Drugs for hypertension: Part 3

Question 1

Centrally acting alpha 2 agonists names

Answer 1

Clonidine (Catapres), Methyldopa (Aldomet) -safe in pregnancy

Question 2

Centrally acting alpha 2 agonists

Answer 2

Acts within the brainstem - suppresses sympathetic outflow to heart and blood vessels ( vasodilation and reduced CO)

Question 3

Adverse effects of Centrally acting alpha 2 agonists

Answer 3

Dry mouth / sedation / sedation / fluid and sodium retention

Question 4

Adverse effects of Clonidine

Answer 4

Rebound hypertension if abruptly discontinued

Question 5

Adverse effects of Methyldopa

Answer 5

Hemolytic anemis and liver dysfunction

Used during pregnancy

Question 6

Adrenergic neuron blockers names

Answer 6

Guanethidine (Ismelin), Guanadrel (Hylorel), Resperpine

Question 7

Adrenergic neuron blockers

Answer 7

Potent
Inhibits / depletes norepinephrine
Decreases sympathetic stimulation of heart / vessels

Question 8

Adverse effects of adrenergic neuron blockers

Answer 8

Severe orthostatic hypertension

Depression

Question 9

Adrenergic neuron blockers are last choice agents for chronic hypertension d/t…

Answer 9

The risk of postural hypotension

Question 10

Direct acting vasodilators

Answer 10

Reduces BP by promoting dilation of arteries

Question 11

Why is there very little OH with direct acting vasodilators?

Answer 11

Because there is no significant dilation of arterioles

Question 12

Adverse effects of direct acting vasodilators

Answer 12

Reflex tachycardia, renin release, fluid retention

Question 13

Calcium channel blockers examples

Answer 13

Nifedipine (Procardia) Verapamil (Calan), Diltiazam (Cardizem)

Question 14

Calcium channel blockers…

Answer 14

Promote dilation of arteries

Question 15

Verapamil and Diltiazem also have..

Answer 15

Direct suppressant effects on the heart

Question 16

Adverse affects of calcium channel blockers

Answer 16

Reflex tachycardia (less with Verapamil and Diltiazem)

Question 17

Virapamil and Diltiazaem are used cautiously in patients with…

Answer 17

Bradycardia, heart failure or AV block

Question 18

Nifedipine adverse effects

Answer 18

May increase mortality in patients with MI and unstable angina

Question 19

Blocking of calcium prevents…

Answer 19

Vasospasticity

Question 20

Should you see beta blockers and calcium blockers together?

Answer 20

No (too much heart suppression)

Question 21

Nifedipine is now being used to treat….

Answer 21

Pre-term labor

Question 22

ACE inhibitors examples

Answer 22

Captopril (Capoten), Enalapril (Vasotec), Lisinopril (Prinivil)

Question 23

ACE inhibitors

Answer 23

Prevent formation of angiotensin II which prevents angiotensin II - mediated vasoconstriction and aldosterone-mediated volume expansion

Question 24

What do ACE inhibitors do for DM patients with renal damage?

Answer 24

Slows kidney injury

Question 25

Adverse effects of ACE inhibitors

Answer 25

Constant irritated cough First-dose hypotension Angioedema Hyperkalemia (Avoid K supplements and K sparing diuretics)

Question 26

Should ACE inhibitors be taken during pregnancy?

Answer 26

NO - reduces placental blood flow

Question 27

Angioedema

Answer 27

Swelling from the chest up - can cause trachea to swell and airway to close

Question 28

Angiotensin II receptor receptor blockers examples

Answer 28

Losartan (Cozaar), Valsartan (Diovan)

Question 29

ARBS are similar to...

Answer 29

ACE inhibitors (Newer, better version)

Question 30

ARBS

Answer 30

Prevent angiotensin II mediated vasoconstriction and release of aldosterone

Question 31

Adverse effects of ARBS

Answer 31

Dizziness / drowsiness | Angioedema

Question 32

ACE inhibitors __________ while ARBS

Answer 32

Stop the formation of angiotensin II | Blocks angiotensin from being able to act

Question 33

Treatment algorithm for HTN

Answer 33

>Lifestyle changes >Single drug >Second drug (after failure of first is assessed)

Question 34

What are the first-line drugs chosen for HTN?

Answer 34

Thiazides and beta blockers unless they are diabetic

Question 35

Dosing of HTN medication should..

Answer 35

Start low and gradually increased (after 1 year should be decreased)

Question 36

Preferred drugs for renal disease

Answer 36

ARBS, ACE inhibitors and loops

Question 37

Preferred drugs for diabetes

Answer 37

ACE inhibitors, ARBS, CCB, and diuretics

Question 38

What should be the first step for African Americans with hypertension?

Answer 38

Decreased salt in diet

Question 39

Hypertension in African Americas..

Answer 39

Develops at an earlier age and has higher mortality rates

Question 40

What drugs are less effective in African Americans?

Answer 40

Beta blockers and ACE inhibitors

Question 41

What drugs are more effective in African Americans?

Answer 41

Calcium channel blockers and alpha 2 blockers

Question 42

Pregnant women will..

Answer 42

Continue to take most hypertensive drugs that were taken prior to pregnancy

Question 43

When is drug therapy indicated during pregnancy?

Answer 43

180/110

Question 44

What drugs are contraindicated with pregnancy?

Answer 44

ACE and ARBS because they decrease placental blood flow