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Questions and Answers
What is the primary effect of Captopril as it relates to the renin-angiotensin system?
What is the primary effect of Captopril as it relates to the renin-angiotensin system?
- ACE inhibition leading to vasodilation (correct)
- Increase in angiotensin II production
- Inhibition of aldosterone secretion
- Stimulating renin release
Which statement correctly describes the role of Beta-blockers in treating hypertension?
Which statement correctly describes the role of Beta-blockers in treating hypertension?
- They only affect beta-2 receptors in vascular smooth muscle.
- They are first-line treatments in all hypertensive patients.
- Their use is contraindicated in individuals with asthma and diabetes. (correct)
- They act as vasodilators by directly relaxing blood vessels.
What is the main action of Aliskiren in the context of hypertension management?
What is the main action of Aliskiren in the context of hypertension management?
- Promotion of vasoconstriction
- Inhibition of ACE activity
- Direct renin inhibition (correct)
- Stimulation of aldosterone secretion
Beta-blockers exert their antihypertensive effect primarily through which mechanism?
Beta-blockers exert their antihypertensive effect primarily through which mechanism?
Which of the following is a likely consequence of increased aldosterone secretion?
Which of the following is a likely consequence of increased aldosterone secretion?
What potential complication can arise from using Beta-blockers in hypertensive patients?
What potential complication can arise from using Beta-blockers in hypertensive patients?
Which of the following drugs acts by preventing the breakdown of cGMP?
Which of the following drugs acts by preventing the breakdown of cGMP?
What is the primary mechanism of action for nitrates in terms of vasodilation?
What is the primary mechanism of action for nitrates in terms of vasodilation?
Which of these drugs directly opens potassium channels in vascular smooth muscle cells, leading to vasodilation?
Which of these drugs directly opens potassium channels in vascular smooth muscle cells, leading to vasodilation?
Which of the following is a characteristic of cGMP-mediated vasodilation, compared to cAMP-mediated vasodilation?
Which of the following is a characteristic of cGMP-mediated vasodilation, compared to cAMP-mediated vasodilation?
Which of the following statements is TRUE regarding directly acting vasodilators?
Which of the following statements is TRUE regarding directly acting vasodilators?
What is the common mechanism of action for drugs that increase cAMP levels in vascular tissue?
What is the common mechanism of action for drugs that increase cAMP levels in vascular tissue?
What is the primary mechanism by which calcium channel blockers (CCBs) reduce blood pressure?
What is the primary mechanism by which calcium channel blockers (CCBs) reduce blood pressure?
Which of the following are examples of dihydropyridine calcium channel blockers?
Which of the following are examples of dihydropyridine calcium channel blockers?
Which of the following are common side effects associated with the use of calcium channel blockers?
Which of the following are common side effects associated with the use of calcium channel blockers?
Which of the following is NOT a primary pharmacological strategy to reduce blood pressure?
Which of the following is NOT a primary pharmacological strategy to reduce blood pressure?
What is the mechanism of action of directly acting vasodilators?
What is the mechanism of action of directly acting vasodilators?
Which of the following drugs acts as a directly acting vasodilator, often used in the treatment of pulmonary hypertension?
Which of the following drugs acts as a directly acting vasodilator, often used in the treatment of pulmonary hypertension?
Which of the following describes the mechanism of action of nitrates in reducing blood pressure?
Which of the following describes the mechanism of action of nitrates in reducing blood pressure?
What is the primary mechanism by which phosphodiesterase inhibitors, like milrinone, reduce blood pressure?
What is the primary mechanism by which phosphodiesterase inhibitors, like milrinone, reduce blood pressure?
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Study Notes
Pharmacological Strategies for Hypertension
- Blood pressure (BP) = cardiac output (CO) x peripheral vascular resistance (PVR)
- CO = heart rate (HR) x stroke volume (SV)
- Main strategies to reduce BP:
- Reduce PVR: dilate blood vessels
- Reduce CO: decrease HR, contractile force, or blood volume
Calcium Channel Blockers (CCBs)
- L-type calcium channel blockers
- Reduce Ca2+-dependent contraction in smooth muscle
- Dihydropyridines (e.g., nifedipine, amlodipine) selective for vascular muscle
- Used to prevent vasospasm
Alpha-Blockers
- Doxazosin, prazosin
- a1 adrenoreceptor activation causes vasoconstriction (Gq)
- a1 blockers vasodilatory: ↓PVR
- Effective at reducing BP and very well tolerated; side effects: oedema, postural hypotension, dry mouth
Directly Acting Vasodilators
- Nitrates (e.g., glyceryl trinitrate, nitroprusside): NO → ↑cGMP
- Phosphodiesterase inhibitors (e.g., sildenafil): prevent cGMP breakdown
- Minoxidil: opens K+ATP channels and hyperpolarizes vascular smooth muscle cells
- Hydralazine: MoA unclear; multiple mechanisms?
ACE Inhibitors and Angiotensin Receptor Blockers
- Angiotensin converting enzyme (ACE) inhibitors
- Angiotensin receptor blockers
- Reduce angiotensin II-mediated vasoconstriction and aldosterone secretion
Beta-Blockers
- β1 & β2 antagonists
- Second line hypertension treatment in UK
- Contraindicated in hypertensive individuals with asthma / COPD, diabetes, some arrhythmias
- b1 / b2 receptor antagonism: negative chrono- and inotropic in heart; b2 receptor antagonism: vascular smooth muscle constriction
Side Effects of Vasodilators
- Common side effects of CCBs, alpha blockers, directly acting vasodilators:
- Oedema
- Flushing
- Postural hypotension (dizziness)
- Fatigue
- Reflex tachycardia (baroreceptor response)
- Headache
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