Drugs used in hypertension and heart failure

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  • Created by: SamDavies
  • Created on: 20-04-19 23:11
Main class of diuretic used in hypertension. Examples: bendroflumethiazide, chlortalidone, hydrochlorothiazide, indapamide
Thiazide diuretic
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Class of diuretic used in hypertension with impaired renal function.
Loop diuretic
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Name of an aldosterone antagonist used in resistant hypertension.
Spironolactone
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Class of drug which blocks the conversion of angiotensin I to angiotensin II. Side effects: persistent dry cough, first dose postural hypotension. Examples: ramipiril, perindopril, lisinopril
ACE inhibitor
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Class of drug which blocks the action of angiotensin II at the receptor. Side effects: first dose postural hypotension. Examples: candersartan, losartan, Irbesartan.
ARB
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Name of a renin antagonist.
Aliskiren
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Drug class which blocks beta adrenoreceptors and reduces work of the heart. They are cardioselective but not specific. Side effects: bronchospasms, cold hands + feet, bradycardia, masks hypoglycaemia. Examples: atenolol, bisoprolol, metoprolol
Beta blocker
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Drug class used as add-ons in resistant hypertension that has not responded well to other drugs. Risk of first dose postural hypotension. Examples: doxazosin, indoramin, terazosin
Alpha blockers
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Centrally acting agent that can be used in difficult to treat hypertension. This drug can be used in pregnancy.
Methyldopa
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A subset of calcium channel blockers which block slow Ca2+ channels, promoting vasodilation. Side effects: headache, flushing, swollen ankles, gum atrophy. Examples: amlodipine, felodipine, nifedipine
Dihydropyridines
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A phenylakyl amine which acts as a vasodilator but also reduces heart rate (rate-limiting calcium channel blocker). Can cause constipation
Verapamil
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A benzothiazepine derivative which acts as a vasodilator but also reduces heart rate (rate-limiting calcium channel blocker)
Diltiazem
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A vasodilator used in difficult to treat hypertension which can cause reflex tachycardia and peripheral oedema. It also causes hirsuitism so is not suitable for women.
Minoxidil
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A direct acting arterial and venous dilator-IV-for hypertensive emergency and acute control of blood pressure during anaesthesia.
Sodium nitroprusside
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A cardiac glycoside that is used in atrial fibrillation in pts with co-existing heart failure. It increases contractility by inhibiting Na+K+ATPase so increases intracellular Ca2+ concentration, and reduces heart rate by blocking AV conduction.
Digoxin
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A sympathomimetic which acts on beta 1 receptors in medium doses (causes tachycardia and increased force of contraction) but at high doses works on alpha receptors, causing peripheral vasoconstriction
Dopamine
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A sympathomimetic predominantly acts on beta 1 receptors (with some beta 2 action). Causes less tachycardia than dopamine.
Dobutamine
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A sympathomimetic which works on alpha, beta 1 and beta 2 receptors. Causes massive peripheral vasoconstriction (alpha effects) and strong positive chronotropia (beta effects). Used in cardiac arrest.
Adrenaline
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A drug class that is rarely used in clinical practise anymore due to high mortality rate. It inhibits the degradation of intracellular cAMP, which increases contractility and heart rate. Examples: enoximone, milrinone
Phosphodiesterase inhibitor
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Name of a beta blocker which is licensed for heart failure alongside bisoprolol and nebivolol
Carvedilol
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These two drug classes are used for first line treatment in heart failure.
ACE inhibitors and beta blockers licensed for heart failure
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These two drug classes should be avoided in heart failure because they reduce contractility
Rate limiting calcium channel blockers and short-acting dihydropyridines
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The preferred drug class of diuretic for fluid retention in those with heart failure
Loop diuretic
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Name of an ARB licensed for heart failure alongside candesartan and losartan
Valsartan
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Drug considered in patients with HFrEF who are intolerant of ACE inhibitors and ARBs (particularly those of afro-caribbean origin)
Hydralazine combined with nitrate
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Name of a potassium sparing diuretic used in HFrEF pts who continue to have symptoms of heart failure
Spironolactone
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A drug used in specialist treatment for HFrEF in those with left ventricular ejection fraction of <35% and who are taking a stable dose of ACEi or ARBs
Sacubitril valsartan
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A drug recommended in specialist treatment for worsening or severe heart failure due to LVSD. Do not monitor serum drug concentrations routinely - only if toxicity is suspected.
Digoxin
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A drug given under specialist treatment for heart failure which inhibits the If channels in the SA node to slow heart rate. Avoid grapefruit juice. Side effects: temporary brightness in field of vision, breathlessness, fatigue, arrhythmia
Ivabradine
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Other cards in this set

Card 2

Front

Class of diuretic used in hypertension with impaired renal function.

Back

Loop diuretic

Card 3

Front

Name of an aldosterone antagonist used in resistant hypertension.

Back

Preview of the front of card 3

Card 4

Front

Class of drug which blocks the conversion of angiotensin I to angiotensin II. Side effects: persistent dry cough, first dose postural hypotension. Examples: ramipiril, perindopril, lisinopril

Back

Preview of the front of card 4

Card 5

Front

Class of drug which blocks the action of angiotensin II at the receptor. Side effects: first dose postural hypotension. Examples: candersartan, losartan, Irbesartan.

Back

Preview of the front of card 5
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