Lecture 20 - Antihypertensive Drugs

Question 1

Hypertension is risk of?

Answer 1

stroke, coronary artery disease, renal disease, CVS death

Question 2

Lifestyle changes?

Answer 2

diet (salt), weight loss, exercise, reduce alcohol

Question 3

Problems with treatment?

Answer 3

lifelong, concurrent diseases, perceived benefits, asymptomatic, daily adherence, side effects

Question 4

Diuretics example?

Answer 4

bendrofluazide, chlorthalidone, hydrochlorothiazide

Question 5

Diuretic mechanism?

Answer 5

inhibit Na/Cl in DCT, decrease BP, vasodilator (opens K channels), takes 12wk

Question 6

Thiazide/diuretic side effects?

Answer 6

increased glucose and urate, decreased K, Na and Mg, diuresis, erectile dysfunction

Question 7

Loop diuretics?

Answer 7

e.g. frusemide, inhibit Na/K/Cl cotransporter (ascending LoH), potent diuretic, little antihypertensive effect but potent w ACEi

Question 8

Frusemide PDs?

Answer 8

steep does-response curve, most effective diuretic, little effect on BP as monotherapy

Question 9

Spironolactone?

Answer 9

aldosterone antagonist, inhibits Na/K exchange @ collecting duct; side effects: gynaecomastia, hyperkalaemia, dehydration

Question 10

Decision to treat?

Answer 10

> 160/100, >140/90 plus co-morbidity (diabetes, renal failure), 10 year CVS risk >20%

Question 11

Most effective multi therapy?

Answer 11

thiazide diuretic + ACEi + vasodialtor e.g. bendrofluazide, cilazapril, felodipine