Pharmacology Quiz on Cardiovascular Drugs
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Questions and Answers

Which of the following is a common side effect of ACE inhibitors?

  • Cough (correct)
  • Increased heart rate
  • Hypoglycemia
  • Hyperkalemia

ACE inhibitors are contraindicated in patients with bilateral renal artery stenosis.

True (A)

What is the mechanism of action for Angiotensin Receptor Blockers (ARBs)?

ARBs block the action of Angiotensin II on AT1 receptors, preventing vasoconstriction and aldosterone release.

Spironolactone is an example of a(n) ___________ antagonist.

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

Match the following drug classes with their primary mechanism of action.

<p>ACE inhibitors = Block the conversion of angiotensin I to angiotensin II ARBs = Block the action of angiotensin II on AT1 receptors Calcium Channel Blockers = Block calcium entry into vascular smooth muscle Aldosterone Antagonists = Block the action of aldosterone in the kidneys</p> Signup and view all the answers

Which of the following is a major concern when using ACE inhibitors in patients with impaired renal function?

<p>Increased risk of hyperkalemia (C)</p> Signup and view all the answers

Calcium Channel Blockers (CCBs) primarily target L-type calcium channels in the heart.

<p>False (B)</p> Signup and view all the answers

Explain how Calcium Channel Blockers (CCBs) reduce blood pressure.

<p>CCBs block calcium entry into vascular smooth muscle, leading to relaxation of the muscle and vasodilation. This reduces peripheral resistance, resulting in lower blood pressure.</p> Signup and view all the answers

The ______ is a device that measures out the exact mass of powder using a dosing tube in a dosing chamber.

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

Tamping fingers are used to force plugs of compacted powder through holes in the dosing disc.

<p>True (A)</p> Signup and view all the answers

Which of the following is NOT an advantage of hard capsules?

<p>Increased production steps (A)</p> Signup and view all the answers

What is the primary route of administration for most capsules?

<p>Oral (A)</p> Signup and view all the answers

Match the following components of a softgel shell with their respective functions:

<p>Plasticiser = Increases flexibility and prevents brittleness Water = Maintains the gel's moisture content Opacifier = Adds opacity to the shell Preservatives = Prevents microbial growth</p> Signup and view all the answers

Hard capsules are made of a single piece of shell material.

<p>False (B)</p> Signup and view all the answers

What is the primary form of drug delivery for orally administered softgels?

<p>Systemic drug delivery</p> Signup and view all the answers

The primary component of hard capsule shells is ______.

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

Match the following components of hard capsules with their properties:

<p>Gelatin = Provides structural integrity and dissolves in the digestive tract Water = Essential for gelatin's flexibility and solubility Opacifier (e.g. TiO2) = Gives capsules a white or opaque appearance Dye (e.g. erythrosine) = Provides color for visual identification Plasticiser (e.g. glycerol) = Increases flexibility and prevents brittleness Surfactant (e.g. SLS) = Aids in wetting during capsule formation</p> Signup and view all the answers

A monodisperse population of particles contains particles of varying sizes.

<p>False (B)</p> Signup and view all the answers

Which particle sizing technique is most suitable for measuring particles in the range of 0.001 to 1 mm?

<p>Photon correlation spectroscopy (D)</p> Signup and view all the answers

The ______ method uses a calibrated grid background to measure the projected area, perimeter, Feret's, and Martin's diameters of particles.

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

What is the typical size range for particles that would be classified as 'very fine powder' based on their median size (X50)?

<p>125 mm or less</p> Signup and view all the answers

Match the particle sizing technique to its typical size range:

<p>Sieving = 45 -- 1000 mm Microscopy (light) = 0.2 -- 100 mm Sedimentation rate (gravitational) = 5 -- 300 mm Electrical sensing zone (Coulter Counter) = 0.1 -- 1000 mm Laser diffraction = 0.2 -- 1000 mm Photon correlation spectroscopy = 0.001 -- 1 mm</p> Signup and view all the answers

Which of the following is NOT a symptom of pulmonary hypertension?

<p>Increased appetite (B)</p> Signup and view all the answers

Pulmonary hypertension is a common and easily treatable condition.

<p>False (B)</p> Signup and view all the answers

What is the main type of medication used to treat pulmonary hypertension?

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

Pulmonary hypertension can weaken the ______ side of the heart.

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

Match the following symptoms with their potential causes:

<p>Shortness of breath = Increased pressure in pulmonary arteries Fatigue = Reduced oxygen delivery to the body Dizziness or fainting = Low blood pressure Chest pain = Reduced bloodflow to the heart</p> Signup and view all the answers

What type of microscopy provides 3-dimensional images?

<p>Scanning electron microscopy (A)</p> Signup and view all the answers

The flow rate of powder through an orifice is always higher with larger particles.

<p>True (A)</p> Signup and view all the answers

What is the name of the technology used to measure particle size distribution by analyzing the diffraction pattern of light scattered by the particles?

<p>Laser Diffraction</p> Signup and view all the answers

The use of a ______ can improve powder flow by reducing friction and cohesion between particles.

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

Match the following powder particle size categories with their typical size range (in micrometers).

<p>Granules = 200--500 Coarse powders = 350--1,000 Medium fine powders = 100--350 Fine powders = 50--100 Very fine powders = 10--50 Micronized powders = &lt;10</p> Signup and view all the answers

Which of the following is NOT a factor influencing powder flow rate through an orifice?

<p>Particle color (B)</p> Signup and view all the answers

What is the name of the phenomenon where particles in a powder clump together due to attractive forces?

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

Using a spray drying technique can create more spherical particles, leading to better powder flow.

<p>True (A)</p> Signup and view all the answers

Flashcards

Monodisperse

A population of particles that are all the same size.

Polydisperse

A population of particles that have a range of sizes.

Sieving

A method to classify particles based on their size using a screen or mesh.

Coulter Counter

An electrical sensing zone method used for counting and sizing particles in a fluid.

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Micronised Powder

A powder with a median size of less than 10 mm, often less than 5 mm.

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Cardiac Output

The volume of blood the heart pumps per minute.

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RAAS

Renin-Angiotensin-Aldosterone System, regulates blood pressure and fluid balance.

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ACE Inhibitors

Medications that block the conversion of angiotensin I to angiotensin II, lowering BP.

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Hypotension

Abnormally low blood pressure, can cause fainting.

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Bilateral Renal Artery Stenosis

Narrowing of renal arteries leading to decreased blood flow to kidneys.

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Aldosterone Antagonists

Drugs that inhibit the action of aldosterone, reducing blood pressure.

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Calcium Channel Blockers (CCBs)

Drugs that prevent calcium entry into muscles, causing vasodilation.

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Dihydropyridines

A class of CCBs targeting blood vessel smooth muscle, reducing BP.

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Dosator

A device that measures out exact mass of powder using a dosing tube.

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Tamping Fingers

Tools that force plugs of compacted powder through holes in the dosing disc.

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Advantages of Hard Capsules

Benefits include versatility, product stability, production efficiency, clinical trial blinding, and user acceptance.

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Softgel Shell Material

A continuous soft gelatin shell typically containing plasticizers, water, and sometimes preservatives.

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Softgel Fill Material

Can be in lipophilic or hydrophilic solutions, often using oils or PEG.

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Capsule Definition

Solid dosage forms containing active drug in a shell.

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Oral Administration

Capsules are primarily designed for oral consumption but can also be used for other routes.

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Types of Capsules

The two main types are hard capsules and soft capsules (softgels).

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Hard Capsule Composition

Made of two pieces containing gelatin, water, and additives for structure and stability.

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Capsule Size and Features

Hard capsules consist of a cap and body; smaller diameter body fits into cap.

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Gelatin Sources

Gelatin is hydrolysed collagen from connective tissues like skin and bones.

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Gelatin Types

Two types: A (acid-hydrolysed) and B (alkali-hydrolysed), used for construction of capsules.

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Dosing Systems

Capsules can be filled by dependent (using volume) or independent (weight-based) systems.

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Vasodilators

Medications that relax blood vessels to lower blood pressure.

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α1-antagonists

Drugs that block alpha1 receptors, used to treat hypertension.

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Pulmonary Hypertension (PH)

High blood pressure in the pulmonary arteries, affecting lung function.

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Common Symptoms of PH

Includes shortness of breath, fatigue, chest pain, and dizziness.

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Diagnosing PH

Involves echocardiograms and right heart catheterization.

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Treatment Options for PH

Includes medications, oxygen therapy, and treating underlying conditions.

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Prognosis for PH

Depends on cause, stage, and symptom severity. Early treatment is crucial.

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Risk Factors for PH

Includes lung diseases, blood clots, and conditions affecting pulmonary arteries.

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Light Microscopy

Produces 2-dimensional images of specimens using light.

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Scanning Electron Microscopy (SEM)

Creates 3-dimensional images using electron beams.

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Particle Size Measurement

Uses laser diffraction to determine particle sizes based on light scattering.

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Powders Definition

Solid particles of similar or different chemical compositions, varying in size.

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Flow Rate Through Orifice

Amount of powder discharged through an orifice per unit time.

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Improving Powder Flow

Methods to enhance powder flow, e.g. using larger particles or glidants.

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Effects of Cohesion

Greater shear strength leads to poorer flow due to higher cohesion.

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Glidants in Powders

Additives like SiO₂ that reduce friction between particles for better flow.

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Study Notes

Hypertension Lecture Notes

  • Blood pressure is the force of blood against artery walls, varying with activity, across the day and from day to day.
  • Consistently high blood pressure damages arteries and organs, leading to stroke, heart disease, and kidney disease.
  • Even a 5 mmHg decrease in blood pressure significantly lowers the risk of severe health problems.
  • Consequences of hypertension include stroke, heart failure, erectile dysfunction, vision loss, heart attack and kidney failure.
  • Approximately 1 in 4 people in the UK have high blood pressure, with many undiagnosed cases.
  • The National Health Service (NHS) aims to treat 80% of hypertensive patients by March 25, which requires identifying patients and managing their hypertension..
  • In most cases (90-95%), high blood pressure has no identifiable cause (primary hypertension).
  • Secondary hypertension requires treatment of the underlying cause (e.g., chronic kidney disease, Cushing's syndrome, obstructive sleep apnea, and renovascular disease).
  • Drugs that can cause hypertension include amphetamines, corticosteroids, decongestants, nonsteroidal anti-inflammatory drugs (NSAIDs), and oral contraceptives containing estrogen.

Hypertension in Adults (Diagnosis & Treatment)

  • Patients with blood pressure below 140/90 mmHg require less frequent monitoring.
  • Those with pressures between 140/90 mmHg and 179/119 mmHg require regular ambulatory blood pressure monitoring (ABPM) or home blood pressure monitoring (HBPM) to confirm diagnosis.
  • ABPM/HBPM monitoring alongside clinic measurements will assist in a clinical review to investigate target organ damage.
  • Those with blood pressure 180/120 mmHg or higher need immediate review for target organ damage and starting drug treatment.
  • Patients over 80 with blood pressure consistently above 150/90 mmHg require lifestyle advice and possible drug treatment .
  • Patients under 80 with target organ damage, cardiovascular disease, renal disease, diabetes or a 10-year cardiovascular disease risk of 10% or higher need lifestyle advice and discussion about starting drug treatment.
  • The decision to prescribe drugs or not to treat may need to consider long-term benefits and risks, and consider patient preferences and cardiovascular risk.

Hypertension Case Finding Opportunities

  • Identifying people ≥ 40 years with high blood pressure, not previously diagnosed.
  • Onward referral to General Practice (GP) surgery for appropriate management.
  • Clinic and ambulatory blood pressure checks at the request of a general practice.
  • Promote healthy behaviors to service users by the providing opportunities to support adherence.

Ambulatory and Home Blood Pressure Monitoring

  • ABPM and HBPM are used to obtain blood pressure recordings throughout the day and night, and are an alternative to clinic readings.
  • A minimum of 14 daytime readings are needed for diagnosis.

Lifestyle Advice for Hypertension

  • DASH eating plan (rich in fruits, vegetables, and low-fat dairy products, with reduced fat intake).
  • Regular aerobic exercise (at least 30 minutes a day).
  • Reduced dietary sodium intake (ideally less than 2400mg, ideally 1600mg per day).
  • Moderation of alcohol consumption as needed.
  • Weight loss to achieve or maintain a BMI of 18.5–24.9 where appropriate.

Target Organ Damage Associated with Hypertension

  • Symptoms include albumin-creatinine ratio (ACR), haematuria (blood in the urine), and abnormal blood tests (electrolytes, creatinine, eGFR, liver function, and thyroid function).

Blood Pressure Targets

  • NICE (National Institute for Health and Care Excellence) guidelines recommend specific targets for clinic blood pressure readings for under and above 80 years old, adjusting as needed.
  • Use of ABPM/HBPM targets are also essential to consider.

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Description

Test your knowledge on various cardiovascular drugs, including ACE inhibitors, ARBs, and Calcium Channel Blockers. This quiz covers their mechanisms of action, side effects, and clinical considerations. Perfect for pharmacy students and healthcare professionals alike.

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