PPT 1 Flashcards
Bendroflumethiazide
Thiazide diuretic - blocks Na/Cl reabsorption in the DCT
Oedema and hypertension
Contraindication: diabetes, Addison’s, hypontremia
Can cause hypokalaemia
Indapamide
Thiazide ‘like’ diuretic - blocks Na reuptake at DCT (exact mechanism unclear)
Can cause hypokalaemia
Chlortalidone
For heart failure, hypertension, ascites and diabetes insipidus
Thiazide ‘like’ diuretic - blocks NaCl reuptake in DCT
Furosemide
Loop diuretic - blocks NKCC2 in ascending loop of henle
For oedema and resistant hypertension
Contraindicated in renal failure due to nephrotoxic drugs, severe hypokalaemia and severe hyponatremia
Hypokalaemia can occur with both thiazide and loop diuretics
Bumetanide
Loop diuretic
Used for oedema
Inhibits the Na/K ATPase pump and blocks active reabsorption of Cl and Na in the ascending loop
Amiloride
K sparing diuretic
Inhibits Na uptake in the DCT
Increases Na excretion and thus reduces K+ and H+ excretion
Spironolactone
K sparing diuretic
Competetively inhibits mineralocorticoid receptors in the DCT to promote Na and water loss while sparing K+
Eplerenone
K+ sparing diuretic
Aldosterone/ mineralocorticoid receptor antagonist
Propranolol
Non-selective beta blocker
Causes vasoconstriction, inhibition of vascular endothelial growth factors and down-regulation of RAAS
Bisoprolol
Hypertension and angina
B-blocker - cardioselective B1
*even though it is considered to be cardio-selective, it should still be avaoided in patients with a hx of asthma, bronchospasm or COPD (can be given under specialist supervision)
Atenolol
Cardioselective B1 b-blocker
Hypertension, arrhythmias, migraine
Avoid use in hx of asthma, COPD and bronchospasm
Metoprolol
Cardioselective B1 blocker
Hypertension, angina, arrhythmias, migraine, hyperthyridism adjunct
Avoid if hx of asthma, COPD and bronchospasm
Carvedilol
Beta and alpha 1 blocker
Beta blocker: inhibits exercise induced tachycardia
Alpha blocker: smooth muscle relaxation in vasculature thus lowering peripheral resistance
Hypertension, angina
Avoid in hx of obstructive airway disease and bronchospasm
Amlodipine
Dihydropyridine calcium channel blocker
Selective for peripheral vasculature therefore associated with fewer adverse cardiac effects e.g. myocardial depression and conduction anomalies
Felodipine
Long acting dihydropyridine calcium channel blocker
Angina and hypertension
Acts primarily on smooth muscle cells
Prevents calcium-dependent myocyte contraction and vasoconstriction - reduces cardiac contractility
Diltiazem
Calcium channel blocker - works on the heart and the vasculature
Blocks influx of calcium into cardiac and vascular smooth muscle during depolarisation
Verapamil
Calcium channel blocker
Binds to the alpha1 subunit of L-type calcium channels
** check if it works specifically on the heart or peripheral vessels too**
Ramipril
ACEi
Hypertension, systemic heart failure, MI prophylaxis
Lisinopril
ACEi
Hypertension, short-term post MI, heart failure, renal complications of diabetes
Losartan
Angiotensin II receptor blocker
Used for chronic hert failure when ACE inhibitors are unsuitable or contra-indicated
Candesartan
Angiotensin II receptor blocker
Hypertension & heart failure with left ventricular systolic function when ACEi are not tolerated
Valsartan
Angiotensin II receptor blocker
Hypertension, heart failure when ACEi can’t be used
Contraindications: viliary cirrhosis and cholestasis
Doxazosin
Selectively inhibits post synaptic alpha-1 receptors on vascular smooth muscle thus decreasing peripheral resistance and reduces blood pressure
Hypertension and BPH (relaxes smooth muscle in the prostate and bladder thus relieving frequency, urgency and weak stream)
Tamsulosin
Alpha 1A and 1B blocker
For BPH
