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cardioresp drugs > HTN > Flashcards

HTN Flashcards

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1
Q

Thiazide diuretics

A

Bendroflumethiazide
Chlortalidone
Indapamide
Metolazone

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2
Q

Bendroflumethiazide drug class

A

Thiazide diuretic

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3
Q

Bendroflumethiazide targets

A

Na+ Cl

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4
Q

where is Bendroflumethiazides target (what part of the kidney)

A

DCT

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5
Q

Bendroflumethiazide moa

A

Inhibits sodium and chloride reabsorption = Natriuresis and reduction in blood volume and pressure

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6
Q

Bendroflumethiazide important side effects

A

electrolyte imbalance

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7
Q

Bendroflumethiazide causes the excretion of

A

sodium, chloride, and water

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8
Q

Bendroflumethiazide may inhibit

A

carbonic anhydrases in the smooth muscle

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9
Q

what does Chlortalidone inhibit

A

odium ion transport across the renal tubular epithelium

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10
Q

where does Chlortalidone work

A

ascending limb of the loop of Henle

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11
Q

what else does Chlortalidone decrease

A

potassium

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12
Q

Chlortalidone class

A

thiazide-like diuretics

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13
Q

Chlortalidone stimulates synthesis of

A

hypotensive prostaglandin PGE2

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14
Q

Chlortalidone blocks

A

rectifier potassium current

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15
Q

Metolazone class

A

thiazide-like diuretics

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16
Q

Metolazone length of action

A

long

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17
Q

Metolazone actions

A

lower BP

potassium loss

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18
Q

Metolazone inhibits

A

sodium reabsorption

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19
Q

where does Metolazone work

A

cortical diluting site

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20
Q

Loop diuretics

A

Furosemide

Bumetanide

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21
Q

Furosemide target

A

Na+ K+ 2Cl symporter

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22
Q

where is Furosemides target in the kidney

A

thick ascending limb of the loop of Henlé

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23
Q

Furosemide moa

A

Prevents the transport of sodium from the lumen of the loop of Henle into the basolateral interstitium. Consequently, the lumen becomes more hypertonic while the interstitium becomes less hypertonic, which in turn diminishes the osmotic gradient for water reabsorption throughout the nephron

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24
Q

important adverse effects of Furosemide

A

Electrolyte distubances
Metabolic disturbances
Ototoxicity; Nephrotoxicity; Hepatic encephalopathy

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25
which part does Furosemide bind to
Chloride binding site
26
Bumetanide drug class
loop D
27
Potassium-sparing diuretics
Amiloride | Spironolactone
28
amiloride moa
inhibits sodium reabsorption predominantly in the collecting ducts
29
how strong is spironolactone
weak
30
spironolactone moa
competing for intracellular aldosterone receptor
31
where in the kidney does spironolactone work
DCT
32
difference between propanolol and atenolol
atenolol does not have a negative inotropic effect
33
high dose atenolol can do what
competitively block beta(2)-adrenergic responses in the bronchial and vascular smooth muscles
34
describe propanolol
non-cardioselective beta-adrenergic antagonist
35
Calcium channel blockers
Amlodipine Felodipine Diltiazem Verapamil
36
amlodipine target
L-type calcium channels (Dihydropyridines favour depolarised closed Ca++)
37
amlodipine moa
Inhibit influx of calcium ions into vascular smooth muscle cells through L-type calcium channels = Decreased arterial smooth muscle contratility leading to vasodilatation
38
common adverse effects of amlodipine
Headache; Tachycardia; Peripheral oedema
39
bad side effect of amlodipine
Heart failure in patients with poor left ventricular function
40
where are depolarised closed Ca++ commonly found
vascular smooth muscle cells
41
Verapamil class
Class IV anti-arrhythmia agent
42
Verapamil inhibits
voltage-dependent calcium channels
43
what happens when Verapamil blocks L type calcium channels
reduction in ionotropy and chronotropy, reducing heart rate and blood pressure
44
how is Verapamil given
IV
45
first line ACE
ramipril
46
what does ACE do
converts angiotensin I to angiotensin II
47
how does angiotensin II work
Stimulation of secretion of aldosterone from the adrenal cortex Stimulation of Vasopression secretion from the posterior pituitary gland. Through direct arterial vasoconstriction
48
angiotensin II affect of hypothalamus
stimulates hypothalamic neurons = thirst
49
what does ACE deactivate
bradykinin
50
ACE side effect
cough
51
Losartan class
angiotensin II receptor blocker
52
good thing about ARBs to ACEi
do not affect bradykinin = no cough
53
Doxazosin class
alpha-adrenergic blocking agent
54
Doxazosin inhibits
selective inhibitor of the α1-adrenoceptors
55
where is Doxazosin target
smooth muscle
56
Spironolactone drug class
Aldosterone-dependent potassium sparing diuretics
57
Spironolactone target
Intracellular aldosterone receptors (mineralocortocoid receptors (MR)) in the renal tubules
58
Spironolactone important adverse effect
Hyperkalaemia Gynaecomastia/hypogonadism, impotence in males, menstrual irregularities AKI
59
when to stop Spironolactone
V and D - dehydration
60
bisoprolol moa
Inhibits binding of noradrenaline, this inhibits activation of adenylyl cyclase enzymes leading to reduced cyclic AMP. This in turn leads to reduced intracellular calcium levels.
61
bisoprolol overall aim on the heart
Reduce contractility, reduce heart rate, reduce blood pressure, reduce cardiac
62
bisoprolol important side effects
``` Hypotension Bronchoconstriction Bradycardia and heart block Hypoglycaemia Peripheral vasoconstriction = intermittent claudication and Raynaud’s phenomenon ```
63
bisoprolol in diabetics risk
may mask hypo symptoms
64
what does cardioselective mean
β1 only
65
examples of cardioselective BB
Atenolol, Metoprolol
66
examples of non cardio selective BB
Carvedilo
67
noradrenaline is released from
released from sympathetic adrenergic neurones
68
Reduced contractility proper name
negative intropy
69
reduce heart rate proper name
negative chronotropy
70
diltiazem drug class
Rate-limiting calcium channel blocker
71
diltiazem target
L-type calcium channels
72
diltiazem moa
Inhibit influx of calcium ions into cardiomyocytes through L-type calcium channels
73
diltiazem affect on heart
Negative inotropic effect – decreases cardiac contractility
74
diltiazem risks
Sino-atrial and AV block
75
ramipril moa
Inhibits synthesis of angiotensin II leading to vascular smooth muscle relaxation and vasodilatation
76
common side effects of ramipril
Persistent dry cough | (First dose) hypotension
77
bad side effects of ramipril
Acute renal failure Hyperkalaemia Angioedema, hypersensitivity reactions
78
what to do if ramipril acuses a cough
swap to ARB
79
when to take first ramipril
night
80
1st line drug in those below 55
Ramipril
81
sartan target
Angiotensin II AT1 receptor
82
sartan side effects
1st dose hypotension
83
sartan bad side effects
Hyperkalaemia | Acute renal failure
84
doxazosin drug class
α1 specific Alpha blockers
85
doxazosin target
Alpha adrenoceptor
86
doxazosin moa
inhibits binding of noradrenaline This inhibits activation of phospholipase-C enzyme leading to reduced inositol triphosphate; this in turn blocks the downstream phosphorylation cascade.
87
doxazosin bad side effect
Postural hypotension

cardioresp drugs (13 decks)

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