HTN medications

Question 1

What are the common side effects of ACE-I, ARNI and ARB?

Answer 1

HYPERKAELEMIA

Renal injuries

Question 2

Can the patient be given ACE-I and ARB at the same time?

Answer 2

No. As ACE-I and ARB work on RAAS.

Question 3

What are the beta antagonist approved for Heart Failure?

Answer 3

Carvidilol, bisoprolol and metoprolol

Question 4

What are the side effects for propranolol ?

Answer 4

Hypotension 
Bradycardia 
AV blocks
Bronchocontriction 
Vivid dreams, depression 
Withdrawal syndrome

Question 5

How does GTN work to reduce angina?

Answer 5

Nitric oxide donor. Causing vasorelaxation.
Venodilation, decreasing preload, and decrease oxygen consumption, decrease angina.

Arteriolar dilation, decreasing afterload, decreases heart workload, then decrease angina.

It also increases coronary blood flow, redistribution of coronary blood flow to ischemia region, then decreases angina

Question 6

Discuss the side effects of nitrate ?

Answer 6

1. Reflex tachycardia: vasorelaxation triggers sympathetic system, and stimulates the baroreceptor, to increase heart rate
2. Hypotension
3. Headache: due to increase meningeal artery vesodilation
4. May lead to tolerance, thus therapy should not be given more than 48hrs

Question 7

What are the clinical uses for amlodipine?

Answer 7

Amlopipine is a dihydropyridines calcium channel blocker. It can be used to treat hypertension,
Angina
And to prevent Myocardial infarction and stroke

Question 8

The effects of ACE-I on bradykinin ?

Answer 8

Prevent the bradykinin from deactivation and Increase bradykinin, increasing nitric oxide and prostaglandin. Nitric oxide causes vasodilation, dry cough and rarely angioedema

Question 9

Ethacrynic acid , bumetamide, furosemide primarily affects which part of the nephron?

Answer 9

The thick ascending loop of Henle.

Blocks the Na/K/2Cl transportor

Question 10

Indapamide, thiazide hydrochlorothiazide, chlorthalidone primarily affects which part of the nephron ?

Answer 10

The distal convoluted tubule

Blocks the Na/Cl transporter

Question 11

Amiloride, triamtrerene primarily works on which part of the nephron ?

Answer 11

Collecting tubule

Blocks the Na channel from openning, Na Cannot be reabsorpted, K cannot be excreted.

Question 12

Similarity of these three medication:
Amiloride
Eplerenone
Triamteren

Answer 12

Potassium sparing diuretics

Question 13

Pt is on enalapril for hypertension, having very bad dry cough, which group would you change it to ?

Answer 13

ARB

Question 14

Two drugs belong to dihydropyridine calcium channel blocker ?

Answer 14

Nifedipine

Amlodipine

Question 15

What antihypertensive can be used for pragnancy ?

Answer 15

Methyldopa
Labetalol
beta blocker, CCB, diuretics

Question 16

Which beta blocker has both alpha and beta blocking properties?

Answer 16

Carvedilol

Labetolol

Question 17

Two drugs belong to non dihydropyridine calcium channel blocker ?

Answer 17

Varapamil

Diltiziam

Question 18

1st line choice of antihypertensive medication for patient with DM and microalbuminuria ?

Answer 18

ARB or ACE-I

Question 19

Drug combos:

Which is avoided for pt with DM or risk for DM ?

Answer 19

Beta blockers and diuretics

Question 20

In order to achieve good BP control: what are the effective combo?

Answer 20

ACE I /ARB +/- CCB +/- DIURETICs