PHARM GOOD SHIT

Question 1

HTN treatment (first line therapy)

Answer 1

Thiazides diuretics
ACEI
ARBs
CCBs

Question 2

MOA of Diuretic?

Answer 2

THIAZIDES (HCTZ)
Reduce fluid volume–> decrease CO and Blood volume initially (but they return to normal)

Second mechanism: decrease vascular reactivity to NE and decrease BP (hyperpolarize blood vessels which leads to Vasodilation) (this mechanism stays reduced)

Question 3

MOA of CCBs

Answer 3

PRILS
decrease Ca++ –> slow conduction through AV node–> decrease HR –> decrease CO
Also…
decreases BP –> decreases TPR

Adverse effects: decreases GI motility

Works well with Comorbid pts!

Question 4

IF pt has HTN and gums are red, swollen and bleeding, what drug are they on?

Answer 4

Calcium channel blockers

Question 5

Which cardio depressant drug slows the heart the most?

Answer 5

Verapamil doesn’t cause reflex tachy because it works directly on the heart

Question 6

Which CCB is most likely to vasodilate and cause reflex tachy?

Answer 6

Dipines

Question 7

ACEI MOA?

Answer 7

Blocks ACE –> prevents conversion of ANGI to ANGII (potent vasoconstrictor)

Also stops Bradykinin from being inactive so it continues to Vasodilate

Question 8

What is a major side effect of ACEI?

Answer 8

COUGH!!!

because of bradykinin being inhibited

Question 9

BLOCK: Which drug below directly inhibits renin?

Answer 9

Aliskirien

Question 10

Block: A pt is placed on aliskirien, what will accumulate because of it?

Answer 10

Angiotensinogen

Question 11

As a result of pt being on Aliskirien, what can not be made?

Answer 11

ANGI

Question 12

Pt complains of nagging cough with ACEI… what drug could you switch them to not having a cough?

Answer 12

ARBs

Question 13

ARBs act on what?

Answer 13

AT-1 receptor… found on blood vessels and Adrenal cortex

Question 14

What prevents or delays the progression of renal disease?

Answer 14

Diabetic nephrology (protect kidney)

Question 15

Why does ACEI help diabetics?

Answer 15

It saves your kidney, ACEI stops ANG2… So afferent and efferent dilate which decreases GFR…. Work on kidney decreases

Question 16

When is dilation of Efferent arteriole bad? Or therefore use of ARBs

Answer 16

Bilateral renal artery stenosis (because GFR is already low because both afferent and Efferent are constricted, so you don’t want to decrease GFR any more)

Question 17

What’s the most serious side effect of ACEI?

Answer 17

Angioedema

Question 18

What should you check if trying to give ACEI? If this is really low you shouldn’t use ACEI to help.

Bilateral renal artery stenosis

Answer 18

Check GFR

Question 19

ANGII receptor antagonists MOA

Answer 19

Inhibits AT1 receptor which blocks ANGII –> dilate efferent arteriole

Question 20

Elderly black male with HTN what are 2 drugs that would be good and 2 that would be bad?

Answer 20

Thiazides and CCB’s

Probably don’t give BBs and ACEIs

Question 21

Alpha 1 blocker MOA

Answer 21

Block A1s on Arterioles and venules

Relaxes Vascular smooth muscle

Question 22

Which drug below is good for HTN and also BPH?

Answer 22

Prazosin

Question 23

WHich drugs can be used with pregnancy?

Answer 23

METHYLDOPA, Diuretics, CCBs, BBs, A1 blockers, A2 agonists

Question 24

Which drugs should not be used while pregnant?

Answer 24

AAA: don’t want to have to call your triple A agent when prego
Aliskieren, ACEI, ARBs

Question 25

What if pt gets tired of being tired? They end up stopping their HTN meds. What happens?

Answer 25

REbound HTN