Anti-Hypertensives (Exam VI)

Question 1

Lisinopril

Answer 1

RAAS inhibitor; ACEi
Uses: CHF, HTN, diabetic renal disease
Tox: bradykinin cough reflex, hyperkalemia, teratogenic

Question 2

Valsartan

Answer 2

RAAS inhibitor; AT-II receptor antagonist
Uses: CHF, HTN
Tox: hyperkalemia, teratogenic
Notes: no bradykinin cough reflex

Question 3

Metoprolol

Answer 3

Beta-1 adrenergic receptor antagonist
Uses: CHF, HTN
Tox: bradycardia, AV block, CNS sedation
Notes: fewer bronchial effects

Question 4

Labetalol

Answer 4

Alpha-1 Beta-1 adrenergic receptor antagonist
Uses: pregnancy-induced HTN, hypertensive crisis
Tox: bradycardia, AV block, CNS sedation
Notes: 4 stereoisomers

Question 5

Doxazosin

Answer 5

Alpha-1 adrenergic receptor antagonist
Uses: benign prostatic hypertrophy (BPH), HTN
Tox: orthostatic hypotension, reflex tachycardia
Notes: used in unresponsive HTN patients

Question 6

Clonidine

Answer 6

Alpha-2 adrenergic receptor antagonist
Uses: ADHD, HTN
Tox: severe withdrawal, sedation
Notes: penetrates CNS

Question 7

Verapamil

Answer 7

Cardioselective L-type Ca2+ channel blocker
Uses: angina, arrhythmias, HTN
Tox: excessive cardiac depression, constipation

Question 8

Amlodipine

Answer 8

Vascular selective L-type Ca2+ channel blocker
Uses: angina, arrhythmias, HTN
Tox: hypotension, flushing, dizziness

Question 9

Hydrochlorothiazide

Answer 9

Diuretic; inhibits NCC pump
Uses: CHF, hypercalcinuria, HTN
Tox: hypokalemic metabolic alkalosis
Notes: distal convoluted tubule; slow onset of action

Question 10

Furosemide

Answer 10

Diuretic; inhibits NKCC2 pump
Uses: edema, hypercalcemia, HTN
Tox: hypokalemia, ototoxicity
Notes: thick ascending limb of Henle; rapid onset of action

Question 11

Ambrisentan

Answer 11

Endothelia-A receptor antagonist
Uses: pulmonary hypertension
Tox: hepatic impairment, headache
Notes: 100x selective for endothelinA over endothelinB

Question 12

Hydralazine

Answer 12

Vascular smooth muscle K+ channel activator
Uses: hypertensive crisis, pregnancy induced hypertension, heart failure
Tox: tachycardia, salt + water retention
Notes: can cause Lupus-like syndrome

Question 13

Sildenafil

Answer 13

PDE5 inhibitor
Uses: pulmonary hypertension, angina, erectile dysfunction
Tox: tachycardia, hypotension, vision disturbances
Notes: contraindicated with nitrovasodilators

Question 14

Epoprostenol

Answer 14

Prostacyclin I2 analogue
Uses: pulmonary hypertension, Raynaud’s syndrome
Tox: hypotension, flushing, dizziness
Notes: contraindicated with nitrovasodilators