B: 17-20

Question 1

Ca2+ ch. blockers

Answer 1

Dihydropiridines: Nifedipine, Amlodipine, Felodipine, Nomidipine
Non: Verapamil, Diltiazem

Question 2

Dihydropiridines

Answer 2

Nifedipine
Amlodipine
Felodipine
Nimodipine

Question 3

Dihydropiridines indications

Answer 3

HTN
Hypertensive emergency
Pregnancy HTN (Nifedipine)
Angina
Prinzmetal's angina
Raynaud's phenomenom
Subarachnoid hemorrhage (Nimodipine)

Question 4

Which drug should wew give in case of Subarachnoid hemorrhage

Answer 4

Nimodipine

Question 5

Verapamil indications

Answer 5

HTN
Angina
Migrane prophylaxis
Anti arrhythmic class IV

Question 6

NO releasing agents

Answer 6

Hydralazine

Question 7

Hydralazine MOA

Answer 7

Induce release of NO from endothelial cells
Mainly arterial vasodil.
Orally active
6-8 h duration

Question 8

Hydralazine indications

Answer 8

HTN

Induces baroreceptor homeostatic compensatory response

Question 9

Patient with HF and reduced ejection fraction can be given

Answer 9

Hydralazine + Isosorbide dinitrate

Question 10

Hydralazine side effects

Answer 10

Drug induced Lupus at high dose

Question 11

Endothelin antagonist

Answer 11

Bosentan

Question 12

Bosentan indications

Answer 12

Pulmonary HTN

Question 13

Bosentan side effects

Answer 13

Teratogenic

Hepatotoxicity

Question 14

PDE-5 inhibitor

Answer 14

Sildenafil

Question 15

Sildenafil indications

Answer 15

Erectile dysfunction

Pulmonary HTN

Question 16

Sildenafil side effects

Answer 16

Severe hypotension in combination with Nitrates
Priapism (Prolonges erection)
Blue tinted vision

Question 17

K sparing diuretics- Aldosteron-R inhibitors

Answer 17

Spironolactone

Eplerenone

Question 18

Spironolactone duration of action

Answer 18

24-48 h

Question 19

Spironolactone indications

Answer 19

Hyperaldestronism
Hypokalemia caused by other diuretics
CHF
Antiadronergic

Question 20

Spironolactone side effects

Answer 20

Hyperkalemic metabolic acidosis

Anti-adronergic effect

Question 21

ACE inhibitors MOA

Answer 21

Inhbition of ACE → ↓ AG-II, ↓ Aldosterone

↑ endogenous vasodilators (Bradykinin)

Question 22

ACE inhibitors names

Answer 22

Captopril
Enalapril
Perindopril
Ramipril

Question 23

ACE inhibitors indications

Answer 23

HTN
Protective of diabetes nephropathy
CHF (reduced mortality)
Acute coronary syndrome

Question 24

ACE inhibitors side effects

Answer 24

Dry cough
Teratogenic
Hyperkalemia
AKI in renal patients

Question 25

ARB's

Answer 25

Losartan Valsartan Irbesartan

Question 26

ARB's indications

Answer 26

HTN Protective of diabetes nephropathy CHF (reduced mortality)

Question 27

ARB's side effects

Answer 27

Teratogenic | Hyperkalemia

Question 28

Drug used in Ischemic heart disease (Angina pectoris)

Answer 28

``` Nitroglycerine Isosorbid-mononitrate / dinitrate CCB B blockers (Propranonlol) Trimetaidine Ivabradine ```

Question 29

Nitrates MOA

Answer 29

``` Release NO NO stimulates guanylyl cyclase Increased in cGMP Dephosphorylation of myosin light chain Smooth muscle relaxation ```

Question 30

Nitrates effects

Answer 30

``` Vasodilation (venous>>>arterial) Preload ↓↓ Afterload ↓ Cardiac work ↓ O2 demand ↓ ```

Question 31

``` Short acting nitrates How to give Onset of action Duration of acation Indications ```

Answer 31

``` Nitroglycerin Sublingual Onset in 1 min Lasts 10-20 min Acute angina, Acute coronary, Hypertensive emergency, Acute pulmonary edema ```

Question 32

``` Intermediate acting nitrates How to give Onset of action Duration of acation Indications ```

Answer 32

``` Nitroglycerin Oral Slow 2-4 h Angina prophylaxis Reduced mortalilty in atients with stable angina ```

Question 33

``` Long acting nitrates How to give Onset of action Duration of acation Indications ```

Answer 33

``` Nitroglycerin Transdermal patch Slow 8-10 h Angina prophylaxis Reduced mortalilty in atients with stable angina ```

Question 34

Isosorbid-mononitrate | Evrything

Answer 34

Sublingual Rapid acting 30 min duration of action Acute angina, Acute coronary, Hypertensive emergency, Acute pulmonary edema

Question 35

Nitrates side effects

Answer 35

``` Headache Reflex tachycardia Cutaneous flushing Orthostatic hypotension Syncope Methemoglobinemia in high conc. Tolerance after 8-10 h ```

Question 36

Nitrates contraindications

Answer 36

Systolic BP < 90 mmHg Right vent. MI Patient took PDE-5 within last 24 h Hypertrophic obstructive cardiomyopathy

Question 37

CCB used to treat angina

Answer 37

Nifedipine Verapamil Diltiazem

Question 38

B blocker used in angina prophylaxis

Answer 38

Propranolol