Pharm

Question 1

AntiHT
Mx guide lines for es.HT
4th stage can add

Answer 1

55yr or all blacks
C/D
A+C/D
A+C+D

55

Question 2

HT with HF RX

Bblocker not given if

Answer 2

ACEI/ARB
Diuretics
Bblockers
Spironolactone

De compensated HF or cardiogenic shock

Question 3

HT with DM RX

Importance of A

Answer 3

A/B/C/D

Protective against diabetic nephropathy

Question 4

CCB
Types 2-eg/acts where
Mechanism of action
Clinical use
Clevidipine  use
Nimodipine use
Specificity to tissues
SE
Verapamil special SE

Answer 4

Amlodipine, clevidipine, nicardipine, nifedipine, nimodipine (dihydropyridines)
act on vascular smooth muscle)

diltiazem, verapamil (non-dihydropyridines)
act on heart

Block voltage-dependent L-type calcium channels of cardiac and smooth muscle Ž - reduce muscle contractility.

Vascular smooth muscle—amlodipine = nifedipine > diltiazem > verapamil.

Heart—verapamil > diltiazem > amlodipine = nifedipine (verapamil = ventricle).

Dihydropyridines (except nimodipine): hypertension, angina (including Prinzmetal), Raynaud phenomenon.

Nimodipine: subarachnoid hemorrhage (prevents cerebral vasospasm).

Clevidipine: hypertensive urgency or emergency.

Non-dihydropyridines: hypertension, angina, atrial fibrillation/flutter.

Cardiac depression, AV block (non-dihydropyridines),
peripheral edema, flushing, dizziness, hyperprolactinemia (verapamil), constipation, gingival hyperplasia.

Question 5

Hydralazine 
MOA 
Uses 3
Not to be use in,why
Usually given with ,why
SE-special one

Answer 5

Increase cGMP Ž -smooth muscle relaxation. Vasodilates arterioles > veins; afterload reduction.

Severe hypertension (particularly acute),
HF (with organic nitrate).
Safe to use during pregnancy.

Frequently coadministered with a β-blocker to prevent reflex tachycardia.

Compensatory tachycardia (contraindicated in angina/CAD), fluid retention, headache, angina.
Lupus-like syndrome.

Question 6

Drugs used in severe HT 5
Nitroprosside-MOA/SE
Fenoldopam-MOA/sites/results

Answer 6

clevidipine
fenoldopam
labetalol
nicardipine
nitroprusside.

Nitroprossside-
Short acting
Increase cGMP via direct release of NO.
Can cause cyanide toxicity (releases cyanide).

Fenoldopam-
Dopamine D1 receptor agonist—coronary, peripheral, renal, and splanchnic vasodilation. 

Reduce BP,  natriuresis.

Question 7

HT in pregnancy drugs

Answer 7

Hydralazine
Methyl dopa
Labetalol
Nifedipine