Hypertension

Question 0

List thiazides diuretics

Answer 0

Chlorothiazide (Diuril)
chlorthalidone (generic)
hydrochlorothiazide (Microzide, HydroDIURIL†) 
polythiazide (Renese)
indapamide (Lozol†)
metolazone (Mykrox)
metolazone (Zaroxolyn)

(See JNC-7 for dosing range http://www.nhlbi.nih.gov/guidelines/hypertension/express.pdf)

Question 1

Which drugs are recommended by the JNC-7 for heart failure?

Answer 1

1- thiazide diuretic
2- beta blocker
3- ACEI
4- ARB
5- Aldosterone antagonist

Question 2

List types of beta blockers

Answer 2

atenolol (Tenormin†)
betaxolol (Kerlone†)
bisoprolol (Zebeta†)
metoprolol (Lopressor†)
metoprolol extended release (Toprol XL) 
nadolol (Corgard†)
propranolol (Inderal†)
propranolol long-acting (Inderal LA†) 
timolol (Blocadren†)

Question 3

List types of ACEI

Answer 3

benazepril (Lotensin†) 
captopril (Capoten†)
enalapril (Vasotec†)
fosinopril (Monopril)
lisinopril (Prinivil, Zestril†) 
moexipril (Univasc)
perindopril (Aceon) 
quinapril (Accupril)
ramipril (Altace) 
trandolapril (Mavik)

Question 4

List types of ARBs

Answer 4

candesartan (Atacand) 
eprosartan (Teveten) 
irbesartan (Avapro) 
losartan (Cozaar) 
olmesartan (Benicar) 
telmisartan (Micardis) 
valsartan (Diovan)

Question 5

List types of Aldosterone antagonists

Answer 5

eplerenone (Inspra)

spironolactone (Aldactone†)

Question 8

What is the most important goal of HTN treatment?

Answer 8

Prevent TOD (target organ damage)

Question 9

Define prehypertension

Answer 9

SBP 120-139 or DBP 80-89

Question 10

For which compelling indication(s) are aldosterone antagonists used?

Answer 10

1- Post MI

2- Heart failure

Question 11

For which compelling indication(s) are thiazide diuretics used?

Answer 11

1- heart failure
2- high CAD risk
3- DM
4- recurrent stroke prevention

Question 12

For which compelling indication(s) are beta blockers used?

Answer 12

1-Heart failure
2-Post MI
3-High risk CAD
4-DM

Question 13

For which compelling indication(s) are angiotensive converting enzyme inhibitors used? (Hint: 6)

Answer 13

1- heart failure
2- post MI
3- high CAD risk
4- DM
5- Chronic renal disease
6- recurrent stroke prevention

Question 14

For which compelling indication(s) are calcium channel blockers used?

Answer 14

1-high CAD risk

2- DM

Question 15

For which compelling indication(s) are angiotensin receptor blockers used?

Answer 15

1-heart failure
2- DM
3- chronic renal disease

Question 16

List types of non-dihydropyridine calcium channel blockers

Answer 16

Diltiazem extended release (Cardizem CD, Dilacor XR, Tiazac†)
diltiazem extended release (Cardizem LA)
verapamil immediate release (Calan, Isoptin†)
verapamil long acting (Calan SR, Isoptin SR†)
verapamil—Coer, Covera HS, Verelan PM)

Question 17

List types of dihydropyridine calcium channel blockers

Answer 17

amlodipine (Norvasc)
felodipine (Plendil)
isradipine (Dynacirc CR)
nicardipine sustained release (Cardene SR)
nifedipine long-acting (Adalat CC, Procardia XL)
nisoldipine (Sular)

Question 18

Which drug should be initiated for new stage I HTN?

Answer 18

A thiazide diuretic

Question 19

Which drug classes may be added to the initial drug therapy, or used as an alternative initial drug, for stage I HTN?

Answer 19

ACEI
ARB
BB
CCB

Question 20

Give examples of potassium sparing diuretics

Answer 20

amiloride (Midamor†)

triamterene (Dyrenium)

Question 21

For which conditions are ACEIs contraindicated?

Answer 21

Pregnancy

H/o angioedema

Question 22

For which conditions are ARBs contraindicated?

Answer 22

Pregnancy

Question 23

What are the major risk factors for cardiovascular disease?

Answer 23

Hypertension
Cigarette smoking
Dyslipidemia
Diabetes mellitus
Obesity (BMI >_ 30)
Physical Inactivity
Microalbuminuria or GFR < 60
Age (older than 55 for men, 65 for women)
Family history (men under age 55 or women under age 65)

Question 24

Define stage I hypertension

Answer 24

SBP 140-159/90-99

Question 25

Define stage II hypertension

Answer 25

> =160/>=100