HTN Practice Pt2

Question 1

amlodipine

Answer 1

norvasc -dhp ccb

Question 2

nifedipine er

Answer 2

procardia - dhp ccb

Question 3

diltiazem

Answer 3

cardizem - non dhp ccb

Question 4

aliskiren

Answer 4

tekturna - diirect renin inhibitor

Question 5

bisoprolol

Answer 5

zebata - cardioselective beta blockers (beta 1)

Question 6

metoprolol succinate

Answer 6

toprol - cardioselective beta blocker (beta 1)

Question 7

carvedilol

Answer 7

coreg - alpha/beta blocker (beta 1 and 2, alpha 1)

Question 8

dhp ccb moa

Answer 8

inhibits calcium ions from entering slow channels of vascular smooth muscle- leading to vasodilation

Question 9

dhp ccb contraindications

Answer 9

none

Question 9

dhp ccb adr

Answer 9

peripheral edema, pulmonary edema, hepatotoxicity, thrombocytopenia

Question 10

dhp ccb ddi

Answer 10

major substrate of CYP3A4

Question 11

dhp ccb notes

Answer 11

immediate release nifedipine has increased risk of mi and mortality- only er is used, can take up to one week to see bp lowering effects- no electrolyte changes, major substrate of cyp3a4

Question 12

non dhp ccb moa

Answer 12

inhibits calcium from entering vascular smooth muscle and myocardium, slowing av node/hr

Question 13

non dhp ccb contraindications

Answer 13

2nd or 3rd degree heart block

Question 14

non dhp ccb adr

Answer 14

peripheral edema, pulmonary ede3ma, ha, heart failure, heart block, hepatotoxicity

Question 15

non dhp ccb ddi

Answer 15

major substrate of CYP3A4, moderate inhibitor of CYP3A4- worse with verapamil than dilt

Question 16

non dhp ccb notes

Answer 16

cyp3a4 major substrate and moderate inhibitor (dose adjustments for lovastatin/simvastatin), avoid use in patients with hfref, avoid routine use with beta blockers, multiple brands exist, following timing for administration (dilt only), some brands are capsules that can be opened and sprinkled on food (dilt only)

Question 17

amlodipine dosing

Answer 17

norvasc is normally dosed at 2.5-10 mg daily

Question 18

nifedipine er dosing

Answer 18

procardia is dosed at 30-120 mg daily

Question 19

diltiazem dosing

Answer 19

cardizem is dosed at 120-360 mg daily

Question 20

beta blocker moa

Answer 20

inhibiting beta 1 (all) and beta2(some) to decrease hr and myocardial contractility- variable inhibition based on selectivity

Question 21

beta blocker contraindication

Answer 21

severe bradycardia
precaution: with copd disease

Question 22

beta blocker adr

Answer 22

dizziness, fatigue, reduced exercise tolerance, bronchospasm, insomnia, impotence

Question 23

beta blocker ddi

Answer 23

additive av nodal blockage with non dhp ccb

Question 24

beta blocker notes

Answer 24

avoid abrupt withdrawal- can cause rebound tachycardia, angina, and mi, patients may feel fatigued when starting- this will go away with time, may mask feelings of low blood glucose, use with caution in patients with severe bronchospastic disease, can enhance hypoglycemic effects of insulin and sulfonylureas

Question 25

bisoprolol dosing

Answer 25

zebata is usually dosed at 2.5-10mg daily
cardioselective

Question 26

metoprolol succinate dosing

Answer 26

toprol xl is dosed at 50-200 mg daily
cardioselective

Question 27

carvedilol dosing

Answer 27

coreg is dosed at 12.5-50 mg in 2 divded doses
combined alpha and beta selectivity

Question 28

direct renin inhibitor notes

Answer 28

do not use raas drugs in combination., long half life, lack of long term studies on cv outcomes, high drug costs, electrolyte impact

Question 29

aliskiren dosing

Answer 29

tekturna is dosed at 150-300 mg daily