1
Q

Above what blood pressure is it clinically classified as high blood pressure?

A

140/90 mmHg or higher

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2
Q

What is a normal blood pressure?

A

160/95 mmHg

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3
Q

What is the equation linking blood pressure, peripheral resistance and cardiac output?

A

BP = CO x TPR

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4
Q

What is the equation linking blood pressure, peripheral resistance and cardiac output?

A

BP = CO x TPR

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5
Q

Cardiac output is heart rate x _____ ______

A

Stroke volume

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6
Q

What is the main characteristic of high blood pressure?

A

Increase in peripheral resistance

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6
Q

What is the main characteristic of high blood pressure?

A

Increase in peripheral resistance

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7
Q

Which adrenoreceptor targets the level of sympathetic resistance?

A

Alpha 1 receptors

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8
Q

Why do patients usually have to take multiple drugs to target high blood pressure?

A

Some drugs may only target either heart of vasculature, meaning the baroreceptor reflex may still have a reactive effect to try return the blood pressure to “normal”, which is not desirable

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9
Q

Name 4 areas that can be targeted to reduce the peripheral resistance

A

1- Reduce mean arterial blood pressure
2- Reduce stroke volume
3- Reduce heart rate
4- Increase vasodilation

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10
Q

Define primary hypertension

A

Hypertension with no known mechanism/cause

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11
Q

Define secondary hypertension

A

Hypertension caused by an existing condition

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12
Q

Name 4 conditions that can cause high blood pressure

A

Phaechromocytoma
Primary aldosteronism
Cushings syndrome
Renal glomerulonephritis

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13
Q

Name 2 smooth muscle vasodilators

A

Bendroflumethiazide
Hydralazine

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13
Q

Name 2 smooth muscle vasodilators

A

Bendroflumethiazide
Hydralazine

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14
Q

Is the mechanism of smooth muscle vasodilators known?

A

Unknown how they work, they do not work via diuresis

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15
Q

How does the baroreceptor reflex react to vasodilation?

A

Baroreceptor reflex -> activate beta 1 receptors to increase heart rate and stroke volume -> reversing the effects of low blood pressure

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16
Q

What kind of smooth muscle does hydralazine act on?

A

Arteriolar smooth muscle only

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17
Q

How does RAAS react to vasodilators?

A

Activation of beta 1 -> increases renin release form the kidneys, -> increased angiotensin 2 -> activation of aldosterone -> increases salt and water retention

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18
Q

What may happen to the patient if RAAS is activated in response to a vasodilator?

A

Oedema due to water retention

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19
Q

What type of drug is minoxidil?

A

K+ channel opener

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20
Q

On which cells are K+ channel openers used?

A

Arteriolar smooth muscle cells

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20
Q

On which cells are K+ channel openers used?

A

Arteriolar smooth muscle cells

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21
Q

How does minoxidil act to open K+ channels?

A

Minoxidil blocks ATP from binding to K+ channels, by making the K+ channels bind to sulphonic urea receptors instead - this forces the K+ channels to be open

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22
What is the effect of K+ channel openers?
Causes an efflux of K+ -> which hyperpolarises the membrane -> calcium channels will be closed if the membrane is not depolarised -> prevents smooth muscle contraction from occurring
23
What is another use of K+ openers other than treating high blood pressure?
For treatment of hypertrichosis (baldness)
24
Name 2 Ca2+ channel blockers
Amlodipine Nifedipine
24
Name 2 Ca2+ channel blockers
Amlodipine Nifedipine
25
What is the mechanism of Ca2+ channel blockers preventing vascular smooth muscle contraction?
Calcium channels being blocked prevents calcium influx -> so no muscular contraction occurs -> leading to vasodilation
26
Are nitrovasodilators used for chronic hypertension?
No
27
Give an example of a nitrovasodilator
Sodium nitroprusside
28
What is the mechanism of nitrovasodilators?
NO diffuses into smooth muscles -> increased conversions of GTP to cGMP through guanylate cyclase -> muscular relaxation
29
How is sodium nitroprusside administered?
Through an IV drip
30
What group of drugs is known for being an indirect vasodilator?
Alpha 1 antagonists
31
Name 2 indirect vasodilators that prevent noradrenaline from activating alpha 1 receptors
Prazosin Doxazosin
32
Name a vasodilator that prevents noradrenaline being released form the nerve terminal
Guanethidine
33
What is the mechanism of action of hexamethonium?
Prevents nervous impulse passing from the preganglionic neurones to the post ganglionic neurones -> by binding to nicotinic ACh receptors
34
Why is hexamethonium not used anymore?
Because it affects the sympathetic and parasympathetic pathways so causes adverse effects as well as its desired effect
35
What group of drugs acts by causing diuresis?
K+ sparing diuretics
36
Give an example of a K+ sparing diuretic
Spironolactone
37
What is the mechanism of spironolactone?
Changes expression of Na+/K+ ATPases -> blocks the receptor for aldosterone -> decreases number of ENaC on the cell membrane -> less sodium and water reabsorption -> circulation volume decreases -> blood pressure decreases
38
What group of drugs can act on the central parts of the sympathetic nervous system?
Alpha 2 agonists
39
How do alpha 2 agonists reduce sympathetic outflow?
Alpha 2 receptors causes the reuptake of noradrenaline -> agonists will increase the reuptake of noradrenaline -> prevents nervous impulse form being transmitted -> also inhibits the sympathetic outflow from the RVLM and NTS
40
Where do alpha 2 agonists act to prevent sympathetic outflow to preganglionic neurones?
RostraVentroLateral Medulla Nucleus of Solitary Tract
41
Give an example of an alpha 2 agonist
Clonidine
42
What is one counter action of alpha 2 agonists?
They can also activate the alpha 2 receptors of the post synaptic membrane -> contributes to vasoconstriction
43
Is the amount of vasoconstriction from alpha 2 agonists significant?
No, there is a bigger effect of reducing noradrenaline release and reducing sympathetic stimulation than the small amount fo vasoconstriction
44
Name a false transmitter that reduces sympathetic outflow
Alpha methyl DOPA
45
What is the mechanism of alpha methyl DOPA?
Synthesised through same pathway as noradrenaline -> less noradrenaline packaged into vesicles -> alpha methyl noradrenaline has lower affinity to alpha 1 -> alpha 1 antagonist and alpha 2 agonist -> vasodilation
46
What are side effects of alpha methyl DOPA?
Postural hypotension (blood pressure too low that sympathetic outflow does not increase enough when standing up) Dry mouth (saliva production is inhibited)
47
List the 4 functions of beta adrenoreceptor antagonists
Reduces cardiac output Reduces renin release Reduces sympathetic tone Resets the baroreceptor reflex
48
Is the baroreceptor reflex activated by beta adrenoreceptor antagonists?
No, beta blockers do not cause a reactive mechanism from the baroreceptor reflex
49
Name 3 contraindications of beta receptor antagonists
Asthma Diabetes Peripheral vascular disease
50
How do beta receptor antagonists cause an contraindication to diabetes?
Prevents action of adrenaline -> adrenaline helps indicate whether blood glucose levels are high or low
51
How do beta receptors cause a contraindication to asthma?
Blockage of beta 2 receptors -> cannot activate relaxation of airway smooth muscle
52
How would the RAAS system of the kidneys react to a lower blood pressure?
Reduced perfusion of kidneys -> release of renin into the blood -> angiotensinogen from liver cleaved to angiotensin 1 -> ACE from pulmonary endothelium cleaves angiotensin 1 to angiotensin 2
53
List the effects of angiotensin 2
Increased sympathetic activity Vasoconstriction Reabsorption of ions Releases aldosterone which increases salt and water retention ADH release from pituitary gland
54
Which drugs action prevents renin cleaving angiotensinogen?
Aliskiren
55
Name 3 ACE inhibitors
Ramipril Captopril Enalapril
56
What type of drug is Losartan?
Angiotensin 2 receptor antagonist -> prevent angiotensin 2 from acting on its various receptors
57
What are mineralocorticoid antagonists?
Prevents aldosterone from having its effects on sodium and water retention -> decreases circulating volume -> lowers blood pressure
58
Give an example of a mineralocorticoid antagonist
Amiloride triamterene
59
Do nitrovasodilators cause an increase or decrease in cardiac work/output?
Decreases
60
Do calcium channel blockers affect cardiac muscle and other smooth muscle tissues as well as vascular smooth muscle?
Yes
61
Do calcium channel blockers cause tachycardia?
No
62
What do ACE inhibitors so to the concentration of bradykinin?
Inhibits breakdown of bradykinin so concentration increases

Pharmacology Y2 (9 decks)

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