Hypertension Medications

Question 1

What are the long-term complications of hypertension?

Answer 1

Brain (stroke, TIA), Eye (blindness), Heart (angina, heart attack, heart failure), kidney failure, legs - peripheral artery disease

Question 2

What is the target blood pressure for pts over 60 years old?

Answer 2

150/90mmHg with medication

Question 3

What is the target blood pressure for pts under 60 years old?

Answer 3

140/90mmHg with medication

Question 4

What are the 2 classes of diuretics?

Answer 4

Thiazides and Loops

Question 5

What is the prototypical thiazide diuretic?

Answer 5

Hydroclorothiazide

Question 6

What is the prototypical loop diuretic?

Answer 6

Type II Furosemide (Lasix)

Question 7

How do diuretics work?

Answer 7

Cause renal excretion of excess NaCl from the blood stream. Water follows into the kidney and increases urination

Question 8

This diuretic pulls off blood volume from vascular space (the blood stream)

Answer 8

Hydroclorothiazide

Question 9

This diuretic pulls off blood volume from peripheral/pulmonary edema.

Answer 9

Loop diuretic

Question 10

This diuretic works in the ascending Loop of Henle.

Answer 10

Loop Diuretic

Question 11

This diuretic occurs in the distal convulated tubule.

Answer 11

Thiazide Diuretic

Question 12

What are the 2 mechanisms of Thiazide diuretics?

Answer 12

Decreasing blood volume and decreasing peripheral resistance in the arms and legs

Question 13

Peripheral resistance (vasodilation) takes how long to occur in the body?

Answer 13

3-4 weeks

Question 14

Hydroclorothiazide _____ calcium excretion.

Answer 14

decreases.. acts as mini-osteoporosis drugs

Question 15

Thiazide has a ____ diuretic effect

Answer 15

mild

Question 16

It the thiazide is taken as needed.. urine excretion will ____

Answer 16

remain steady

Question 17

If the thiazide is taken every day..urine excretion will ______

Answer 17

wear off and the main mechanism will be peripheral resistance

Question 18

Thiazides ____ uric acid secretion. What disease does this increase the risk for?

Answer 18

decrease uric acid.

Gout

Question 19

Furosemide (Lasix) ______ calcium excretion in the urine

Answer 19

increases

Question 20

Loops inhibits the ____ pump to to inhibit reabsorption of NaCl

Answer 20

sodium-potassium pump

Question 21

Loops can pull of _____ volumes of fluid

Answer 21

large

Question 22

Loops are the DOC for reducing acute pulmonary edema in what disease?

Answer 22

Congestive Heart Failure

Question 23

Hypokalemia, Hyperuricemia, and hypercalcemia are caused by which diuretic

Answer 23

Thiazides

Question 24

Acute hypovolemia, hypokalemia, hyperuricemia, hearing loss are characteristics of what diuretic?

Answer 24

Loops

Question 25

Propranolol is a type of ________ beta-blocker

Answer 25

non-selective

Question 26

At low doses, cardiac selective beta blockers plug into B_ receptors.

Answer 26

B1 cardiac receptors

Question 27

Beta 2 receptors are found where?

Answer 27

in the lungs and periphery

Question 28

Beta 1 receptors are found where?

Answer 28

in the cardiac muscle

Question 29

What are the ADRs of beta blockers?

Answer 29

Fatigue, depression, nightmares, sexual dysfunction, bronchoconstriction, bradycardia

Question 30

Do not give pt a beta blocker when the HR is _____.

Answer 30

Less than or equal to 60 bpm

Question 31

What are the 3 prototypes for Ace-Inhibitors

Answer 31

Enalapril (Vasotec), Lisonopril (Prinivil, Zestril) | Ramipril (Altace)

Question 32

T or F: Ace inhibitors effect the renin-angiotensin-aldosterone system (RAAS)

Answer 32

True

Question 33

The basic MOA for ace-inhibitors is to decrease or completely inhibit ____.

Answer 33

Ang I from becoming Ang II

Question 34

Angiotensin II act as a...

Answer 34

vasoconstrictor which increases one's blood pressure

Question 35

What is the main problem with ACE inhibitors?

Answer 35

ACE escape -- some enzyme is still able to convert Ang I to Ang II

Question 36

What 5 things do Ace-inhibitors do?

Answer 36

Decreases prod. of Ang II, Decreases output of sympathetic nervous system, Increases vasodilation, decreases aldosterone, increases levels of bradykinin

Question 37

An accumulation in bradykinin causes the pt to ____.

Answer 37

cough

Question 38

ARB acts by what MOA?

Answer 38

Blocks/plugs the receptors of Ang II so Ang I cannot bind

Question 39

What percentage of patients experience the Ace cough?

Answer 39

10-30%

Question 40

What allergic rxn is unique to ACE and ARB that involves the mouth and lips?

Answer 40

Angioedemia

Question 41

Which Dihydropyridine CCB should be used?

Answer 41

Amlodipine

Question 42

Non-dihydropyridine CCB (are/aren't) peripheral dilators

Answer 42

Are not

Question 43

Dihydropyridine CCBs (are/aren't) peripheral dilators

Answer 43

Are

Question 44

What are the 2 non-dihydropyridine CCBs? Do they work directly on the heart?

Answer 44

Verapamil and Diltiazem Yes, work on myocardium to decrease cardiac output

Question 45

Amlodipine and Nifedipine causes vasodilation by focusing on the ___ and ___.

Answer 45

arms and legs

Question 46

Constipation, gingival hyperplasia, worsening of CHF are all side effects of ?

Answer 46

Verapamil

Question 47

T or F: Using beta-blockers with verapamil can stop the heart from beating?

Answer 47

True

Question 48

Why don't we use nifedipine anymore?

Answer 48

causes fast vasodilation in peripher. Pt will experience increased heart rate and palpitation

Question 49

Amlodipine (Norvasc) is better than Nifedipine, but still causes ____ edema

Answer 49

peripheral