Antihypertensive Drugs

Question 1

A unique formulation of which of the following antihypertensive medications is worthy of CONSIDERATION for this patient because it can be administered once every 7 days?

Answer 1

Clonidine

Question 2

Selection of antihypertensive drugs for noncompliance

Answer 2

preferred:
once-daily dosages regimens
or
transdermal clonidine

Question 3

reflex tachycardia when used alone

Answer 3

hydralazine
minoxidil
dihydropyrides

Question 4

Labetalol

Answer 4

beta 1 and alpha 1 antagonist

Question 5

treatment of hypertensive emergency

Answer 5

nicardipine or clevidipine with labetalol and/or esmolol

Question 6

digoxin action

Answer 6

slows rate of AV node conduction

Question 7

Fenoldopam

Answer 7

pure D1 agonist

can be used in hypertensive emergency

Question 8

scleroderma crisis drug tx

Answer 8

ACE inhibitors

Question 9

Nitrate toxicity

Answer 9

pronounced vasodilation resulting in: orthostatic hypotension, tachycardia
throbbing headache

tolerance w/ repeated exposure

Monday’s disease

Question 10

Sildenafil complication

Answer 10

profound hypotensive crisis when nitroglycerin administer

Question 11

Phosphodiesterase type 5 inhibitors

Answer 11

Increase cGMP (cGMP does not get deactivated)

sildenafil
vardenafil
tadalafil
Avanafil

Question 12

intracellular molecule that is responsible for vasodilation in the corpus cavernosum to improve erectile function

Answer 12

cGMP (cyclic guanosine monophosphate)

Question 13

Management of afib without CHF

Answer 13

beta-blocker
CCB
Digoxin

Question 14

Management of afib with CHF

Answer 14

beta blockers
Digoxin (Increase cardiac output)

(never CCB)

Question 15

Thyroxine

Answer 15

will enhance the renal clearance (CLr) of digoxin when used to treat CHF and control ventricular rate

Question 16

Drugs that enhance digoxin toxicity

Answer 16

quinidine, amiodarone, captopril, verapamil, diltiazem, cyclosporin

decreases renal clearance and/or volume distribution

Question 17

Drugs that reduce digoxin toxicity

Answer 17

thyroxine (increase clearance)
cholestyramine (decrease GI absorption)

Hypothyroidism decreases renal clearance

Question 18

ECG changes relates to the BENEFICAL effects of digoxin on rate control

Answer 18

pro-longed P-R interval

Question 19

Sites of action of Digoxin

Answer 19

AV node - prolonged refractory period = slowed conduction = prolonged PR interval

Ventricle
- accelerated repolarization = shortened Q-T interval
- changes in phase 2 or 3, or in direction of repolarization = depressed S-T segment or inverted T-wave

Question 20

appropriate drugs to use in combination for the treatment of a 59-year-old woman during the EARLY stages of chronic heart failure (CHF)

Answer 20

Furosemide + captopril + metoprolol

Question 21

3-step treatment of CHF

Answer 21

step 1: initiate ACE inhibitor to reduce workload. add beta blocker if stable systolic dysfunction
step 2: persistent symptoms add aldosterone antagonist
step 3: still persistent add digoxin, ARB

**for african-american patients add hydralazine/isosorbide dinitrate (bidil)

Question 22

Ivabradine

Answer 22

slows rate without affecting force of contraction

selective and specific inhibitor of the hyperpolarization activated cyclic nucleotide-gated channels (If channels; funny current) - inhibition of If ion current flow prolongs diastolic depolarization, slows firing in the SA node.

CYP3A4