hypertensive drugs

Question 1

thiazide diuretics

• example
• mechanism

Answer 1

e.g. bendrofluazide

inhibits tubular reabsorption in distal tubule causing natriuresis (blocks Na/Cl channel in DCT)

effects of resistance vessels (opens K channels & hyper polarise) = vasodilation

activates RAAS therefore given with ACEi

Question 2

side effects of thiazide diuretics

Answer 2

• increased glucose
• gout
• decreased K. Na, Mg
• erectile dysfunction

Question 3

loop diuretics

• example
• mechanism

Answer 3

e.g. flusemide

inhibit Na/K/Cl co-transporter in ascending loop

potent diuretic, little anti-hypertensive effect alone (used with ACEi)

Question 4

side effects of loop diuretics

Answer 4

• dehydration

- low serum level of cations

Question 5

K-sparing diuretics

• example
• mechanism

Answer 5

e.g. spironolactone

antagonist of aldosterone (inhibiting Na/K exchange in collecting duct giving natriuresis)

Question 6

side effects of K-sparing diuretics

Answer 6

• hyperkalaemia
• dehydration
• gynaecomastia

Question 7

medication used and not used for hypertension in pregnancy

Answer 7

medicines used = labetalol, nifedipine, methyldopa

avoid = ACEi, AIIA, atenolol, diuretics

Question 8

treatment for hypertension

Answer 8

• lifestyle changes
• diet
• weight loss
• exercise
• reduce alcohol
• drug therapy (e.g. polypharmacy)

Question 9

potential problems with treatment

Answer 9

• is a lifelong disease
• concurrent diseases
• perceived benefits of treatment
• hypertension is asymptomatic
• adherence
• side-effects

Question 10

effective therapy

Answer 10

effective triple therapy

= thiazide diuretic, ACEi, vasodilator (alpha blocker, Ca channel blocker)