TBL - HTN

Question 1

What are complications of HTN?

Answer 1

End-organ damage:

In heart = MI, HF

in brain = Strokes

In eyes = retinopathy (blindness)

In kidneys = CKD

Question 2

What drugs are 1st line for hypertension?

Answer 2

Thiazide diuretics

ACEIs

ARBs

CCBs

Question 3

What drugs are 2nd line for HTN?

Answer 3

Loop diuretics

Beta blockers

MR antagonists

Question 4

What are examples of thiazides diuretics?

Answer 4

Hydrochlorothiazide

Chlorthalidone

Question 5

How do thiazides work?

Answer 5

Inhibit NCC on distal tubule

Inc. salt excretion = dec. total body sodium = dec. BP

Question 6

What are AEs associated with thiazides?

Answer 6

Hypo:

• volemia
• tension
• magnesemia
• kalemia
• natremia

Hyper:

• uricemia
• calcemia
• glycemia
• lipidemia

Metabolic alkalosis
Skin rash
Photosensitivity

Question 7

What are CIs associated with thiazides?

Answer 7

Advanced kidney failure

Sulfonamide allergy

Question 8

What are situations with potentially favorable effects if taking thiazides?

Answer 8

Osteoporosis

Nephrolithiasis

High-normal K+

African American + elderly patients

Question 9

Name an ACEI

Answer 9

Enalapril

Question 10

What AEs are associated with Enalapril?

Answer 10

Hypotension

AKI

Hyperkalemia

Cough

Angioedema

Question 11

What are situations with potentially favorable effects for enalapril patients?

Answer 11

Low normal K+

DM
CKD
CAD
Prior stroke
LV dysfunction

Question 12

When is enalapril contraindicated?

Answer 12

Pregnancy

Question 13

Name an ARB

Answer 13

Losartan

Question 14

What AEs are associated with losartan?

Answer 14

Hypotension

AKI

Hyperkalemia

Less cough

Less angioedema

Question 15

What situations are ARBs potentially favorable?

Answer 15

Low normal K+

DM
CKD
CAD
Prior stroke
LV dysfunction

Question 16

When is losartan contraindicated?

Answer 16

Pregnancy

Question 17

Name two CCBs

Answer 17

DHP =
Nifedipine

Non-DHP =
Verapamil

Question 18

What are AEs associated with nifedipine?

Answer 18

Hypotension

Peripheral edema

Reflex tachycardia

Question 19

What are AEs associated with verapamil?

Answer 19

Hypotension

Bradycardia

AV block

HF

Constipation

Question 20

What situations would Nifedipine be potentially favorable?

Answer 20

Raynaud’s phenomenon

African american + elderly patients

Question 21

What situations would Verapamil be potentially favorable?

Answer 21

SVTs

Tachycardia

Angina

African american and elderly patients

Question 22

What are contraindications for verapamil?

Answer 22

AV block

HF

Question 23

Name a loop diuretic

Answer 23

Furosemide

Question 24

What situations would furosemide be potentially favorable?

Answer 24

Edema

Severe CKD

Question 25

What AEs are associated with furosemide?

Answer 25

Hypo:

• volemia
• tension
• calcemia
• magnesemia
• kalemia
• natremia

Hyper:

• uricemia
• glycemia
• lipidemia

Metabolic alkalosis
Skin rash
Photosensitivity

Ototoxicity

Question 26

Name 2 beta blocker examples

Answer 26

Metoprolol
(Beta1)

Propranolol
(Nonselective)

Question 27

What are AEs associated with beta blockers?

Answer 27

Beta1 blockade =

• bradycardia
• AV block
• HF
• hypotension
• hyperkalemia
• hypoglycemia

Beta2 blockade =

• bronchoconstriction
• hyperkalemia
• hypoglycemia

Question 28

What situations would beta blocker be potentially favorable?

Answer 28

SVTs

HF

CAD

Angina

Question 29

When are beta blockers contraindicated?

Answer 29

Bradycardia

AV block

Acute HF

Question 30

Name a MR antagonist

Answer 30

Spironolactone

Question 31

What AEs are associated with spironolactone?

Answer 31

Hyperkalemia

Gynecomastia

ED

Question 32

What situations is sprironolactone potentially favorable?

Answer 32

HF hirsutism

Acne (women)

Question 33

What are contraindications for spironolactone?

Answer 33

Hyperkalemia