Blood Pressure

Question 1

What are the 5 diuretics for blood pressure medication?

Answer 1

Chlorthalidone
Furosemide
Hydrochlorothiazide
Mannitol
Spironolactone

Question 2

What are the common uses of diuretics

Answer 2

treats edema (peripheral and pulmonary), hypertension and heart failure. Mannitol is specifically for cerebral edema caused by head trauma

Question 3

what are some common problems with diuretics?

Answer 3

dehydration, hypotension, and electrolyte imbalances, nocturia (can be counteracted if taken before 2pm)

Question 4

This medication is a powerful loop diuretic that can cause S/S of hypokalemia: weakness/fatigue, muscle cramps, dysrhythmias, N/V
Adverse effects: hearing loss (ototoxicity), ringing in ears (tinnitus)

Answer 4

furosemide

Question 5

How can you counteract hypokalemia caused by furosemide, chlorthalidone, and hydrochlorothiazide?

Answer 5

Eat potassium rich foods winter squash, sweet/baked potatoes, white beans, yogurt, orange juice, broccoli, and cantaloupe

Question 6

1st line treatment for hypertension

Answer 6

hydrochlorothiazide and chlorthalidone

Question 7

What medication is a potassium-sparing diuretic?

Answer 7

Spironolactone

Question 8

Why would spironolactone be prescribed?

Answer 8

To counteract the potassium loss from other diuretics

Question 9

What is important to know about Mannitol

Answer 9

1. Useful for head trauma (edema)
2. Worsen pulmonary edema & HF
3. crystalizes at room temperature so must be kept warm and used with a filter when given for IV.
4. urinary catheter should be placed to monitor the patient’s input and output

Question 10

Cardio selective beta blockers for BP

Answer 10

Atenolol and Metoprolol

Question 11

Nonselective beta blockers for BP

Answer 11

carvedilol, labetalol, Propranolol

Question 12

What are some high yield concepts for beta blockers

Answer 12

1. Bradycardia/hypotension (hold if under 50bpm or BP 100)
2. Blood sugar regulation
   3 Bronchoconstriction (not given to COPD/asthma patient)
3. Depression (especially propanolol)
4. Erectile dysfunction

Question 13

what patient should avoid receiving nonselective beta blockers such as carvedilol, labetalol, and propranolol

Answer 13

COPD and asthma patients

Question 14

Name 3 ACE inhibitors and their MOA

Answer 14

Benazepril, Lisinopril, Ramipril
MOA: Blocks angiotensin converting enzyme which results in decreased blood pressure but more pee

Question 15

What are the 4 high yield concepts of ACE inhibitors

Answer 15

Hypotension, Hyprkalemia, Persistent dry cough, angioedema (treatment would be epinephrine)

Question 16

What are 3 (ARBs) angiotensin II receptor blockers , MOA , and common use

Answer 16

Losartan, olmesartan, valsartan

MOA: block angiotensin II receptors in blood vessels/adrenal glands –> causes vasodilation and increases renal excretion of sodium and water

Prescribed like ACE but can also slow progression of CKD by reducing pressure inside kidney

Question 17

What are the high-yield concepts for ARBs?

Answer 17

They can cause hypotension and angioedema and evidence for cardioprotection is weaker than ACE inhibitors

Question 18

4 Calcium channel blockers which 2 are dihydropyridines and which are nondihydroridines for BP?

Answer 18

VAND
Dihydropyridines: amlodipine and nifedipine (block CC in arteries)
Nondihydropyridines: diltiazem and verapamil (block cc in AV SA nodes)

Question 19

What are some high-yield concepts from taking calcium channel blockers?

Answer 19

orthostatic hypotension, edema in ankles, facial flushing, and headaches,

nondihydropyridine =bradycardia (especially when in combination with a beta blocker) and constipation (verapamil only)

Nondihydropyridine must avoid grapefruit juice

Question 20

This BP drug can cause constipation

Answer 20

verapamil

Question 21

This drug is prescribed for hypertension, typically combines with another antihypertensive, however it has a short half life and requires frequent dosing. Name the drug

Answer 21

Hydralazine

Question 22

What’s is furosemide prescribed for?

Answer 22

It is prescribed for heart failure, edema, hypertension

Question 23

What should you monitor for patients taking spironolactone?

Answer 23

Hyperkalemia: dysrhythmias, muscle weakness, fatigue

*avoid salt substitutes and less potassium intake

Question 24

What are common uses for beta blockers?

Answer 24

Hypertension, angina, atrial fibrillation, and cardio protection following a heart attack

Question 25

How does beta adrenergic antagonist work?

Answer 25

Alpha 1 = located in artery/vein, decreases blood pressure
Beta 1 = located in heart, decrease heart rate and strength of contraction
Beta 2 = located in lungs causes bronchoconstriction (not good)