7. Drugs for Hypertension

Question 1

Drug:
Characteristics: competitive antagonist of a1, used in HTN, greater likely hood of stroke and CHF with doxazosin, causes orthostatic hypotension, retrograde ejaculation

Answer 1

prazosin

Question 2

Drug:
Characteristics: similar to prazosin, marketed for benign prostatic hypertrophy and used to help kidney stones pass (wheelchair man with HTN and BPH)

Answer 2

Tamulosin, terazosin (doxazosin)

Question 3

Drug:
Characteristics: a2 agonist, increase in blood pressure via IV, then get stimulation resulting in reduced sympathetic outflow, causes drowsiness, xerostomia, *REBOUND hypertension if dose is missed

Answer 3

Clonidine

Question 4

Drug:
Characteristics: used for gestational hypertension, has a positive coombs test and may have a SLE like syndrome

Answer 4

alpha-methyldopa

Question 5

Drug:
Characteristics: nonselective competetive B1/2 blocker, contraindicated in peripheral vascular dz cause causes cold extremities, bronchospasm/dyspnea, CHF, nightmares

Answer 5

Propranolol

Question 6

Drug:
Characteristics: competitive B1 antagonist, can cause bradycardia, raynauds phenonmon

Answer 6

atenolol

Question 7

Drug:
Characteristics: widely used b1 selective blocker shorter half life than atenolol, extended release, more lipid soluble so more like to produce CNS effects

Answer 7

Metoprolol

Question 8

Drug:
Characteristics: notable for having highest beta1 selectivity

Answer 8

bisoprolol

Question 9

What happens if a daily a2 agonist or b blocker is stopped abruptly?

Answer 9

Deadly rebound hypertension

Question 10

B blockers are no longer used for hypertension, more ACE or ARBS are used. GFR falls due to ACE inhibition resulting in what serum increases in all patients?

Answer 10

creatinine

Question 11

Drug:
Characteristics: competitive inhibitor of angiotensin converting enzyme, 1/2 life is 1.7 hours, can have a cough and angioedema

Answer 11

Captopril

Question 12

Drug:
Characteristics: like captopril, a prodrug with active form availble for iV

Answer 12

enalapril

Question 13

Drug:2
Characteristics: both widely used as ACE inhibitor, longer half life permitting 1x/day dose

Answer 13

benazepril

lisinopril

Question 14

Drug:
Characteristics: used post ACE cough or angioedema, competitive NONPEPTIDE angiotensin II receptor antagonist specific for AT1, 1/2 life 2hrs

Answer 14

losartan

Question 15

Drug:
Characteristics: like losartan, t1/2 is 6-10 hours, is not a prodrug requiring activation, excreted primarily in feces as unchanged

Answer 15

valsartan

Question 16

Drug:
Characteristics: 1/2 life 5-9hours *relatively irreversible binding (artan)

Answer 16

candesartan

Question 17

Drug:
Characteristics: direct renin inhibitor, for HTN, 1/2 life 24 hours, oral route, new expensive no obvious benefits, increased risk of adverse events (not first choice)

Answer 17

Aliskiren

Question 18

Drug:
Characteristics: direct vasodilator of arterioles, dec systemic resistance, Hypertensive emergency in pregnancy, may cause drug induced lupus

Answer 18

Hydralazine

Question 19

Drug:
Characteristics: vasodilation on venous and arteriolar smooth muscle, IV - 1/2 life is 2min*, many side effects- causes cyanide poisoning

Answer 19

Nitroprusside

Question 20

the primary agents for hypertension are thiazides, ACE inhibitors, ARBs, CCB (dihydropyridines) and

Answer 20

CCB nondihydropyridines