Antihypertensive agents

Question 1

Diuretics used for hypertension

Answer 1

hydroclhorothiazide, chlorthalidone (better due to longer duration of action)

Question 2

MOA of diuretics

Answer 2

initially decrease vascular volume

long-term indirectly decreases TPR through depletion of calcium

Question 3

Dosing of Thiazides

Answer 3

low dose monotherapy lowers BP 10-15mm, takes 4-6 weeks

in combination with other antihypertensives reduces Na+ and water retention caused by vasodilators and sympatholytics

Question 4

Adverse effects of Thiazides

Answer 4

Hypokalemia (reduce sodium uptake)
Hyperuricemia (goat)
Hyperglycemia, hyperlipidemia
Erectile dysfunction

Question 5

Prototype of loop diuretics

Answer 5

furosemide (not often used)

Question 6

Aldosterone antagonist prototype

Answer 6

Spironolactone (K+ sparring and survival benefit)

Question 7

MOA of ACE inhibitors

Answer 7

inhibits ACE and bradykinin degradation

Question 8

Prototype ACE inhibitors

Answer 8

captopril

Question 9

Which patients do ACE inhibitors greatly benefit

Answer 9

Diabetics (not associated with metabolic disturbances)

Question 10

Clinical advantages with ACE inhibitors

Answer 10

No cardiac, metabolic, bronchial, ED effects

Survival benefit

Question 11

Adverse effects of ACE inhibitors

Answer 11

Hyperkalemia, cough, angioedema, first dose hypotension (start on low dose)

Question 12

Angiotensin receptor blocker (ARB) prototype

Answer 12

losartan

Question 13

Renin inhibitor prototype

Answer 13

aliskiren (usefulness unclear)

Question 14

CCBs used for hypertension

Answer 14

nifedipine, verapamil, diltiazem

Question 15

Vasodilators for hypertension

Answer 15

Nitroprusside, Hydralazine, Minoxidil

Question 16

Administration of nitroprusside

Answer 16

IV only during emergencies, decomposses to NO

Question 17

Hydralazine use

Answer 17

specifically for hypertension with CHF in AA patients

Question 18

Minoxidil use

Answer 18

seldom used due to serious adverse effects