Pharmacology

Question 1

How many times a day do we aim to take an anti hypertensive drug?

Answer 1

Once a day

Question 2

What are the 4 types of anti hypertensive drugs?

Answer 2

• Beta blockers
• Diuretics
• Vasodilators
• Inhibitors of renin -angiotensin-aldosterone axis

Question 3

What are beta blockers competing with?

Answer 3

• Noradrenaline
• Adrenaline

Question 4

What do NAdr and Adr stimulate when they bind to the beta receptors?

Answer 4

Sympathetic nervous system

Question 5

Are the beta blockers used for hypertension selective or non-selective?

Answer 5

Selective for the beta 1 receptors

Question 6

Why is important that the beta blockers are selective?

Answer 6

This minimises the side effects of the drugs

Question 7

Give two of the common side effect that you will experience with beta blockers?

Answer 7

Cold hands and fatigue

Question 8

Give two of the less common side effects of beta blockers

Answer 8

Cardiac depression and bronchospasm

Question 9

What’s the basis of the diuretic drugs?

Answer 9

To reduce salt and water reabsorption from the glomerulus and increase excretion of sodium and water.

Question 10

Where do the diuretics take action in the nephron?

Answer 10

Loop of Henle and distal convoluted tubule

Question 11

What areas of the nephron are permeable to water?

Answer 11

Descending limb and distal convoluted tubule

Question 12

What areas of the nephron are impermeable to water?

Answer 12

Thick ascending limb

Question 13

Where do the loop diuretics take action?

Answer 13

In the ascending limb, and they block the Na/K/Cl transporter

Question 14

Where are the basolateral Na/K pumps?

Answer 14

In the distal convoluted tubule

Question 15

How do you increase the expression of basolateral Na/K pumps and their activity

Answer 15

You have to activate the mineralcorticoid receptors by aldosterone binding to it

Question 16

What does spironolactone block?

Answer 16

Aldosterone binding to the mineralcorticoid receptors

Question 17

How do K sparing drugs work?

Answer 17

Block aldosterone from binding to the MR which increases the excretion of Na and H2O while preserving K in the circulation

Question 18

What are the three different types of diuretics?

Answer 18

Loop diuretics, thiazide diuretics and aldosterone antagonists

Question 19

What type of diuretics have the highest diuretic potency?

Answer 19

Loop diuretics

Question 20

What diuretics have the lowest diuretic potency?

Answer 20

Aldosterone antagonists

Question 21

What diuretic drug could cause fatal hyperkaelemia?

Answer 21

Aldosterone antagonist

Question 22

What levels should you monitor for patients that are on diuretics?

Answer 22

Serum electrolyte and creatinine levels

Question 23

What’s the overall mechanism of the vasodilators?

Answer 23

They dilate arteries and arterioles to reduce the role peripheral resistance

Question 24

Is calcium needed to maintain muscle constriction or not?

Answer 24

No it’s not needed to maintain it, but it’s needed to activate it

Question 25

What are the two GPCRs that are involved with vasodilator drugs?

Answer 25

Alpha adrenoceptor and angiotensin 1 receptors

Question 26

When the GPCRs get activated in the smooth muscle (to cause muscle constriction) and activate PLC, what does the PLC release?

Answer 26

IP3 and DAG

Question 27

What channels on the membrane can allow calcium to enter the cell?

Answer 27

Chloride channels, K channels, voltage operated Ca channels (VOCC)

Question 28

Are alpha adrenorecptor blockers used as first line vasodilators or not?

Answer 28

No, but they do work well in combination with other drugs

Question 29

What are the 2 most commonly prescribed alpha adrenorecptor blockers?

Answer 29

Doxazosin and terazosin

Question 30

What’s the main side effect of alpha adrenorecptor blocker?

Answer 30

Postural hypotension

Question 31

What are the 3 types of calcium antagonists?

Answer 31

Dihydropyridines, phenylalkylamines and benzothiazepines

Question 32

Where do Dihydropyridines selectively bind?

Answer 32

Smooth muscles

Question 33

Where do phenylalkylamines selectively bind?

Answer 33

Cardiac muscles

Question 34

Where do benzothiazepines selectively bind?

Answer 34

They poorly discriminate between cardiac and smooth muscle channels

Question 35

What’s the first line treatment for patients under 55 who are not of black African or black Caribbean origin?

Answer 35

Angiotensin 1 receptor blockers

Question 36

What’s ACE inhibitors biggest side effects?

Answer 36

Persistent dry cough

Question 37

What is a side effect of ACE inhibitors that will wear off over time?

Answer 37

Hypotension

Question 38

When ACE inhibitors are administered with diuretics what’s the side effect?

Answer 38

Severe hypotension

Question 39

What should be monitored when your patient is on renin-angiotensin-aldosterone blocking drugs?

Answer 39

Creatinine levels, to check for renal damage

Question 40

What do ACE inhibitors block?

Answer 40

The conversion of angiotensin 1 to angiotensin 2