Antihypertensives

Question 1

Patients intolerant to ACEi.
Diabetic nephropathy
Avoid in pregnancy

Answer 1

Isosartan- Angiotensin II Receptor Blocker

Question 2

Outline the 1st line, 2nd line and 3rd line Hypertension Treatment

Answer 2

1st Line = ACEi/ARB OR Low dose thiazide diuretic OR CCB
2nd Line = ACEi/ARB + thiazide low dose OR ACEi/ARB + CCB
3rd Line = ACEi/ARB + thiazide low dose + CCB

Question 3

Not first line HT drug.

Used in Angina, post MCI, arrhythmias, NOT used in diabetes or asthma

Answer 3

Propanolol

Beta Blockers. Not used with central CCB such as verapamil

Question 4

Drug used in angina, tachyarrhythmias, NOT heart failure

Answer 4

Verapamil

CCB - dont use with BB

Question 5

HT drug used NOT in gout, diabetes or hypercholesteraemia

Answer 5

Chlorothiazide, hydrochlorothiazide.

Thiazide diuretics, NOT WITH digoxin

Question 6

Heart Failure drug not used in gout.

Answer 6

Frusemide - Loop diuretic, NOT WITH aminoglycosidase (antibiotics), digoxin, warfarin, ACE inhibitors

Question 7

Most effective HT combination.

Answer 7

Enalapril/ Isosartan PLUS Verapamil r

Question 8

HT drugs especially with heart failure or stroke

Answer 8

Enalapril/ Isosartan PLUS chlorothiazide

Question 9

HT - recommended for post MI or in people with heart failure.

Answer 9

Enalapril/ Isosartan AND propanolol

Question 10

HT - at risk of hyperkalaemia

Answer 10

ACEi/ARB + spironolacton OR amioloride / triamterence

Question 11

Acute renal failure, localised oedema, raised intracranial pressure, glaucoma:

Answer 11

Mannitol - osmotic diuretic

Question 12

Localised oedema (not generalised), glaucoma

Answer 12

Acetazolamide - carbonic anhydrase inhibitor

Question 13

Pulmonary oedema, CFH, liver cirrhosis, renal failure (HT)drug overdose. Thiazide of K+ sparing diuretics

Answer 13

Frusemide - loop diuretics not with aminoglycoside (antibiotic) digoxin, warfarin, ACE, inhibitor.

Question 14

Most efficacious diuretics

Answer 14

Frusemide

Question 15

Hyperaldosteronism give wth thiazides or loop diuretics

Answer 15

Spironolactone

Question 16

Often used with thiazides or loop diuretics to prevent hypoalkalaemia and hypertension.

Answer 16

Amiloride, triamtere

Question 17

Enalapril S/E

Answer 17

Cough, increased levels of bradykinin, hypotension.

Question 18

Isosartan S/E

Answer 18

Cough, increase level of bradykinin, hypotension

Question 19

Propanolol - BB S/E

Answer 19

Bronchoconstriction, bradycardia, AV block, depression, sedation, exacerbate diabetes, mask hypoglycaemia, impotence

Question 20

Verapamil - CCB - S/E

Answer 20

Cardiac depression, bradycardia, dizziness, constipation, nausea, headache.

Question 21

Spironolactone

Answer 21

Hyperkalaemia, decrease libido

Question 22

Drug given for heart failure - good for diabetics as renal fxn preserved

Answer 22

Enalapril - ACEi - do not give with K+ supplements