Cardiology Pharm (Antihypertensive Agents)

Question 1

What are the Antihypertensive Agents? (4)

Answer 1

Diuretics: see Renal Pharm
RAA system: ACE inhibitors; ARB (Ang II receptor blockers
Sympathoplegics
Vasodilators

Question 2

What are the RAA system effectors? (2)

Answer 2

ACE inhibitors

Losartan

Question 3

What are the ACE inhibitors? (3)

Answer 3

Captopril
Enalapril
Fosinopril

Question 4

What is the mechanism of Action ACE inhibitors?

Answer 4

Inhibits the conversion of Ang I to Ang II -> decreases Ang II and prevents vasoconstriction from Ang II

Question 5

What are the indications for ACE inhibitors? (4)

Answer 5

Hypertension
CHF
post MI
vasodilator

Question 6

What are the adverse effects of ACE inhibitors? (4)

Answer 6

Hyperkalemia, cough, angioedema,

Contraindicated in Pregnancy (fetal Renal malformations)

Question 7

What is the mechanism of Action Losartan?

Answer 7

ARB (Ang II receptor blockers) => prevents vasoconstriction from Ang II

Question 8

What are the indications for Losartan?

Answer 8

Hypertension

Question 9

What are the adverse effects of Losartan? (2)

Answer 9

Fetal renal toxicity

Hyperkalemia

Question 10

What are the Sympathoplegics? (13)

Answer 10

Metoprolol, Atenolol, Acebutolol, Esmolol, Propranolol,
Timolol, Carvedilol
Prazosin
Clonidine
Methyldopa
Hexamethonium
Reserpine
Guanethidine

Question 11

What is the mechanism of action of Metoprolol, Atenolol, Acebutolol, Esmolol, Propranolol,
Timolol, Carvedilol?

Answer 11

B1-Blocker: Metoprolol, Atenolol, Acebutolol, Esmolol
B1 and B2 Blocker: Propranolol,
Timolol
Alpha and B-Blocker: Carvedilol

Question 12

What are the indications for B-Blockers? (4)

Answer 12

Hypertension
Angina
MI
Antiarrhythmic

Question 13

What are the adverse effects of B-Blockers? (7)

Answer 13

Impotence
Asthma
Bradycardia
Av block
Heart failure
Sedation
Sleep alterations

Question 14

What is the mechanism of action of Prazosin? (2)

Answer 14

aplha 1-Blocker -> vasodilation -> decreases TPR

Question 15

What are the indications for Prazosin? (2)

Answer 15

Pheochromocytoma

Hypertension

Question 16

What are the adverse effects of Prazosin?

Answer 16

Orthostatic Hypotension

Question 17

What is the mechanism of action of Clonidine?

Answer 17

alpha 2 agonist => decreases peripheral resistance

Question 18

What are the indications for Clonidine? (4)

Answer 18

Hypertension
Smoking
Cocaine
Heroin withdrawal

Question 19

What are the adverse effects of Clonidine? (3)

Answer 19

Drowsiness
Dry mouth
Rebound hypertension after abrupt withdrawal

Question 20

What is the mechanism of action of Methyldopa?

Answer 20

alpha agonist => decreases peripheral resistance

Question 21

What are the indications for Methyldopa?

Answer 21

Hypertension

Question 22

What are the adverse effects of Methyldopa? (2)

Answer 22

Sedation and Hemolytic Anemia

(+) Coombs Test

Question 23

What is the mechanism of action of Hexamethonium?

Answer 23

Nicotinic ganglionic blocker

Question 24

What are the indications for Hexamethonium?

Answer 24

Hypertensive Emergency

Question 25

What are the adverse effects of Hexamethonium? (4)

Answer 25

Severe orthostatic hypotension Blurred vision Constipation Sexual dysfunction

Question 26

What is the mechanism of action of Reserpine?

Answer 26

Prevents the storage of monoamines in synaptic vesicle

Question 27

What are the indications for Reserpine?

Answer 27

Hypertension

Question 28

What are the adverse effects of Reserpine?

Answer 28

Mental depression

Question 29

What is the mechanism of action of Guanethidine?

Answer 29

Interferes with norepinephrine release

Question 30

What are the indications for Guanethidine?

Answer 30

Severe hypertension

Question 31

What are the adverse effects of Guanethidine?

Answer 31

Contraindicated in patients taking TCA's

Question 32

What are the Vasodilators? (6)

Answer 32

``` Hydralazine Minoxidil Nifedipine Verapamil Nitroprusside Diazoxide ```

Question 33

What is the mechanism of action of Hydralazine?

Answer 33

increases cGMP -> smooth muscle relaxation -> vasodilates arterioles -> afterload reduction

Question 34

What are the indications for Hydralazine? (3)

Answer 34

Severe hypertension CHF 1st line treatment for hypertension in pregnancy

Question 35

What are the adverse effects of Hydralazine? (4)

Answer 35

Compensatory tachycardia Fluid retention Lupus like syndrome Contraindicated in angina/CAD because of compensatory tachycardia

Question 36

What is the mechanism of action of Minoxidil?

Answer 36

K+ channel opener -> hyperpolarizes and relaxes smooth muscle

Question 37

What are the indications for Minoxidil?

Answer 37

Severe hypertension

Question 38

What are the adverse effects of Minoxidil? (2)

Answer 38

Hypertrichosis | Pericardial effusion

Question 39

What is the mechanism of action of Nifedipine, Verapamil?

Answer 39

Ca+ channel antagonists

Question 40

What are the indications for Nifedipine, Verapamil? (5)

Answer 40

``` Hypertension Angina Arrythmia (not Nifedipine) Prinzmetal Angina Raynaud's ```

Question 41

What are the adverse effects of Nifedipine, Verapamil? (4)

Answer 41

Flushing Dizziness Cardiac depression Peripheral edema

Question 42

What is the mechanism of action of Nitroprusside?

Answer 42

Direct release of NO -> increases cGMP -> vasodilator

Question 43

What are the indications for Nitroprusside? (3)

Answer 43

Hypertensive emergency CHF Angina

Question 44

What are the adverse effects of Nitroprusside? (3)

Answer 44

Cyanide toxicity Hypotension Short acting

Question 45

What is the mechanism of action of Diazoxide?

Answer 45

K+ channel opener -> hyperpolarizes and relaxes smooth muscle

Question 46

What are the indications for Diazoxide?

Answer 46

Hypertension

Question 47

What are the adverse effects of Diazoxide? (2)

Answer 47

Hypoglycemia (reduces insulin release) | Hypotension