Cardiovascular System 3

Question 1

How many class of drugs for hypertension

Answer 1

5

Question 2

Class of drugs for hypertension

Answer 2

Diuretics- thiazides, high ceiling, aldo. Antag
RAAS inhibitors: ACE, ARB, Direct inhibitor
Sympathetic inhibitors: B blockers, A+B blockers, A blocker, Central sympatholytics
CCB: phenylalkynes, benzothiazines, DHP
Vasodilators: Arteriolar, venous

Question 3

4 steps of choosing antihypertensive drugs

Answer 3

Step 1:
Below 55 years: ACE/ARB
Above 55 years: CCB/Diuretic
Step 2: ACE/ARB + CCB/diuretic
Step 3: ACE/ARB + CCB + Diuretic
Step 4: ACE/ARB + CCB + Diuretic + spironolactone or vasodilating B blocker(carvedilol Nebivolol)

Question 4

Antihypertensive combinations to be avoided

Answer 4

1. A or B blocker with clonidine: antagonism of clonidine action
2. Hydralazine and DHP: same action
3. ARB and ACE
4. CCB and B blocker: marked bradycardia, AV block
5. B Blocker with diuretic: hyperglycemia

Question 5

Two types of hypertension in pregnancy

Answer 5

1. Pre existing
2. BP rises after 20 weeks; preeclampsia

Question 6

Treatment of preexisting hypertension in pregnancy

Answer 6

Continue same drugs
Replace drugs not to be given in pregnancy with alternatives

Question 7

Treatment of preeclampsia

Answer 7

Give aspirin at 12 weeks

Question 8

Antihypertensive to be avoided in pregnancy

Answer 8

ACE/ARB: foetal damage, growth retardation
Diuretics: reduces plasma volume, utero placental perfusion deficit- increase risk of placental infarcts, miscarriage, still birth
Non selective B blocker: propanolol as it causes low birth weight, decreased placental size. Bradycardia and hypoglycemia
Sod. Nitroprusside: contraindicated

Question 9

Antihypertensive to be used in pregnancy

Answer 9

Labetalol: A + B adrenegric blocker
Nifedipine
Methyl dopa
Hydralazine