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34 Cards in this Set
- Front
- Back
How does amiloride work |
Blocks ENAC (where aldosterone activates) can’t go to nucleus to increase transcription. No upreg of Na channels in lumen. Less sodium retention and thus less water retention |
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What receptors does ang2 work on to cause vasiconstriction |
AT1-R |
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How does the sympathetic system cause increase in TPR |
NA binds to alpha-1 receptors in veins and arterioles |
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Who is ACE inhibitors the choice of drug for? |
<55 (not black African/American) |
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When are Ca+ channels first line treatment |
>55 or black/African American |
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If don’t give ACE inhibitor what do you give |
ARB - AT-1 receptor blocker |
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What counts as treatable high blood pressure |
150/95 |
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If already on 2 drugs (ca2+ blocker and ARB) what would be given as a third |
Thiazide like diuretics |
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What’s a side effect of Ace inhibitors |
Dry cough |
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Why does Ace inhibitor cause dry cough |
Inhibits an enzyme that breaks down substance P/ bradykinin. If this builds up surmounts to dry cough |
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Further Side effects of ACE |
First dose hypotension Hyeprkalaemia |
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When are ACE inhibitors contraindicated? |
Renal impairment more specifically bilateral renal artery stenosis |
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Example of ACE inhibitor |
Ramipril |
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Eg of angiotensin receptor blocker |
Losartan |
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Eg of an aldosterone antagonist |
Spironolactone |
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What’s amlodipine |
A calcium channel blocker |
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What’s verapamil |
Ca channel blocker specifically on the heart (IHD) |
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What’s a similar drug to verapamil |
Diltiazem |
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Side effects of Ca channel blockers |
Peripheral oedema Flushing and headaches |
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Why does amlodipine cause peripheral oedema |
Due to loss of control of precapillary sphincter leads to an increase in hydrostatic pressure and less reabsorption |
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Why can you not have grapefruit juice with amlodipine |
It enhanves action of CYP3A4 which breaks down ca2+ blockers |
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Example of thiazide like diuretic |
Indapamide |
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How do thiazide like diuretics work |
They block reabsorption of Na at the DCT Also work on smooth muscle of blood vessels - dilation - by hyper-polarisation |
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Side effects thiazide like diuretics |
Hypokalaemia Increase in urate Increase in blood lipids |
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Why are thiazide diuretics used less frequently |
Increase blood glucose and lipids. Not good if high risk CVD |
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When not to use thiazide like diuretics |
Diabetes |
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Example of beta blocker |
Propranolol |
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Example of beta blocker |
Propranolol |
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Selective b1 antagonist |
Bisoprolol |
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What are beta blockers mainly used to treat |
Angina/ IHD |
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Side effects beta blockers |
TATT - and no reaction to hypoglycaemia/ broncho constriction |
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Alpha 1 antagonist eg |
Doxazosin |
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Alpha 1 antagonist eg |
Doxazosin |
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When is doxazosin used |
BP in men with prostate hypertrophy |