Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MPharm 2 - PH2113 COPY > Unit 6 - cardiovascular system 4 > Flashcards

Unit 6 - cardiovascular system 4 Flashcards

1
Q

What is the function of angiotensin-converting enzyme?

A

Catalyses the conversion of angiotensin I to potent active vasoconstrictor angiotensin II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where are ACE enzymes found?

A

On the luminal surface of capillary endothelial cells, predominantly in the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which receptor is the target of angiotensin II?

A

AT1

AT2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does the AT1 receptor mediate?

A

Classic angiotensin II actions

  • vasoconstriction
  • aldosterone stimulation
  • renal Na+ and fluid retention
  • ADH (vasopressin) release from posterior pituitary
  • cardiac and vascular muscle cell growth
  • stimulation of thirst centres in the brain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What was the first ACE inhibitor synthesised in 1975?

A

Captopril

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the effects of ACE inhibitors?

A 
Decreased angiotensin II production
- vasodilation
- reduction in aldosterone secretion
- reduction in ADH secretion
- reduced cardiac and vascular hypertrophy
- decrease in Na+ and water retention
- decrease in blood volume
Inhibit bradykinin degredation
- vasodilation via
- NOS/NO
- COX/PGI2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is an ARB?

A

Angiotensin II receptor blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which receptors are important in relation to cardiovascular regulation?

A

AT1 receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the advantages of angiotensin II receptor blockers (ARB’s)?

A

Aren’t associated with dry cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the disadvantages of angiotensin II receptor blockers?

A

No effect on bradykinin

- less effective in low-renin hypertensives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why are angiotensin II receptor blockers (ARBs) more effective at preventing angiotensin II mediated vasoconstriction?

A

They directly target AT1 receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Give some examples of angiotensin II receptor blockers?

A
  • losartan

- candesartan cilexetil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the function of a Ca2+ channel blocker (CCB)?

A

Block voltage gated Ca2+ channel (VGCCs)

- target calcium initiated smooth muscle contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the three classes of L-type Ca2+ channel blockers?

A
  • dihydropiridines
  • benzothiazapines
  • phenylalkylamines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the advantages of using dihyropyridines?

A

More selective for peripheral vasculature

- reduced total peripheral resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the disadvantages of using dihydropyridines?

A

Can lead to reflex tachycardia

17
Q

What is the third major class of antihypertensives?

A

Diuretics

18
Q

How do thiazide diuretics work?

A

Moderately potent

- inhibit Na+ reabsorption in distal convoluted tubule

19
Q

What are the effects of thiazide diuretics?

A

Lower blood and extracellular volume

20
Q

What are the long term effects of thiazide diuretics mediated by?

A

Sensitivity of vascular smooth muscle to vasoconstrictors

  • Ca2+
  • Noradrenaline
21
Q

What are the effects of beta blockers?

A

Decrease sympathetic tone by blocking noradrenaline and reducing myocardial contraction

  • decreased cardiac output
  • decreased renin secretion

Antihypertensive effects

22
Q

Give two examples of beta blockers?

A
  • bisoprolol

- atenolol

23
Q

Which drugs are less effective than other hypertensives at reducing risk of stroke and cardiovascular disease?

A

Beta blockers

24
Q

Why are beta blockers contraindicated in asthmatics?

A

Can cause bronchial vasoconstriction

25
Q

Why should beta blockers be used with caution in diabetics?

A

Mask tachycardia

- sign of insulin induced hypoglycaemia

26
Q

What is the ACD algorithm used for?

A

The treatment of hypertension

27
Q

What is step 1 in the ACD scheme for treatment of hypertension?

A

Younger than 55 years or with type 2 diabetes
- ACE inhibitor or ARB
55 years or older or of Black African/Caribbean descent of any age
- Ca2+ channel blocker
- thiaziade-like diuretic if not tolerated

28
Q

What is step 2 in the ACD scheme for treatment of hypertension?

A

Younger than 55 years or with type 2 diabetes
- ACE inhibitor or ARB
OR
- Ca2+ channel blocker
- thiazide-like diuretic if not tolerated
55 years or older or of Black African/Caribbean descent of any age
- Ca2+ channel blocker
OR
- thiaziade-like diuretic
OR
- ARB or ACE inhibitor

29
Q

What is step 3 in the ACD scheme for treatment of hypertension?

A 
All patients
- ACE inhibitor OR ARB
AND
- Ca2+ channel blocker
AND
- thiazide-like diuretic
30
Q

What is step 4 in the ACD scheme for treatment of hypertension?

A 
All patients
- ACE inhibitor OR ARB
AND
- Ca2+ channel blocker
AND
- thiazide-like diuretic
AND
- low dose spironolactone if blood potassium < 4.5 mmol/L
OR
- alpha blocker or beta blocker if blood potassium > 4.5 mmol/L

MPharm 2 - PH2113 COPY (39 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions