WEEK 2 ANTIHYPERTENSIVES & DIURETICS

Question 1

Describe the action of ACE inhibitors

Answer 1

Blocks angiotensin-converting enzyme from converting angiotensin I to angiotensin II

Question 2

What are 2 therapeutic effects of ACE inhibitors?

Answer 2

1. Prevent vasoconstrictive effect of angiotensin II
2. Prevent the release of aldosterone

Question 3

Name 1 example of an ACE inhibitor

Answer 3

Ramipril (Altace)

Question 4

Name 3 side effects associated with ACE inhibitors

Answer 4

1. Dry cough
2. Hypotension
3. Renal dysfunction/hyperkalemia

Question 5

Which ethnic group do ACE inhibitors have a higher chance of causing adverse effects in?

Answer 5

African americans (angioedema)

Question 6

What are 2 medications that interact negatively with ACE inhibitors?

Answer 6

1. Potassium (inc. risk for hyperkalemia)
2. NSAIDs (decrease effectiveness, harder on kidneys)

Question 7

Describe the action of angiotensin receptor blockers (ARBs)

Answer 7

Blocks angiotensin II receptors at various sites, to prevent vasoconstriction and aldosterone release

Question 8

Name 2 therapeutic effects of ARBs

Answer 8

1. Prevent the vasoconstrictive effect of angiotensin II
2. Prevent the release of aldosterone thereby preventing fluid retention

Question 9

Name 1 example of an ARB

Answer 9

Losartan

Question 10

Name 3 side effects of ARBs

Answer 10

1. Hypotension
2. Hyperkalemia
3. Diarrhea

Question 11

Name 2 medications that interact negatively with ARBs

Answer 11

1. Potassium (inc. risk for hyperkalemia)
2. NSAIDs (decrease effectiveness, harder on kidneys)

Question 12

Describe the action of calcium channel blockers (CCBs)

Answer 12

Blocks entry of calcium into myocardial and vascular smooth muscle cells to inhibit contraction

Question 13

Name 2 therapeutic effects of CCBs

Answer 13

1. Reduces blood pressure by decreasing heart rate and contractility, and inhibiting vasoconstriction
2. Prevents angina by decreasing the heart’s demand for oxygen by decreasing heart rate and contractility

Question 14

Name 1 example of a CCB

Answer 14

Amlodipine

Question 15

Name 3 side effects of CCBs

Answer 15

1. Hypotension (dizziness and headache)
2. Peripheral edema
3. Constipation

Question 16

What 2 comorbid conditions should CCBs be used with caution in?

Answer 16

1. Hepatic impairment
2. Severe CHF

Question 17

Describe the action of beta blockers

Answer 17

Blocks stimulation of myocardial beta-1 adrenergic receptors

Question 18

Name 3 therapeutic effects of beta blockers

Answer 18

1. Decreases blood pressure by decreasing heart rate
2. Prevents angina by reducing the oxygen demand of the heart
3. Slows the progression of heart failure by decreasing afterload

Question 19

Name 1 example of a beta blocker

Answer 19

Metoprolol

Question 20

Name 3 side effects of beta blockers

Answer 20

1. Erectile dysfunction
2. Fatigue/weakness
3. Hypotension/dizziness

Question 21

What are 2 reasons beta blockers would be held?

Answer 21

1. Bradycardia
2. Pulmonary edema

Question 22

What 2 comorbid conditions should beta blockers be used with caution in?

Answer 22

1. Diabetes (may mask hypoglycemia)
2. Asthma/COPD (bronchospasm)

Question 23

Why should beta blockers not be abruptly discontinued?

Answer 23

May cause rebound hypertension

Question 24

When should diuretics be held?

Answer 24

Anuria

Question 25

Which drug class may inhibit the effects of some diuretics?

Answer 25

NSAIDs

Question 26

Describe the action of thiazide diuretics

Answer 26

Inhibits sodium reabsorption in the distal tubule to increase excretion of water, sodium, and other electrolytes

Question 27

Name 1 example of a thiazide diuretic

Answer 27

Hydrochlorothiazide

Question 28

Name a contraindication unique to thiazide diuretics

Answer 28

Sulfa allergy

Question 29

Name a side effect unique to thiazide diuretics

Answer 29

Hyperglycemia

Question 30

Describe the action of loop diuretics

Answer 30

Inhibits reabsorption of sodium and chloride from the loop of Henle to increase excretion of water and electrolytes

Question 31

Name 1 example of a loop diuretic

Answer 31

Furosemide

Question 32

What are 2 side effects of both loop and thiazide diuretics?

Answer 32

1. Hypokalemia 2. Hypotension

Question 33

Which drugs may cause ototoxicity when taken with loop diuretics?

Answer 33

Aminoglycosides

Question 34

Describe the action of potassium-sparing diuretics

Answer 34

Antagonizes aldosterone to cause sodium bicarbonate and calcium loss while saving potassium and hydrogen ions

Question 35

What are 2 therapeutic effects of loop, thiazide, and potassium-sparing diuretics?

Answer 35

1. Lowers BP by decreasing blood volume 2. Promotes diuresis in patients with edema

Question 36

Name 1 example of a potassium-sparing diuretic

Answer 36

Spironolactone

Question 37

Name 2 side effects of potassium-sparing diuretics

Answer 37

1. Hyperkalemia 2. Hypotension

Question 38

Name a contraindication unique to potassium-sparing diuretics

Answer 38

Severe renal impairment (CrCl <30)