Pharmacology of Antihypertensives

Question 1

These anti-hypertensive agents are contraindicated in pregnancy.

Answer 1

ACE Inhibitors, ARBs, Aliskiren

Question 2

What ADRs are associated with dihydropyridine calcium channel blockers?

Answer 2

Reflex tachycardia, pedal edema, gingival hyperplasia

Question 3

These beta blockers are partial agonists.

Answer 3

Pindolol, acebutolol, penbutolol

Question 4

What is the MOA of Aliskiren?

Answer 4

Competitive inhibitor of renin

Question 5

What is the first-line diuretic for treatment of hypertension?

Answer 5

Thiazides - hydrochlorothiazide (Loop diuretics are used when thiazides are ineffective or contraindicated)

Question 6

This beta blocker has an extremely short half life and is used in hypertensive emergencies and operations.

Answer 6

Esmolol

Question 7

What are the common alpha blockers?

Answer 7

Doxazosin, prazosin, terazosin (-zosin)

Question 8

These beta blockers are beta 1 selective.

Answer 8

Metoprolol and atenolol

Question 9

True/False. Vasodilators may be used as monotherapy.

Answer 9

False - they are always adjunctive. The body has compensatory mechanisms to vasodilation that must be inhibited with other drugs

Question 10

This vasodilator is a potassium channel opener that hyperpolarizes and relaxes vascular smooth muscle. It is also used topically to treat male baldness.

Answer 10

Minoxidil

Question 11

What are the non-dihydropyridine calcium channel blockers?

Answer 11

Diltazem, verapamil

Question 12

What are the common dihydropyridine calcium channel blockers?

Answer 12

Amlodipine, nifedipine

Question 13

What electrolyte abnormality is associated with thiazides and loop diuretics?

Answer 13

Hypokalemia

Question 14

What is the MOA of clonidine?

Answer 14

Centrally acting alpha2 agonist - temporarily increases BP until drug enters the CNS and decreases sympathetic signaling

Question 15

What is the most common ADR associated with beta blockers?

Answer 15

Reduce exercise tolerance due to decreased CO and total peripheral resistance

Question 16

What is the MOA of methyldopa?

Answer 16

Acts as a false neurotransmitter to stimulate central alpha2 receptors and decrease sympathetic signaling

Question 17

What is the MOA of propanolol?

Answer 17

Non-selective beta antagonist

Question 18

True/False. With hypertension, both cardiac output and peripheral vascular resistance are typically increased.

Answer 18

False - generally, only peripheral vascular resistance is increased

Question 19

What is the MOA of fenoldopam?

Answer 19

Activates vascular D1 receptors to stimulate vasodilation

Question 20

What drugs can be prescribed to prevent reflex tachycardia caused by anti-hypertensive medications?

Answer 20

Beta blockers

Question 21

What ADRs are associated with methyldopa?

Answer 21

Sexual dysfunction, somnolence, positive Coombs test (hemolytic anemia)

Question 22

This vasodilator is used in hypertensive emergencies, but is associated with cyanide toxicity.

Answer 22

Sodium nitroprusside

Question 23

What is the MOA of losartan?

Answer 23

Angiotensin Receptor Blocker (ARB) - inhibit the effects of angiotensin II

Question 24

What ADR is most assocaited with alpha blockers?

Answer 24

Postural hypotension

Question 25

What ADRs are associated with ACE inhibitors?

Answer 25

Hypotension, cough, hyperkalemia, angioedema, rash

Question 26

What are the MOA of catopril and lisinopril?

Answer 26

Angiotensin Converting Enzyme (ACE) Inhibitors - decrease systemic vascular resistance

Question 27

Hypertension is defined as a BP over what value?

Answer 27

140/90 mmHg

Question 28

Calcium channel blockers inhibit calcium influx through voltage-gated channels to relax vascular smooth muscle. How do the dihyropyridine and non-dihydropyridine CCBs differ?

Answer 28

In addition to relaxing vascular smooth muscle, non-dihydropyridine CCBs also decrease HR by slowing AV nodal conduction

Question 29

What is the MOA of hydralazine?

Answer 29

Releases NO from endothelial cells to cause vasodilation

Question 30

What are the most common ADRs of clonidine?

Answer 30

Sedation, sexual dysfunction

Question 31

This beta blocker acts on both alpha and beta receptors.

Answer 31

Labetolol

Question 32

This long-acting potassium channel opener is used via IV in hypertensive emergencies.

Answer 32

Diazoxide

Question 33

This beta blocker is beta1 selective and increases nitric oxide.

Answer 33

Nevibulol