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Pharmacology Y2 > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What can hypertension cause in the eyes?

A

Hypertensive retinopathy

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2
Q

What can hypertension cause in the brain?

A

Stroke
Small vessel disease (dementia)

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3
Q

What can hypertension cause in the heart?

A

Atherosclerosis
Heart failure

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4
Q

What can hyper tendon cause in the kidneys?

A

Renal disease

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5
Q

Why is home blood pressure measurement better than measuring blood pressure in the clinic?

A

Removes the factor of ‘white coat syndrome’

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6
Q

List 5 causes of essential (idiopathic) hypertension?

A

Genetics
Salt intake
Alcohol
Sedentary lifestyle
Overweight

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6
Q

List 5 causes of essential (idiopathic) hypertension?

A

Genetics
Salt intake
Alcohol
Sedentary lifestyle
Overweight

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7
Q

List 5 causes of secondary hypertension

A

Coarctation of aorta (narrowing)
Decreased blood flow to kidneys (chronic kidney disease)
Primary aldosteronism
Phaechromocytoma (increased adrenaline release
Cushings syndrome

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8
Q

Heart rate greater than x is classified as hypertensive

A

140/90 mmHg

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9
Q

Heart rate greater than x is classified as severely hypertensive

A

180/110 mmHg

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10
Q

What is radio-femoral delay?

A

When you can feel the pulse in the femoral artery before the radial artery

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11
Q

What is renal bruit?

A

Turbulence in a vessel, can be caused by plaque

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11
Q

What is renal bruit?

A

Turbulence in a vessel, can be caused by plaque

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12
Q

Name 3 factors that would make a group high risk for hypertension

A

1 - pre existing cardiovascular disease
2 - diabetes mellitus
3 - chronic kidney disease

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13
Q

What test is used to check for hypertension in the eyes?

A

Fundoscopy

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14
Q

What test is used to check for hypertension in the brain?

A

CT or MRI (not common)

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15
Q

What test is used to check for hypertension in the heart?

A

ECG
Echocardiodiagram
Cardiac MRI for left ventricular hypertrophy

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16
Q

What test is used to check for hypertension in the kidneys?

A

Renal function test (U&Es)
Urine protein quantification (checks for glomerular damage)

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17
Q

Name the 5 groups of first line drugs used for treatment of hypertension

A

C - calcium channel blockers
A - ACE inhibitors
D - Diuretics
B - Beta blockers
K+ sparing diuretics

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18
Q

Which drug group is always given as a first choice?

A

Calcium channels blockers

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19
Q

Which drug group is always given as a first choice?

A

Calcium channels blockers

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20
Q

Name 3 main calcium channel blockers

A

Amlodipine
Nifedipine
Verapamil

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21
Q

What drug class does amlodipine and nifedipine belong to?

A

Dihydropyridines
Only affects peripheral vasculature

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22
Q

What drug class class does verapamil belong to?

A

Phenylalkyamine
Affects cardiac and peripheral vasculature

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23
Q

Which calcium channel blocker has the longest half life?

A

Amlodipine

24
Q

What are possible side effects of calcium channel blockers?

A

Headache (due to vasodilation)
Tachycardia (baroreceptor reflex)
Ankle swelling (oedema)

25
Q

What determines whether calcium blockers or ACE/ARB are first line treatment?

A

Age
Ethnicity

26
Q

Name 4 most commonly used ACE inhibitors for hypertension treatment

A

Ramipril
Lisinopril
Perindopril
Enalapril

27
Q

Name 4 most commonly used ARB for hypertension treatment

A

Losartan
Irbesartan
Valsartan
Candesartan

28
Q

What are possible side effects of ACE inhibitors and ARBs?

A

Hyperkalaemia
Angioedema
Renal impairment
Cough (only ACE)

29
Q

How can ACE/ARBs cause hyperkalaemia?

A

Reducation of aldosterone -> less ion reabsorption in kidneys of sodium -> less excretion in kidneys of potassium

30
Q

What is the action of beta blockers for reducing hypertension?

A

Blocks beta 1 receptors to reduce renin release
Blocks beta 1 receptors on heart to reduce contractility and chronotropy

31
Q

Name 4 beta blockers used in treatment of hypertension

A

Atenolol
Bisaprolol
Labetalol
Carvedilol

32
Q

Which beta blocker is suitable for use in pregnancy?

A

Labetalol

33
Q

Which 2 beta blockers also block alpha 1 receptors?

A

Carvedilol
Labetalol

34
Q

Which 2 beta blockers are long lasting?

A

Atenolol
Bisaprolol

35
Q

What are side effect so beta blockers used in in hypertension?

A

Bradycardia
Asthma/COPD (contraindication)
Uncontrolled heart failure

36
Q

Which drug is favoured to be used after ACE/ARBs?

A

Thiazide like diuretics

37
Q

Name 3 thiazide/thiazide like diuretics used to treat hyper tension?

A

Bendroflumethiazide
Indapamide
Chlortalidone

38
Q

How do thiazide diuretics treat hypertension?

A

They block sodium and chloride channels on DCT -> less reabsorption of water -> lower circulation volume

39
Q

What are some side effects of thiazide like diuretics?

A

Hyperkalaemia
Hypercalcaemia
Hyponatraemia
Gout
Alkalosis

40
Q

What is the last resort drug after beta blockers that is used for treating hypertension?

A

K+ sparing diuretics

41
Q

How do K+ sparing diuretics treat hypertension?

A

Antagonises aldosterone -> reduces salt and water reabsorption without loss of potassium -> lowers circulating volume

41
Q

How do K+ sparing diuretics treat hypertension?

A

Antagonises aldosterone -> reduces salt and water reabsorption without loss of potassium -> lowers circulating volume

42
Q

Name 3 K+ sparing diuretics

A

Spironolactone
Amiloride
Eplerenone

43
Q

Name 3 K+ sparing diuretics

A

Spironolactone
Amiloride
Eplerenone

44
Q

What its first line drug treatment if under 55 with type 2 diabetes?

A

ACE/ARB

45
Q

What is first line drug treatment if over 55 and not of black Africa/Caribbean origin?

A

ACE/ARB

46
Q

What is first line drug treatment if over 55?

A

Calcium channel blocker

47
Q

What is first line drug treatment if of black African/Caribbean origin of any age?

A

Calcium channel blocker

48
Q

What is the second line of drug treatment?

A

Either ACE/ARBs or CCB, depending on what was given as the first line

48
Q

What is the second line of drug treatment?

A

Either ACE/ARBs or CCB, depending on what was given as the first line

49
Q

What is the third line of treatment for hypertension?

A

Thiazide like diuretics

50
Q

What is the fourth line of treatment for hypertension?

A

Beta blockers

51
Q

What is the 5th line of treatment for hypertension?

A

K+ sparing diuretics

52
Q

Why are patients older than 55 not given ACE/ARB as first line?

A

Renin is suppressed with age, therefore treatments that target the RAAS system will be less effective

52
Q

Why are patients older than 55 not given ACE/ARB as first line?

A

Renin is suppressed with age, therefore treatments that target the RAAS system will be less effective

53
Q

Why are those of black African/Caribbean origin always first line with CCB?

A

There is greater prevalence of high blood pressure in those of African origin, and ACE side effects are more common

54
Q

What patients are eligible for treatment of hypertension?

A

With BP >160/100 mmHg
With BP >140/90 mmHg at high risk
Anyone with a prior cardiovascular event
Anyone that has a secondary cause with accelerated hypertension

55
Q

Is it better to reach the target blood pressure or lower than that?

A

Better to target a lower blood pressure, prevent blood pressure form rising again in the future

56
Q

List 3 methods of measuring blood pressure

A

Home BP test
Clinic BP test
ABPM (ambulatory blood pressure monitoring)

Pharmacology Y2 (9 decks)

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