Bahouth Random HTN

Question 1

Labetalol

Answer 1

3rd gen non specific beta and alpha1 antagonist; given IV for HTN emergency

Question 2

Carvedilil

Answer 2

non selective B and alpha1 antagonist; antioxidant, protects membranes from lipid peroxidation; prevents LDL oxidation and decreases LDL uptake into coronaries; used for CHF and HTN

Question 3

Nebivolol

Answer 3

highly B1 selective, with NO-mediated vasodilation; antioxidant effect; used in HTN with metabolic syndrome; significant increase in stroke volume to maintain CO and Systemic Q

Question 4

Major side effects of ACE inhibitors

Answer 4

Hypotension, hyperkalemia, drycough, angioedema, fetotoxicity

Question 5

Losartan

Answer 5

prodrug ARB that acts as competitive antagonist of thromboxane A2; attenuates platelet aggregation; unique in that it increases uric acid urinary excretion (uricosuric)

Question 6

Calcium blockers in HTN treatment

Answer 6

mainly use Dihydropyridines due to selectivity for L type Ca channels in vasculature; decrease SVR and arterial pressure resulting in decrease BP with no effect on baroreceptor activity or HR. Great for HTN with low renin as in elderly and african americans; second line in HTN for diabetics

Preferred in older subjects with systolic hypertension

Question 7

Primary side effect of Alpha2 agonists

Answer 7

Sedation (less so with guanfacine), drowsiness, fatigue

Question 8

Hydralazine

Answer 8

selective arteriolar smooth muscle relaxer; triggers reflex sympathetic stimulation resuling in increased catecholamine/renin secretion

Used for HTN emergency from eclampsia via IV; also used with BB and diuretics

SE: palpitations and pronounced tachycardia; autoimmune reactions - hemolytic anemia

Question 9

Minoxidil

Answer 9

relaxes arteriolar smooth muscle by opening Katp channels; does not affect veins; causes reflex tachycardia and powerful activation of renin secretion

SE: increased renin, hirsutism (topically = rogaine)

Question 10

Nitroprusside

Answer 10

prodrug that forms NO, increasing cGMP in vascular smooth muscle causing relaxation; dilates both arteries and veins, reduces TPR inducing venous pooling, decreased CO (normal subjects), increased CO (pts with left ventricular failure due to decreased afterload), very short half life so given IV in HTN emergency of patients with LVHF