Antihypertensives

Question 1

BP= ___ x ___

Answer 1

CO x TPR

Question 2

First-line agents for hypertension.

Answer 2

Thiazide diuretics
ACE inhibitor/ARB
Calcium channel blockers

Question 3

Second-line antihypertensive recommendation

Answer 3

Increase dose or combine first-line drugs

Question 4

Third line antihypertensives

Answer 4

Beta blockers
Vasodilators

Question 5

Thiazide diuretic drug

Answer 5

Chlorthalidone

Question 6

MOA of chlorthalidone

Answer 6

Increases excretion of Na+ in urine
Decreases blood volume and decreases TPR long term

Question 7

How much do low dose thiazide diuretics lower BP?

Answer 7

10-15mmHg within 4-6 weeks

Question 8

Advantage of chlorthalidone over other thiazides

Answer 8

Longer duration of action
Proven mortality risk decrease

Question 9

Adverse effects of chlorthalidone

Answer 9

Hypokalemia
Hyponatremia
Hypercalcemia
Erectile dysfunction

Question 10

Prototype ACE inhibitor

Answer 10

Captopril

Question 11

MOA of captopril

Answer 11

Inhibits conversion of Ang I to Ang II by ACE
Vasodilation and decreased TPR

Question 12

ACE inhibitors increase release of ___ and ____ and decrease release of ___

Answer 12

Increase renin and Ang I
Decrease aldosterone

Question 13

Advantages of ACE inhibitors

Answer 13

No impaired exercise tolerance or baroreceptor reflex
Safe in asthma pts/no bronchoconstriction
No sexual dysfunction
No elevated glucose or lipids

Question 14

Adverse effects of ACE inhibitors

Answer 14

Generally well-tolerated
Hypotension with first dose
Cough
Angioedema
Hyperkalemia
Reduces GFR

Question 15

ACE inhibitor boxed warning

Answer 15

Contraindicated in pregnancy
Fetopathic in 2nd and 3rd trimester

Question 16

What does ARB stand for?

Answer 16

Angiotensin receptor blockers

Question 17

Prototype ARB

Answer 17

Losartan

Question 18

MOA of ARBs

Answer 18

Competitive antagonist of AngII AT1 receptor

Question 19

Why should ACE inhibitors and ARBs not be used together?

Answer 19

Similar side effects

Question 20

Nitroprusside drug class

Answer 20

Vasodilator

Question 21

Nitroprusside MOA

Answer 21

Decomposes to NO in circulation, causing venous and arterial dilation

Question 22

Nitroprusside is administered __ and is slow/rapid acting

Answer 22

IV, rapid-acting

Question 23

Clinical uses of nitroprusside

Answer 23

Hypertensive emergencies
Controlled hypotension to reduce bleeding in surgery

Question 24

Boxed warnings for Nitroprusside

Answer 24

Excessive hypotension
Cyanide toxicity

Question 25

Nitroprusside can cause _____emia with high dose infusion

Answer 25

Metheglobinemia