Human aspects of Cardiovascular and Renal Pharmacology: Hypertension Flashcards Preview

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Flashcards in Human aspects of Cardiovascular and Renal Pharmacology: Hypertension Deck (21):
1

Phaeochromocytoma

Adrenaline-secreting tumour of chromaffin cells in the adrenal medulla.
Causes hypertension

2

'Clear' causes of hypertension

Phaeochromocytoma
Renal artery disease

3

'Essential' hypertension

Hypertension with no obvious single cause
Majority of cases

4

Blood pressure in 'mild' hypertension?

Diastolic >90, systolic >140 (compared to ~80 and 120 in a normal adult)

5

Propranolol

Uses?

non-specific β-adrenoceptor antagonist
(Now used little clinically. Non-specific drugs can lead to bronchoconstriction & an asthma-like response)

6

Atenolol

β1-adrenoceptor specific antagonist
Hydrophillic- not very CNS penetrant
Very effective antihypertensive

7

Bisoprolol

β1-adrenoceptor specific antagonist

8

Pindolol

Effects on CO and plasma renin?

non-selective β-adrenergic partial agonist
Causes little change in CO
No effect on plasma renin

9

Prazosin

α1 adrenoceptor antagonist

10

Doxazosin

Mechanism?

α1 adrenoceptor antagonist

Dilates resistance & capacitance vessels
Lack of marked tachycardia- probably due to lack of block of presynaptic α2 receptors
Blockade of CNS α1 receptors modulates baroreceptor reflexes, decreasing sympathetic discharge

11

Phentolamine

Causes non-selective α-adrenoceptor blockade

-> vasodilation and as a result a marked reflex tachycardia
Increased SNS activity also increases renin release

12

Labetalol

α1, β1, and β2 antagonist
(more so β than α)

13

Amlodipine

A dihydropyridine
Ca2+ channel antagonist

Cardiovascular effects, also mild diuretic effect
May inhibit aldosterone release

14

Minoxidil

Potassium channel opener
Acts on ATP sensitive channels in vascular smooth muscle-> hyperpolarisation & relaxation

Sole KCO in general use- used in hypertension. Can be used in severe refractory hypertension.
Causes some hirsutism, some use as a topical hair loss treatment

15

Nicorandil

Potassium channel opener
Used in angina

16

Clonidine

Centrally acting α2/I1 agonist
Decreases blood pressure when microinjected into ventrolateral medulla (area rich in α2 Rs, but effect may be mediated by imidazoline I1 R)

17

Guanfacine

Centrally acting α2/I1 agonist
More potent α2 agonist than clonidine, but low efficiacy as a hypertensive

18

Moxonidine

Centrally acting I1 agonist (antihypertensive)
An imidazoline drug
Fewer side effects than α2 agonists

19

α-methyldopa

Centrally acting α2/I1 agonist
Converted in the vesicles of adrenergic neurons -> α-methylnoradrenaline
Acts as a 'false transmitter'
Less potent than NA on α1, more potent on α2

20

Guanethidine

Sympatholytic
Side effect of postural hypotension

21

Reserpine

Sympatholytic
Produces severe depression