Antihypertensives

Question 1

MOA thiazides

Answer 1

Prevent kidney sodium and water reabsorption at the distal tubule

Question 2

Thiazide side effects

Answer 2

Hypo natremia, kalemia
HYPERCALCEMIA 
HYPERURICEMIA
HYPERGLYCEMIA 
*use caution with gout and DM pts

Question 3

Thiazide indications

Answer 3

Uncomplicated hypertension

Question 4

MOA Loop diuretics

Answer 4

Inhibits water transport across the loop of Henle which leads to increased excretion of sodium, chloride and potassium.

Question 5

Side effects loop diuretics

Answer 5

Volume depletion 
Hypokalemia/natremia/calcemia 
HYPERGLYCEMIA 
OTOTOXICITY
Contraindicated in those with sulfa allergy

Question 6

Loop diuretics indications

Answer 6

HTN, CHF, Hypercalcemia

Question 7

Examples of loop diuretics

Answer 7

Furosemide, Bumetanide

Question 8

MOA ACEi

Answer 8

Decrease synthesis of AGII/aldosterone
Leads to decreased preload and afterload
Cardio and Reno protective

Question 9

ACEi indications

Answer 9

HTN, especially if history of DM, nephropathy, post MI

Question 10

ACEi side effects

Answer 10

1st dose hypotension 
Cough
Angioedema 
*due to increase in bradykinin 
HYPERURICEMIA

Question 11

True or false: ACEi and diuretics have a synergistic effect

Answer 11

True

Question 12

What are the two classes of CCB and what is the difference?

Answer 12

Dihydropyridines (amplodipine, nifedipine): vasodilation only

Non-dihydropryidines (verapemil, diltiazam): vasodilation and increase cardiac contractility/conduction

Question 13

Indication for dihydropryadine

Answer 13

HTN

Question 14

Indication for non-dihydropyridine

Answer 14

HTN with A-fib

Question 15

CCB indications

Answer 15

HTN, Raynauds, angina

Question 16

Contraindication for CCB

Answer 16

CHF, 2nd/3rd degree heart block

Question 17

CCB side effects

Answer 17

Headache
Dizziness
Lightheaded
Flushing 
Edema

Question 18

Beta blocker MOA

Answer 18

Blocks adrenergic renin release

Question 19

BB indications

Answer 19

HTN, especially if history of tachycardia and MI
ANGINA
acute MI
ESSENTIAL TREMOR

Question 20

BB side effects

Answer 20

Fatigue
Depression
Impotence
Masks symptoms of hypoglycemia

Question 21

CI of BB

Answer 21

2nd or 3rd degree heart block
Asthma/COPD (nonselective agents)
Hypotension 
Pulse <50
Raynauds

Question 22

Classes of BB and examples

Answer 22

1. Cardioselective (B1): atenolol, metoprolol
   , esmolol
2. Nonselective (B1, B2): propranolol
3. Both alpha 1 and B1, B2: labetalol, carvedilol

Question 23

Choice treatment for uncomplicated HTN in non-AA?

Answer 23

Thiazide diuretics

Question 24

Choice treatment for a-fib

Answer 24

BB or non-dihydropyridines (verapamil)

Question 25

Choice treatment for angina

Answer 25

Beta blockers, CCB

Question 26

Post MI Treatment

Answer 26

Beta blockers, ACEi

Question 27

Choice treatment for systolic heart failure

Answer 27

ACEi, ARB, BB, diuretics

Question 28

Choice treatment for DM, chronic kidney disease in presence of HTN

Answer 28

ACEi

Question 29

Isolated systolic HTN in the elderly treatment

Answer 29

Diuretics

Question 30

Choice treatment for BPH

Answer 30

Alpha 1 blocker

Question 31

Choice treatment for AA HTN

Answer 31

Thiazide + CCB

Question 32

Choice treatment for Young Caucasian male

Answer 32

Thiazide, then ACEi

Question 33

Choice treatment for HTN and gout

Answer 33

CCB

May also use Losartan