Hypertension Flashcards
(27 cards)
Give an example of angiotension converting enzyme inhibitor (ACE inhibitors)
ramipril
lisinopril
perindopril
Which class of drug does ramipril belong to?
ACE inhibitor
What is the mechanism of action of ACE inhibitors?
inhibits angiotensin converting enzymes, preventing the conversion of angiotensin 1 to angiotensin 2 by ACE
What is the drug target of ACE inhibitors?
angiotensin converting enzyme
What are the main side effects of ACE inhibitors?
cough, hypotension, hyperkalaemia, foetal injury, renal failure, uritcaria angioedema
Which ACE inhibitor is NOT a pro drug?
lisinopril
What is meant by pro drug (ACE inhibitors)?
require hepatic activation to generate the active metabolites required for therapeutic effects
Should ACE inhibitors be avoided in pregnant people?
Yes, they can cause foetal injury
What two levels should be monitored when prescribing ACE inhibitors?
eGFR and serum potassium
Why is eGFR and serum potassium monitored in a patient on ACE inhibitors?
ace inhibitors are associated with renal failure and hyperkalaemia
Give an example of a calcium channel blocker
amlodipine, felodipine
Which class of drug does amlodipine belong to?
calcium channel blocker
What is the mechanism of action of calcium channel blockers?
blocks L type calcium channel on predominantly vascular smooth muscle which results in a decrease in calcium influx, with downstream inhibition of myosin light chain kinase and prevention of cross bridge action - resultant vasodilation reduces peripheral resistance
What is the drug target of calcium channel blockers?
L type calcium channel
What are the side effects of calcium channel blockers?
ankle oedema, constipation, palpitations, flushing, headaches
Give examples of thiazide/ thiazide like diuretics
bendroflumethiazide (thiazide)
indapamide (thiazide like)
What is the mechanism of action of thiazide/ thiazide like diuretics?
block sodium chloride transporter in the DISTAL CONVOLUTED TUBULE , inhibiting sodium and chloride reabsorption. the osmolarity of tubular fluid increases, decreasing the osmotic gradient for water reabsorption in the COLLECTING DUCT
What is the drug target of thiazide/thiazide like diuretics?
sodium chloride cotransporter
What are the side effects of thiazide/thiazide like diuretics?
hypokalaemia
hyponatremia
metabolic alkalosis (from the increased hydrogenation excretion) ,
hypercalcemia, hyperglycaemia (hyperpolarised pancreatic beta cells) hyperuricemia
How long does it take for thiazide and thiazide like diuretics to lose diuretic effects?
1-2 weeks of treatment
How do thiazides and thiazide like diuretics continue to have antihypertensive effects past two weeks?
vasodilating properties, which are more pronounced for the thiazide like diuretics
Give examples of angiotensin receptor blockers?
losartan, irbesartan, candesartan
What is the mechanism of action of angiotensin receptor blockers?
agents act as a non competitive antagonist at the AT1 receptor found on kidneys and vasculature
What is the drug target for angiotensin receptor blockers?
angiotension receptor AT1 on kidneys and vasculature
