Antihypertensives II

Question 1

What are the alpha-adrenergic receptor blockers?

Answer 1

Prazosin
Terazosin
Doxazosin

Question 2

What do alpha-adrenergic receptor blockers cause?

Answer 2

Decreased peripheral vascular resistance

Decreased venous capacitance

Question 3

What calcium channel is more important in smooth muscle?

Answer 3

Both L-type and T-type calcium current

Question 4

What calcium channel is more important in cardiac muscle?

Answer 4

L-type calcium current

Question 5

What do dihydropyridines inhibit?

Answer 5

ONLY T-type calcium current channels!

Question 6

What are the only drugs that inhibit L-type calcium channels?

Answer 6

Verapamil
Diltiazem
(never DHPs)

Question 7

What inhibits T-type calcium channels?

Answer 7

DHPs
Diltiazem
Verapamil

Question 8

How do calcium channel blockers work?

Answer 8

By decreasing the voltage of calcium channels so that they are not easily activated; effectively prolongs the inactivation time of the channels/refractory period

Question 9

What do DHPs such as Nifedipine cause?

Answer 9

Reflex HR
Reflex Contractility
Reflex AV conductance

Question 10

Why do DHPs cause a reflex in HR/contractility/AV conductance?

Answer 10

Because they cause vasodilation in the periphery but do not affect the L-type channels in the myocardium so the myocardium compensates

Question 11

What are the DHPs?

Answer 11

Nifedipine: short-acting
Felodipine: long-acting
Amlodipine: long-acting

Question 12

What are the direct vasodilators?

Answer 12

Hydralazine

Minoxidil

Question 13

What two ways does hydralazine work?

Answer 13

1. ) Activates Ca-activated potassium channels in SM causing hyperpolarization
2. ) Inhibits IP3-induced Ca release from SR in SM

Question 14

How does Minoxidil work?

Answer 14

Activates ATP-dependent K channels causing hyperpolarization of SM cells

Question 15

What are the aldosterone antagonists?

Answer 15

Spironolactone

Eplerenone

Question 16

Where can the RAAS blockers block?

Answer 16

Renin
ACE
A-II receptor

Question 17

What are the renin antagonists?

Answer 17

Aliskiren

Question 18

What are the ACE inhibitors?

Answer 18

Captopril

Lisinopril

Question 19

What are the A-II receptor antagonists?

Answer 19

Losartan

Question 20

What receptor does A-II bind and work on?

Answer 20

AT-1 (angiotensin 2 receptor type-I) angiotensin I does not affect a receptor

Question 21

What does A-II cause?

Answer 21

Vasoconstriction and renin formation inhibition

Question 22

What does A-III cause?

Answer 22

Activation of aldosterone and reabsorption of Na and water

Question 23

What does renin do?

Answer 23

Cleaves angiotensinogen to angiotensin I

Question 24

Three categories of diuretics:

Answer 24

Potassium sparing
Thiazide
Loop diuretics

Question 25

What are the potassium sparing diuretics?

Answer 25

Amiloride

Triamterene

Question 26

What are the thiazide diuretics?

Answer 26

Hydrochlorothiazide

Question 27

What are the loop diuretics?

Answer 27

Furosemide

Torsemide

Question 28

What are the first three drugs to start a patient with hypertension based on their ethnicities and co-morbidities?

Answer 28

1. ) ACE inhibitor or A-I receptor antagonist
2. ) Calcium entry blocker
3. ) Thiazide diuretic

Question 29

What antihypertensives do not work well on Africans?

Answer 29

ACE inhibitor or A-II

Calcium blockers

Question 30

What antihypertensive do you give to Africans?

Answer 30

Thiazide diuretics

Question 31

What second or complimentary drugs do you give as antihypertensives?

Answer 31

1.) Direct vasodilator/alpha-receptor blocker + diuretic
or
2.) Direct vasodilator + Beta-adrenergic receptor blocker

Question 32

At what blood pressure do you start antihypertensive agents?

Answer 32

140/90 mmHg

Unless > 60 years old then 150/90 mmHg