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Medical Pharmacology Exam 3 > Antihypertension > Flashcards

Antihypertension Flashcards

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USMLE® Step 1 flashcards
1
Q

Complementary actions, lower dose, reduced side effects and Improved compliance are all advantages of _ regarding hypertension treatment

A

Combined therapy

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2
Q

What is the short range effect of diuretic therapy? What is the long range effect?

A

Short - reduce extracell. fluid volume and cardiac output

Long - Decrease vascular resistance

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3
Q

What is the major condition where diuretics are used? What is the major adverse effect associated with the use of most diuretics? What are the exceptions to this adverse effect?

A

Congestive heart failure
Potassium depletion
Potassium sparing agents

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4
Q

What are the 3 examples of thiazide diuretics provided? What is their mechanism of action? What class of drug reduces their activitiy?

A

Chlorothiazide, chlorthalidone, hydrochlorothiazide
Block Na/Cl symporter in distal convoluted tubule
NSAIDs

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5
Q

What are 3 adverse effects associated with the use of thiazide diuretics?

A

Hypokalemia
Decreased uric acid secretion
Thiazide and sulfonamide cross reactivity

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6
Q

What is an advantage of using thiazide diuretics in post menopausal women?

A

Reduce calcium excretion good for osteoporosis

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7
Q

What are the 4 examples of loop diuretics provided?

A

Furosemide, ethacrynic acid, bumetanide and torsemide

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8
Q

What is the mechanism of action of loop diuretics?

A

Blocks the Na/2Cl/K cotransporter in the ascending loop

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9
Q

What are 2 major adverse effects associated with the use of loop diurectics?

A

Hypokalemia

Decreased uric acid secretion

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10
Q

What is a major adverse effect associated with the use of ethacrynic acid?

A

Deafness

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11
Q

Regarding K+ sparing diuretics, what are 2 mineralocorticoid receptor antagonists? What are 2 sodium channel blockers?

A

Mineralocort - Spironolactone and eplerenone

Na blocker - triamterene and amiloride

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12
Q

What is the major side effect associated with the use of potassium sparing diuretics?

A

Hyperkalemia

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13
Q

Beyond the kidney, what are 2 additional sources of renin / RAS?

A

Vasculature

Brain

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14
Q

Vasoconstriction of peipheral microvessels, increased thirst, increase sympathetic activation, increased cardiac and vacular remodeling. These are all events mediated by _

A

Angiotensin II actions

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15
Q

What are the 2 hormones by which angiotensin 2 stimulates thirst?

A

Aldosterone and vasopressin (ADH)

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16
Q

What are 5 examples of ACE inhibitors provided?

A

Captopril, enalapril, lisinopril, ramipril and fosinopril

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17
Q

What are the 2 conditions for which ACE inhibitors are used?

A

Mild/moderate hypertension

Heart failure

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18
Q

What are 4 major side effects associated with ACE inhibitors? What is an “annoyance” associated with ACE inhibitors?

A

Hyperkalemia, angioedema, hypotension, rash

Dry cough

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19
Q

What are the 5 examples of angiotensin receptor antagonists provided? What is their receptor target?

A

Losartan, valsartan, candesartan, eposartan, irbesartan

AT1 receptor

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20
Q

What are the 2 major conditions for which angiotensin receptor antagonists are used?

A

Hypertension and Heart failure

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21
Q

What are 2 major side effects associated with angiotensin receptor antagonists? What population, similar to ACE inhibitors, should not use this class of drug? Why?

A

Hypotension, hyperkalemia
Pregnant women
Fetal renal damage

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22
Q

What are 2 distinguishing side effects when comparing ACE inhibitors to AT1R blockers?

A

ACE inhibitors give cough and angioedema, ATIR blockers don’t

23
Q

What is the example of the renin inhibitor provided? What is its mechanism? What is its effect on plasma renin levels?

A

Aliskiren
Blocks the plasma renin receptor
Increases plasma renin

24
Q

What medical condition are renin inhibitors used for?

A

Hypertension

25
Q

What are 4 major side effects associated with renin inhibitors?

A

Diabetic / renal impairment
Hypotension
Dry cough
Hyperkalemia

26
Q

What are the 2 examples of cardioselective calcium channel blockers? What are the 4 examples of vascular smooth muscle selective calcium channel blockers? What calcium channel subtypes are targeted?

A
  • Verapamil, diltiazem
  • Nifedipine, nimodipine, nicardipine, amlodipine
  • L-type voltage sensitive channels
27
Q

What are 2 negative chronotropic calcium channel blockers?

A

Verapamil and Diltiazem

28
Q

What calcium channel blocker is used specifically for cerebral hemorrhage and vasospasm? What medical condition is use of calcium channel blockers contraindicated?

A

Nimodipine

Heart failure

29
Q

What is the example of a beta 1 and 2 combined antagonist provided? What are the 2 beta 1 selective antagonists provided?

A
  • combined: propranolol

- 1 selective: metoprolol and atenolol

30
Q

What 3 populations should avoid the use of beta blockers?

A

Asthmatics
Peripheral vascular disease
Diabetics

31
Q

What are the 3 alpha 1 adrenergic receptor antagonists provided as examples?

A

Prazosin, terazosin and doxazosin

32
Q

By blocking alpha1 receptors on vascular smooth muscles, what is the corresponding effect?

A

Dilation of arterioles and capacitance veins

33
Q

How can water retention be avoid when using alpha1 antagonists?

A

Use with diuretic or beta-antagonist

34
Q

What are the 2 examples of beta and alpha 1 receptor antagonists provided? What 2 conditions are they used for?

A

Labetalol and carvedilol

Hypertension and heartfailure

35
Q

What is the adrenergic tranmssion blocker ised in the treatment of hypertension? What is its mechanism? (2)

A

Reserpine

  • blocks NE reuptake
  • Depletes NE from nerve endings
36
Q

Postural hypotension, sedation, dry mouth, nightmare and mental depression are all side effects associated with _

A

Reserpine

37
Q

What are 3 central mediated anti-hypertensives (i.e. affect brainstem alpha 2 receptors)? What is their effect on these receptors? How do they affect cardiac function?

A
  • Clonidine, alpha-methyldopa and guanabenz
  • Stimulate these receptors
  • Increased vagal activity to heart, decrease vascular resistance
38
Q

Sedation, nightmares, depression, drowsiness, dry mouth nasal stuffiness and postural hypotension. These are all side effects associated with _

A

Centrally acting antihypertensives

39
Q

Hydralazine, minoxidil and diazoxide. These 3 drugs are used as _

A

Vasodialators

40
Q

Nitroprusside, nitroglycerine, epoprostenol and bosentan. These 4 drugs are used as _

A

Vasodialators

41
Q

Among the vasodilators, which 2 are used for hypertension?

A

-hydralazine and minoxidil

42
Q

Among the vasodilators, which 2 are used for hypertensive crisis?

A
  • nitroprusside and diazoxide
43
Q

Among the vasodilators, which 2 are used for pulmonary hypertension?

A
  • Epoprostenol and bosentan
44
Q

Among the vasodilators, which is associated in reflex increase in HR, contractility and cardiac output as well as Lupus?

A

Hydralazine

45
Q

Among the vasodilators, which has preferential effects on arteries?

A

Hydralazine

46
Q

Among the vasodilators, which 2 have preferential effects on arterioles?

A

Minoxidil and diazoxide

47
Q

Among the vasodilators, which has the adverse effects of pericardial effusion, cardiac tamponade, reflex tachycardia and abnormal hair growth?

A

Minoxidil

48
Q

Among the vasodilators, which 2 directly affect potassium channels?

A

Minoxidil and diazoxide

49
Q

What vasodialator has the side effect of fluid retention, hyperglycemia and hyperuricemia?

A

Diazoxide

50
Q

What 2 vasodilators produce nitric oxide and are used for hypertensive emergencies?

A

Nitroprusside and nitroglycerine

51
Q

Which vasodialator reduces preload and afterload and is associated with cyanide accumulation?

A

Nitroprusside

52
Q

What vasodilator is a prostacyclin (PGI2) analogue, mediates vasodilation via cAMP and directly conteracts thromboxane? How must it be administered? What is it used for?

A

Epoprostenol
Continuous infusion
Primary pulmonary hypertension

53
Q

Among the endothelin receptor blockers, which is the non selectove blocker? Which is the ETa specific blocker? What are they primarily used to treat?

A

Bosentan
Ambrisentan
Primary pulmonary hypertension

54
Q

Decreased hematocrit, inhibition of spermatogenesis, hepatic effects are all associated with the use of _

A

endothelin receptor blockers (Bosentan, Ambrisentan)

Medical Pharmacology Exam 3 (13 decks)

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