HTN And HLD Drugs

Question 1

What is the MOA of statins?

Answer 1

Inhibits HMG CoA reductase

Question 2

How do statins affect the lipid panel?

Answer 2

Lowers LDL and TGs

Question 3

What are the adverse effects of statins?

Answer 3

Liver toxicity, GI upset, myalgias, and rhabdo

Question 4

What are the absolute and relative contraindications for statin use?

Answer 4

Absolute: Active liver disease, pregnancy
Relative: concomitant use with CYP3A4 inhibitors, chronic kidney and liver disease

Question 5

What is the MOA of bile acid sequestrants?

Answer 5

Binds bile in the intestine and has a synergistic effect with statins

Question 6

How do bile acid sequestrants affect the lipid panel?

Answer 6

Lowers LDL

Question 7

What are the adverse effects of bile acid sequestrants?

Answer 7

Constipation, gas, interference with vitamins absorption, interference with warfarin management, and possible increase TGs

Question 8

What are the absolute and relative contraindications of bile acid sequestrants?

Answer 8

Absolute: TGs > 400
Relative: TGs >200

Question 9

Are bile acid sequestrants safe in pregnancy?

Answer 9

Yes

Question 10

How does nicotinic acid affect the lipid panel?

Answer 10

Reduces LDL, increases HDL, and may reduce TGs

Question 11

What are the adverse effects of nicotinic acid?

Answer 11

Flushing, pruritis, liver damage, and safety concerns when used with a statin

Question 12

What are the absolute and relative contraindications of nicotinic acid?

Answer 12

Absolute: Active liver disease
Relative: Hyperuricemia, hyperglycemia, and unstable angina

**not used in pregnancy

Question 13

How do Fibric acid derivatives affect the lipid panel?

Answer 13

Lowers TGs and increases HDL

Question 14

What are the adverse effects of fibric acid derivatives?

Answer 14

Gallstones, hepatitis, myositis

Question 15

What are the absolute and relative contraindications of fibric acid derivatives?

Answer 15

Absolute: severe Hepatic or renal disease, preexisting gallstones, or taking simvastatin
Relative: other statin use, concurrent warfarin use

Question 16

What is the MOA of Ezetimibe?

Answer 16

Blocks intestinal absorption of dietary and biliary cholesterol

Question 17

How does ezetimibe affect the lipid panel?

Answer 17

Lowers LDL

Question 18

What are the contraindications of Exetimibe?

Answer 18

Use with a statin in active liver disease, pregnancy

Question 19

How do PCSK9 inhibitors affect the lipid panel?

Answer 19

Decreases LDL

Question 20

What should you monitor when your patient it taking a thiazide type diuretic?

Answer 20

Monitor for hyponatremia, hypokalemia, and Uric acid levels

Question 21

What is the contraindication to both thiazide and loop diuretics?

Answer 21

Sulfa sensitivity

Question 22

What is the preferred diuretic in symptomatic HF?

Answer 22

Furosemide (loop)

Question 23

What are the side effects of potassium sparing diuretics?

Answer 23

Hyperkalemia, nephrolithiasis, renal dysfunction (avoid in severe CKD)

Question 24

What is the contraindication for aldosterone antagonists?

Answer 24

Renal impairment

Question 25

What are the compelling indications for ACE inhibitors?

Answer 25

DM, CKD, post MI, and heart failure

Question 26

What are the contraindications for ACE inhibitors?

Answer 26

Pregnancy, angioedema, and renal artery stenosis

Question 27

What are the side effects of ACE inhibitors?

Answer 27

Cough, hyperkalemia, angioedema, dizziness, and acute renal failure

Question 28

What are the side effects of ARBs?

Answer 28

Hyperkalemia, acute renal failure, and angioedema

Question 29

What are the contraindications of ARBs?

Answer 29

Pregnancy and renal artery stenosis

Question 30

What are the side effects of CCBs?

Answer 30

Headache, peripheral edema, bradycardia, and dizziness

Question 31

What are the contraindications of non-dihydropyridine CCBs?

Answer 31

Avoid use with beta blockers, HFrEF

Question 32

What are the contraindications of dihydropyridine CCBs?

Answer 32

HFrEF

Question 33

What are the compelling indications of Beta blockers?

Answer 33

Stable HF, post MI, high CAD risk

Question 34

What should you avoid doing when you’re taking beta blockers?

Answer 34

Avoid abrupt withdrawal because that can precipitate acute coronary events and increase BP

Question 35

What are the common side effects of beta blockers?

Answer 35

Bronchospasm, AV block, fatigue, sleep disturbances

Question 36

What are the contraindications for beta blockers?

Answer 36

Bronchospastic disease, conduction abnormalities, and acute decomposition of CHF

Question 37

What are the contraindications for central alpha agonists?

Answer 37

Methyldopa in liver disease

Question 38

What re the side effects of alpha blockers?

Answer 38

Orthostatic hypotension, reflex tachycardia, and dizziness

Question 39

What is the compelling indication for alpha blockers?

Answer 39

BPH

Question 40

What are the side effects of direct renin inhibitors?

Answer 40

Hyperkalemia, renal impairment, hypersensitivity reactions

Question 41

What are the contraindications for direct renin inhibitors?

Answer 41

Use with ACE or ARB in DM, pregnancy