Pharmacology: Hypertension and Cardiovascular Drugs
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Pharmacology: Hypertension and Cardiovascular Drugs

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Questions and Answers

What is the predicted decrease in blood pressure if salt intake is decreased to 0.4g/100g food?

  • 15mmHg
  • 5mmHg (correct)
  • 10mmHg
  • 3mmHg

    • What is the clinical definition of hypertension in individuals over 80 years old?

  • 150/90 mmHg (correct)
  • 170/110 mmHg
  • 140/90 mmHg
  • 160/100 mmHg

    • What is the formula for blood pressure?

  • BP = CO - TPR
  • BP = CO x TPR (correct)
  • BP = CO + TPR
  • BP = CO / TPR

    • Which of the following is NOT a key contributor to the maintenance of blood pressure?

    <p>Respiratory rate</p> Signup and view all the answers

    What is the equivalent of 1 pharmacotherapy in terms of blood pressure reduction?

    <p>5mmHg</p> Signup and view all the answers

    Which hormone is responsible for increasing blood volume by promoting sodium reabsorption in the DCT?

    <p>Aldosterone</p> Signup and view all the answers

    What is the effect of acetylcholine on blood vessels?

    <p>Vasodilation</p> Signup and view all the answers

    Which receptor is involved in the vasodilatory effect of nitric oxide?

    <p>mAChR3</p> Signup and view all the answers

    What is the effect of β-blockers on the renin-angiotensin system?

    <p>Inhibit renin release from the kidney</p> Signup and view all the answers

    Which type of diuretic inhibits Na+ reabsorption in the DCT?

    <p>Thiazide diuretic</p> Signup and view all the answers

    What is the effect of angiotensin II on blood pressure?

    <p>Increases blood pressure</p> Signup and view all the answers

    What is the primary effect of positive inotropes in heart failure?

    <p>Increase the force of cardiac contractions</p> Signup and view all the answers

    What is the mechanism of action of nitrates in heart failure?

    <p>Release of nitric oxide, leading to vasodilation</p> Signup and view all the answers

    What is the primary effect of beta blockers in heart failure?

    <p>Decrease in sympathetic activity</p> Signup and view all the answers

    What is the primary effect of diuretics in heart failure?

    <p>Decrease in blood volume</p> Signup and view all the answers

    What is the primary effect of angiotensin-converting enzyme inhibitors (ACEi) in heart failure?

    <p>Decrease in vascular tone</p> Signup and view all the answers

    What is the primary cause of death in 50% of worst-case heart failure patients within 6 months of diagnosis?

    <p>Sudden cardiac death</p> Signup and view all the answers

    Which type of diuretics inhibit Na+/K+ exchange in the collecting duct and distal convoluted tubule?

    <p>K+ sparing diuretics</p> Signup and view all the answers

    What is the effect of Ca2+ channel blockers on smooth muscle cells?

    <p>Inhibit Ca2+ influx, leading to decreased SMC contraction</p> Signup and view all the answers

    What is the mechanism of action of K+ channel activators?

    <p>Open K+ATP channels, leading to hyperpolarization of the cell</p> Signup and view all the answers

    Which type of diuretic is most likely to cause hyperkalaemia, particularly in renal impairment?

    <p>K+ sparing diuretics</p> Signup and view all the answers

    What is the primary effect of loop diuretics on blood volume?

    <p>Decrease blood volume</p> Signup and view all the answers

    What is the primary effect of vasodilators on blood pressure?

    <p>Decrease blood pressure</p> Signup and view all the answers

    Noradrenaline increases blood pressure by stimulating β1 receptors.

    <p>False</p> Signup and view all the answers

    Atrial natriuretic peptide decreases blood volume by stimulating the release of aldosterone.

    <p>False</p> Signup and view all the answers

    Angiotensin-converting enzyme inhibitors increase blood pressure by converting angiotensin I to angiotensin II.

    <p>False</p> Signup and view all the answers

    β-blockers increase heart rate by stimulating β2 receptors.

    <p>False</p> Signup and view all the answers

    Thiazide diuretics inhibit potassium reabsorption in the distal convoluted tubule.

    <p>False</p> Signup and view all the answers

    Vasodilators decrease blood pressure by increasing systemic vascular resistance.

    <p>False</p> Signup and view all the answers

    Diuretics are primarily used to treat heart failure by reducing blood volume, which in turn decreases cardiac output.

    <p>True</p> Signup and view all the answers

    The equivalent of 1 pharmacotherapy in terms of blood pressure reduction is a 5 mmHg decrease in blood pressure.

    <p>True</p> Signup and view all the answers

    Β-adrenoceptor antagonists (β-blockers) increase heart rate, which in turn increases blood pressure.

    <p>False</p> Signup and view all the answers

    Vasodilators primarily act by increasing cardiac output, which in turn decreases blood pressure.

    <p>False</p> Signup and view all the answers

    Angiotensin-converting enzyme inhibitors (ACEI) are primarily used to treat hypertension by increasing cardiac output.

    <p>False</p> Signup and view all the answers

    The primary effect of positive inotropes in heart failure is to decrease sympathetic activity.

    <p>False</p> Signup and view all the answers

    Beta blockers are used to increase the volume of the circulatory system in heart failure.

    <p>False</p> Signup and view all the answers

    The renin-angiotensin system is activated in response to increased blood volume.

    <p>False</p> Signup and view all the answers

    Vasodilators, such as nitrates, increase the force of contractions in heart failure.

    <p>False</p> Signup and view all the answers

    The mechanism of action of cardiac glycosides, such as digoxin, involves the inhibition of sGC and the production of cGMP.

    <p>False</p> Signup and view all the answers

    The primary effect of diuretics in heart failure is to decrease sympathetic activity.

    <p>False</p> Signup and view all the answers

    Furosemide decreases blood pressure by inhibiting Na+ reabsorption in the distal convoluted tubule.

    <p>False</p> Signup and view all the answers

    K+ sparing diuretics, such as amiloride, prevent hypokalaemia by inhibiting Na+/K+ exchange in the collecting duct and distal convoluted tubule.

    <p>True</p> Signup and view all the answers

    Ca2+ channel blockers, such as nifedipine, decrease blood pressure by activating K+ATP channels.

    <p>False</p> Signup and view all the answers

    Heart failure is defined as a cardiac output that is inadequate to meet the metabolic demands only during exercise.

    <p>False</p> Signup and view all the answers

    VASODILATORS, such as minoxidil, decrease blood pressure by inhibiting Ca2+ influx.

    <p>False</p> Signup and view all the answers

    Bendroflumethiazide is a type of K+ sparing diuretic.

    <p>False</p> Signup and view all the answers

    Study Notes

    Nervous Control of Blood Pressure

    • Blood pressure is regulated by the nervous system through the autonomic nervous system, which controls heart rate, contractility, and vasodilation or vasoconstriction.
    • Noradrenaline (NA) and adrenaline (A) increase blood pressure, while acetylcholine (ACh) decreases it.
    • NA and A work through α1, β1, and β2 receptors, while ACh works through mAChR2 and mAChR3 receptors.

    Blood Volume

    • Blood volume is regulated by hormones, including aldosterone, antidiuretic hormone (ADH), and atrial natriuretic peptide (ANP).
    • Aldosterone and ADH increase blood volume, while ANP decreases it.

    Autonomic Control of Blood Pressure

    • The autonomic nervous system controls blood pressure through the sympathetic and parasympathetic nervous systems.
    • The sympathetic nervous system increases blood pressure, while the parasympathetic nervous system decreases it.
    • Agonists and antagonists of these systems can be used to regulate blood pressure.

    Anti-Hypertensive Drug Classes

    • Diuretics decrease blood volume and blood pressure.
    • Angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) decrease blood pressure by inhibiting the renin-angiotensin system.
    • Β-adrenoceptor antagonists (β-blockers) decrease blood pressure by inhibiting the sympathetic nervous system.
    • Vasodilators decrease blood pressure by increasing blood vessel diameter.

    Anti-Hypertensive Drugs

    • Vasodilators: calcium channel blockers, potassium channel openers, and β-blockers.
    • ACEI: captopril, enalopril.
    • ARB: losartan, eprosartan.
    • Β-blockers: atenolol, propranolol.
    • Diuretics: thiazide diuretics, loop diuretics, potassium-sparing diuretics.

    Heart Failure

    • Heart failure is defined as the inability of the heart to pump enough blood to meet the body's metabolic demands.
    • It can be caused by coronary artery disease, volume overload, pressure overload, and hyperthyroidism.
    • Symptoms include oedema, breathlessness, fatigue, and cardiac hypertrophy.
    • Treatment options include diuretics, vasodilators, β-blockers, and positive inotropes.

    Treatment of Heart Failure

    • Diuretics: decrease blood volume and relieve peripheral oedema.
    • Vasodilators: decrease blood pressure and peripheral resistance.
    • β-blockers: decrease sympathetic activity and cardiac hypertrophy.
    • Positive inotropes: increase the force of contractions and decrease cardiac hypertrophy.

    Feedback Loops

    • Feedback loops regulate blood pressure and cardiovascular function.

    Vasodilators

    • Vasodilators increase blood vessel diameter and decrease blood pressure.
    • Nitrates release nitric oxide, which binds to soluble guanylyl cyclase and produces cGMP, leading to vasodilation.

    Beta Blockers

    • Beta blockers inhibit β1 receptors on the heart, decreasing heart contractility and rate.
    • They also inhibit renin release from the kidney and decrease blood pressure.

    Heart Failure – Positive Inotropes

    • Cardiac glycosides (e.g., digoxin) inhibit Na+/K+-ATPase, increasing the force of contractions.
    • Side effects include arrhythmia, disturbed vision, and GI disturbances.

    Learning Outcomes

    • Describe the mechanism of action in heart failure and hypertension for ACEI, ARBs, aldosterone antagonists, diuretics, vasodilators, beta-blockers, and positive inotropes.

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    Description

    This quiz covers the basics of pharmacology, focusing on hypertension, diuretics, ACE inhibitors, beta-blockers, and vasodilators. Test your knowledge of these cardiovascular drugs and their effects on the body.

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