BP Lowering Medication

Question 1

Adverse effects for DHP CCBs:

Answer 1

Flushing, headache, excessive hypotension, peripheral edema, and reflex tachycardia

Question 2

MOA of direct renin inhibitor:

Answer 2

Inhibiting the activity of renin (vasodilation) which is responsible for stimulating angiotensin II formation

Question 3

MOA of loop diuretics:

Answer 3

Inhibit Na-K-Chloride cotransporter in thick ascending limb leading to diuresis and natriuresis

Question 4

Contraindications for NON-DHP CCBs:

Answer 4

Preexistent bradycardia, heart conduction defects, heart failure caused by systolic dysfunction

Question 5

Common clinical uses of ACE inhibitors:

Answer 5

Heart failure
CAD
HTN
Chronic renal disease with proteinuria

Question 6

Common clinical uses for BB:

Answer 6

Heart failure
CAD
Tachyarrhythmias
HTN

Question 7

Common clinical uses for aldosterone antagonists:

Answer 7

Heart failure
CAD
HTN
Hyperaldosteronism

Question 8

Adverse effects of alpha-1 blockers:

Answer 8

Headache and dizziness 
Orthostatic hypotension
Nasal congestion 
Reflex tachycardia 
Fluid retention

Question 9

Minoxidil adverse effect:

Answer 9

Hypertrichosis (extensive hair growth) and pericardial effusion (boxed warning)

Question 10

MOA of nitrates:

Answer 10

Dilate both arteries and veins through venous dilation predominates when drugs are given at normal therapeutic doses

Question 11

3 subclasses of beta-blockers:

Answer 11

1. Nonselective BB
2. Beta-1 BB
3. Vasodilating BB

Question 12

MOA of direct vasodilators:

Answer 12

Directly relaxing arteriolar SM (reduce SVR)

Question 13

Which alpha-1 blockers are used in HTN emergencies caused by pheochromocytoma:

Answer 13

Phentolamine and phenoxybenzamine

Question 14

MOA of ARBs:

Answer 14

Blocky type 1 angiotensin II (AT1) receptors on blood vessels and other tissues (heart) preventing angiotensin II induced vasoconstriction

Question 15

Vasodilating BB have what vasodilating properties?

Answer 15

Alpha-1 with beta inhibition

Question 16

4 classes of vasodilators:

Answer 16

1. Non-dihydropyridine calcium channel blockers
2. Dihydropyridine calcium channel blockers
3. Direct vasodilators
4. Nitrates

Question 17

MOA of thiazide diuretics:

Answer 17

Inhibit Na-Chloride transporter in distal tubule of nephron increasing excretion of Na and water

Question 18

Common clinical uses for thiazide diuretics:

Answer 18

HTN
Edema
Calcium nephrolithiasis (kidney stones)

Question 19

Common clinical uses of central alpha-2 agonists:

Answer 19

HTN (NOT 1st line)

Question 20

Hydralazine adverse effect:

Answer 20

Lupus-like syndrome

Question 21

Adverse effects from BB:

Answer 21

1 Exaggeration of cardiac therapeutic actions 
2 Smooth muscle spasm 
3 CNS penetration 
4 Worsened quality of life 
5 Adverse metabolic side effects 
6 Withdrawal phenomenon

Question 22

IV vasodilator stimulates DI-like dopamine receptors:

Answer 22

Fenoldapam

Question 23

MOA of central alpha-2 agonists:

Answer 23

Binding to and activating alpha-2 adrenoceptors:

• reduces sympathetic outflow to heart (decrease CO, HR and contractility)
• reduces sympathetic output to vasculature (decrease SVR)

Question 24

2 classes of diuretics:

Answer 24

1. Loop diuretics

2. Thiazide diuretics

Question 25

Adverse effects of neprilysin inhibitor plus ARB:

Answer 25

Hyperkalemia Angioedema Renal function deterioration Hypotension

Question 26

Adverse effects of NON-DHP CCBs:

Answer 26

Flushing, headache, peripheral edema, excessive hypotension, excessive bradycardia, impaired electrical conduction, and depressed contractility

Question 27

Common clinical uses of nitrates:

Answer 27

HTN Heart failure Angina MI

Question 28

MOA of aldosterone antagonists:

Answer 28

Block the aldosterone receptor in renal collecting tubule which increases sodium and water excretion while conserving K+ and hydrogen ions

Question 29

Adverse effects of thiazide diuretics:

Answer 29

Hypovolemia Electrolyte disturbance (hypokalemia, hyponatremia, hypochloremia, hypomagnesemia) Hypercalcemia, hyperuricemia Alkalosis

Question 30

MOA beta-1:

Answer 30

Inhibit receptors and cause decrease HR, CO, renin release, and BP

Question 31

Aldosterone antagonists adverse effect risk of hyperkalemia:

Answer 31

Increased with declining renal function and with the concurrent use of ARBs and ACE inhibitors

Question 32

Adverse effects for direct renin inhibitor:

Answer 32

Diarrhea Hyperkalemia Angioedema

Question 33

Where are beta-2 receptors found?

Answer 33

Lung and vasculature

Question 34

Common clinical uses for loop diuretics:

Answer 34

Edema Hyperkalemia HTN

Question 35

Common clinical uses for neprilysin inhibitor plus ARB:

Answer 35

Heart failure

Question 36

MOA of neprilysin inhibitor plus ARB:

Answer 36

Inhibition of neprilysin increases the concentration of bradykinin which leads to vasodilation and natriuresis

Question 37

Contraindication for ARBs:

Answer 37

Pregnancy | Bilateral renal artery stenosis

Question 38

Adverse effects of nitrates:

Answer 38

Headache Postural hypotension and reflex tachycardia Lose efficacy with sustained use (tolerance) Risk of thiocyanante toxicity Interact with phosphodiesterase inhibitors to treat erectile dysfunction

Question 39

Common clinical uses for direct renin inhibitor:

Answer 39

HTN

Question 40

Common clinical uses for DHP CCBs:

Answer 40

HTN | Angina

Question 41

Adverse effects of only ACE inhibitors:

Answer 41

Dry cough

Question 42

Adverse effects of central alpha-2 agonists:

Answer 42

- Sedation, dry mouth and nasal mucosa, bradycardia, orthostatic hypotension, impotence - Constipation, nausea and GI upset - Rebound HTN if stopped suddenly bc excessive sympathetic activity

Question 43

MOA of NON-DHP Ca channel blockers:

Answer 43

CCBs bind to L-type calcium channels located on vascular SM, cardiac myocytes, and cardiac nodal tissue

Question 44

Adverse effects of loop diuretics:

Answer 44

Na/volume depletion Hypokalemia, hypocalcemia, hypomagnesemia, alkalosis Ototoxicity Hyperuricemia with chronic therapy

Question 45

5 different classes of renin angiotensin aldosterone system antagonists

Answer 45

1. ACE inhibitors (angiotensin-converting enzyme) 2. ARBs (angiotensin-II receptor blockers) 3. Neprilysin inhibitors Plus angiotensin-II receptor blocker 4. Aldosterone antagonists 5. Direct renin inhibitor

Question 46

Adverse effects of direct vasodilators:

Answer 46

Headaches, flushing Baroreceptor-mediated reflex tachycardia Salt and water retention (edema)

Question 47

Common clinical uses for ARBs:

Answer 47

Heart failure CAD HTN Chronic renal disease with proteinuria

Question 48

What can concomitant use or use within 36hrs of ACE inhibitors cause adverse effect?

Answer 48

Increase risk of angioedema and is contraindicated

Question 49

Contraindication for ACE inhibitors:

Answer 49

Pregnancy | Bilateral renal artery stenosis

Question 50

MOA of ACE inhibitors:

Answer 50

Reduces the synthesis of angiotensin II and prevents bradykinin breakdown -bradykinin>>angiotensin II = vasodilation (reduction in PVR and BP)

Question 51

Common clinical uses for NON-DHP CCBs:

Answer 51

HTN Tachyarrhythmias Angina

Question 52

Where is beta-1 receptors found?

Answer 52

Heart and kidney

Question 53

Common clinical uses of alpha-1 blockers:

Answer 53

HTN | Benign prostatic hypertrophy

Question 54

MOA of alpha-1 blockers:

Answer 54

Block binding of Epi and NE to alpha-1 adrenoceptors located on the vascular SM causing vasodilation

Question 55

3 classes of sympatholytics:

Answer 55

1. Alpha-1 blockers 2. Beta-blockers 3. Central alpha-2 agonists

Question 56

Adverse effects of aldosterone antagonists:

Answer 56

Hyperkalemia Renal function deterioration Gynecomastia

Question 57

MOA of beta-2:

Answer 57

Inhibition of receptors cause bronchospasm and vasoconstriction

Question 58

Common clinical uses for direct vasodilators:

Answer 58

HTN (resistant HTN and emergency) | Heart failure

Question 59

Adverse effects of ACE inhibitors:

Answer 59

Hyperkalemia Acute renal failure Angioedema

Question 60

Contraindication for neprilysin inhibitor plus ARB:

Answer 60

Pregnancy | Bilateral renal artery stenosis

Question 61

Contraindication for direct renin inhibitor:

Answer 61

Pregnancy

Question 62

MOA of DHP CCBs:

Answer 62

Prevent flow of calcium through L-type calcium channels located on vascular SM (reduce SVR and BP)

Question 63

Adverse effects of ARBs:

Answer 63

Hyperkalemia | Acute renal failure