Hypertension Management

Question 1

ACE Inhibitors Names?

Answer 1

Captopril
Enalapril
Lisinopril

Question 2

Concerns for ACE Inhibitors

Answer 2

• Excessive hypotension
• AKI
• Neurologic effects
• Adversely affects ongoing renal development, especially in premature infants

Question 3

ACE Inhibitor: Dosing

Answer 3

Work with your pharmacist!!

Question 4

Beta Blocker Name?

Answer 4

Propranolol

Question 5

Concerns for Beta Blockers

Answer 5

Hypoglycemia

Bronchoconstriction - avoid in pts with asthma, BPD

Question 6

Beta Blocker usage

Answer 6

Treat hemangiomas, monitor for side effects

Question 7

Beta Blocker bioavailability

Answer 7

Only given orally

25% bioavailability

Question 8

Beta Blocker MoA

Answer 8

Reduces secretion of renin and norepi by blocking the action of norepi and epi on the beta receptors of the SNS (inhibits inotropic and chronotropic effects –> decreased HR –> decreased BP)

Question 9

Beta Blocker Monitoring

Answer 9

HR and BP

Question 10

ACE Inhibitor MoA

Answer 10

Inhibits conversion of angiotensin I to angiotensin II –> relaxation of blood vessels, inhibits release of aldosterone –> Increased sodium and water excretion –> decreased blood pressure

Question 11

Calcium Channel Blockers MoA

Answer 11

Reduces influx of calcium into cells of heart and arteries during depolarization –> relaxation of coronary vascular smooth muscle with coronary vasodilation and reduces peripheral vasoconstriction –> decreases arterial BP

Question 12

Calcium Channel Blocker Name

Answer 12

Amlodipine

Question 13

CCB Concern

Answer 13

Mild reflex tachycardia

Question 14

CCB Kinetics/Dynamics

Answer 14

Slow onset of action, long half-life, infrequent dose –> useful for chronic HTN

Question 15

Alpha-adrenergic agonist MoA

Answer 15

Excites pathway that inhibits excitatory CV neurons –> decreased sympathetic outflow from CNS –> Decreased arterial BP

Question 16

Alpha-adrenergic agonist Name

Answer 16

Clonidine

Question 17

Alpha-adrenergic Concerns

Answer 17

Must by discontinued gradually to avoid rebound HTN

Can cause CNS depression including sedation, brady and hypotension

Question 18

Alpha-Adrenergic Primary Use

Answer 18

Neonatal Opioid Withdrawal syndrome

Question 19

Diuretics (Generalized MoA)

Answer 19

Excrete sodium and water –> decrease extracellular and plasma volume –> decrease arterial BP

Question 20

Diuretics Primarily Used

Answer 20

Furosemide (ototoxic)
Chlorothiazide (first line for HTN)
Spironolactone (K sparing)

Question 21

Vasodilator Primarily Used

Answer 21

Hydralazine to reduce afterload - used for episodic significant HTN

Question 22

Hydralazine Concerns

Answer 22

Reflex tachycardia