Drugs

Question 1

Prazosin MOA

Answer 1

Alpha-1-adrenergic blocker - prevents vasoconstriction

Question 2

Prazosin Treats

Answer 2

BPH, Primary HTN

Question 3

Adverse Effects of Propanolol

Answer 3

Highly lipid soluble - CNS effects (sleep), bronchoconstriction (non-specific), bradycardia

Question 4

Thiazide Adverse Effects

Answer 4

Hypokalemia, Alkalosis, Hyperglycemia, Hypercholesterolinemia, limited use for HTN (~10mmHg)

Question 5

Labetolol

Answer 5

Adrenergic alpha- and beta-blocking effects (both are competitive). Alpha-1 and Beta-1,2 (ISA); Decreased TPR due to Alpha-1 activity (vasodilation), Some decrease in CO

Question 6

If a pt does not respond at all to 1 HTN drug initially, you should:

Answer 6

stop that drug and try another

Question 7

“low and slow” approach to starting HTN drugs allows the pt to:

Answer 7

hemodynamically adapt to the resetting of baroreceptors

Question 8

What drug should be avoided while using Nitrates for fear it will cause _________?

Answer 8

Viagra; Fatal Hypotension

Question 9

How do thiazides work for HTN initially, long-term?

Answer 9

Initially they drop CO via natriuresis (limited by RAAS) and long-term use results in decreased TPR.

Question 10

Losartan mechanism

Answer 10

Inhibit the conversion of Angiotensin I –> II, preventing A-II mediated vasoconstriction, and decreased TPR and BP; Decreases A-II synthesis of Aldosterone -> decreased Na/H2O retention; Inhibits A-II facilitated release of NE from peripheral SNS

Question 11

Which drugs in combination w/ K+ Sparing Diuretics could produce adverse effects including hyperkalemia?

Answer 11

RAAS inhibitor

Question 12

Which HTN drug causes a non-productive cough?

Answer 12

ACE inhibitors (high bradykinin)

Question 13

Which class of drugs have the same effects as ACE inhibitors but do not have high bradykinin levels?

Answer 13

ARBs

Question 14

Thiazides are contraindicated for?

Answer 14

Diabetics, Hyperlipidemia pts, Gout pts

Question 15

Cholestyramine causes

Answer 15

malabsorption of other drugs, nutrients in the intestine, binds bile acids, reduces LDL in plasma, causes bloating and constipation

Question 16

Which drug irritates/causes peptic ulcers?

Answer 16

Niacin

Question 17

Pts on HTN meds stop taking them because:

Answer 17

they do not follow-up, lack of perceived benefits, side effects

Question 18

Tolerance tends to build against ______ when used long-term and may result in _________.

Answer 18

Nitroglycerin; Rebound angina

Question 19

Causes of Niacin?

Answer 19

Flushing, burning, itching of skin (vasodilation), Inhibition of intracellular hormone-sensitive lipase, enhanced extracellular LPL, hyperglycemia and glucose intolerance, increased HDL, lowered VLDL, LDL, IDL

Question 20

Indapamide uses

Answer 20

Thiazide diuretic; increased lipid solubility; DOES NOT increase plasma LDL, cholesterol, and TGs and can be used when GFR < 30-40 and in pts w/ hyperlipidemia

Question 21

ACE inhibitors decrease

Answer 21

preload and afterload

Question 22

Which hyperlipidemia drug has the least systemic effects?

Answer 22

Bile-acid resins (cholestyramine)

Question 23

For better control of HTN and prevention of arrhythmia use?

Answer 23

ACE inhibitor + CCB

Question 24

Simvastatin causes

Answer 24

inhibition of HMG-CoA reductase, liver toxicity, reduced LDL and increased HDL, prodrug when orally administered

Question 25

Which drug is best at lowering LDL, VLDL, and increasing HDL

Answer 25

Niacin

Question 26

Nitrates should be given with ___________ to prevent reflexive events

Answer 26

Give w/ beta-blockers

Question 27

Which drugs are known to cause first-dose postural hypotension?

Answer 27

Alpha-1-Blockers (prazosin, Doxazosin, Terazosin)

Question 28

Sudden w/d of a beta-blocker may result in?

Answer 28

Rebound HTN and Angina (even MI)

Question 29

Beta-blockers are dangerous in diabetics bc they mask

Answer 29

hypoglycemic tachycardia

Question 30

Nitro adverse effects

Answer 30

Orthostatic Hypotension; HA from meningeal vasodilation; Reflexive increase in HR and contractility; Systemic Na and H2O retention

Question 31

Which drug is available as a transdermal patch for anti-anginal effects?

Answer 31

Nitro

Question 32

Which diuretics prevent kidney stones and treats osteoporosis?

Answer 32

Thiazide

Question 33

Which diuretic helps treat hypercalcemia?

Answer 33

Loop Diuretics (furosemide, ethacrynic acid)

Question 34

K-Sparing Diuretics include

Answer 34

Triamterene, Amiloride, Spironolactone, Eplerenone, Drospirenone

Question 35

Major side effect of ethacrynic acid?

Answer 35

ototoxicity

Question 36

Which classes of drugs cause K-wasting and aggravate Gout?

Answer 36

Thiazides and Loop Diuretics

Question 37

Severe hyperkalemia may result from which drug combination?

Answer 37

K-Sparing diuretics and RAAS inhibitors

Question 38

Prevents Ca entry into smooth muscle cells causing vaso relaxation

Answer 38

Nifedipine, Amlodipine, Felodipine

Question 39

Bets combination to lower LDL and HTN

Answer 39

Nifedipine and Lovastatin

Question 40

Drugs that won't effect exercise ability, but lowers HTN? same but causes non-productive cough

Answer 40

Losartan (ARBs), Captopril (ACE inhibitors)

Question 41

Which K-sparing diuretic is more specific to not cause anti-androgenic effects

Answer 41

eplerenone

Question 42

Which drugs cause reflexive tachycardia, ankle edema, etc?

Answer 42

CCB (nifedipine, Felodipine, Amlodipine)

Question 43

Non-specific beta-blocker with ISA?

Answer 43

Pindolol

Question 44

Specific beta-blocker with ISA?

Answer 44

Acebutolol

Question 45

Difference b/w ACE inhibitors and ARBs

Answer 45

ACE inhibitors have high bardykinin

Question 46

Drug w/ Alpha and beta-adrenergic blocking ability

Answer 46

Labetolol

Question 47

Which drugs may cause some auto-immune side effects?

Answer 47

Methyldopa

Question 48

Which HTN drugs are available as transdermal patches?

Answer 48

Nitro, Clonidine

Question 49

HTN in combination w/ CHF could be treated with?

Answer 49

ACE inhibitors

Question 50

Drug w/ balanced route of excretion (shifts to liver if renal impairment)?

Answer 50

Fosinopril

Question 51

If beta-blocker, thiazide, and vasodilators fail to control BP...?

Answer 51

Switch to loop diuretics

Question 52

Diabetic pts should use _____ to treat HTN?

Answer 52

CCB

Question 53

Non-productive cough w/

Answer 53

ACE inhibitors

Question 54

Which ACE inhibitor used to treat HTN must first be converted in the liver to active metabolite?

Answer 54

Enalopril

Question 55

Which drug can still be used to treat edema when GFR is < 30-40

Answer 55

Indapamine (loop diuretic)

Question 56

Loop diuretics MOA

Answer 56

inhibition of Na/K/Cl symporter in the thick ascending limb of the loop of henle

Question 57

Thiazide has limited ability to ____________ and may cause

Answer 57

drop BP (~10mmHg) and causes metabolic side effects

Question 58

Which classes of drugs cause metabolic side effects

Answer 58

Thiazides, Loop diuretics, beta-blockers

Question 59

Major side effect of amiloride?

Answer 59

Hyperkalemia

Question 60

Sudden w/d of _________ may cause reflexive HTN and Angina?

Answer 60

beta-blockers and neuronal blockers

Question 61

Best drug to treat both CHF and HTN?

Answer 61

ACE inhibitors

Question 62

Drugs for exercise-induced angina?

Answer 62

Beta-blockers

Question 63

Niacin side effects

Answer 63

metabolic effects

Question 64

Drug contraindicated for bilateral renovascular disease?

Answer 64

ACE inhibitors

Question 65

Drugs used to treat diabetic nephropathy?

Answer 65

ACE inhibitors

Question 66

Which diuretic is NOT a sulfonamide derivative

Answer 66

Ethacrynic acid

Question 67

Ascending loop of hence accounts for ~ ____ % of filtered Na

Answer 67

25%