Antihypertensives and Heart Failure

Question 1

List 4 categories of antihypertensive agents

Answer 1

. Diuretics
. Direct vasodilators
. Agents that block production or action of angiotensin
. Sympathoplegic agents

Question 2

Diuretics MOA and indication in HTN and congestive HF

Answer 2

Increase rate of urine flow, reducing edema. Reduce BP by reducing blood volume and increasing sodium output

Question 3

What class of diuretics are appropriate for most patients with mild or moderate HTN and normal renal and cardiac function?

Answer 3

Thiazide diuretics

Question 4

True or false: HCTZ is preferred to chlorthalidone because it has a longer duration of action

Answer 4

False. Chlorthalidone has a longer duration of action than HCTZ and is more effective

Question 5

What is one of the most common adverse effects of diuretics?

Answer 5

Potassium depletion, with the exception of potassium sparing diuretics

Question 6

Renin is released by _________ cells in the _________

Answer 6

Juxtaglomerular, kidney

Question 7

Aliskiren drug class and MOA

Answer 7

Renin inhibitor. Directly inhibits renin, preventing the formation of angiotensin I and II

Question 8

Enalapril drug class and MOA

Answer 8

Angiotensin converting enzyme inhibitor (ACEi). Inhibit the conversion of angiotensin I to angiotensin II, reducing peripheral vascular resistance and lowering blood pressure

Question 9

Which is the only ACEi that is NOT eliminated primarily by the kidneys?

Answer 9

Fosinopril

Question 10

True or false: All ARBs are acidic drugs

Answer 10

True

Question 11

What is RAAS? What is its function?

Answer 11

Renin-angiotensin-aldosterone system. It is a critical regulator of blood volume and systemic vascular resistance (BP control)

Question 12

Nifedipine drug class and MOA

Answer 12

Calcium channel blocker. Inhibits calcium influx into arterial smooth muscle cells

Question 13

Common adverse effects of CCBs

Answer 13

. Tachycardia
. Palpitations
. Chest pain

Question 14

True or false: CCBs inhibit Ca movement across membranes of myocardial and arterial muscle cells, altering action potential and blocking muscle cell contraction

Answer 14

True

Question 15

(Parasympathetic/sympathetic) neural activation can cause HTN in some patients

Answer 15

Sympathetic

Question 16

Antihypertensive agents that act on the CNS can have what side effects?

Answer 16

. Sedation
. Mental depression
. Sleep disturbances
. Nightmares

Question 17

Agents that reduce release of norepinephrine from sympathetic nerve endings can have what side effects?

Answer 17

. Inhibition of ejaculation
. Hypotension

Question 18

Ganglion blocking agents MOA

Answer 18

Competitively block nicotinic cholinoceptors on postganglionic neurons in both sympathetic and parasympathetic ganglia

Question 19

What agents can be used for HTN during pregnancy?

Answer 19

. Methyldopa
. Labetalol

Question 20

Adrenergic neuron blocking agent MOA

Answer 20

Prevent normal physiological release of norepinephrine from postganglionic sympathetic neurons

Question 21

Example of an adrenergic neuron blocking agent

Answer 21

Reserpine

Question 22

Adverse effects of adrenergic neuron blocking agents

Answer 22

Brain: sedation, nightmares and severe mental depression
GI: mild diarrhea, GI cramps, increased gastric acid secretion