Winter Pharm Quiz #2

Question 0

What severity of hypertension are thiazides primarily used to treat?

Answer 0

Mild hypertension

Question 1

Name 6 classes of anti hypertensive drugs

Answer 1

Beta blockers
Alpha blockers
ACE inhibitors
ARB's (angiotensin II receptor blockers)
Calcium channel blockers
Aldosterone antagonists

Question 2

Explain the MOA of clonidine.

Answer 2

Clonidine stimulates inhibitory alpha 2 receptors in the medulla oblongata. This reduces sympathetic nerve activity to the heart, kidneys, and blood vessels.

Question 3

Explain the MOA of prazosin.

Answer 3

Prazosin selectively blocks alpha 1 receptors causing peripheral vasodilation.

Question 4

Name 2 actions of beta blockers which help to control hypertension.

Answer 4

1. Reduced cardiac output

2. Blocks the release of renin from the kidneys

Question 5

What are the 3 functions of the nephron?

Answer 5

Filtration
Reabsorption
Secretion

Question 6

Regarding kidney function, which products fall under “active reabsorption”? How is this movement controlled?

Answer 6

Amino acids
Lactate
Vitamins
Ions
*movement is linked to sodium by way of sodium/potassium pumps

Question 7

Regarding kidney function, which products fall under “passive reabsorption”? What drives this movement?

Answer 7

Cl-
Water
*movement is dictated by concentration gradients established by sodium/potassium pumps.

Question 8

Regarding kidney function: when substances are secreted which way do they move?
Blood to filtrate 
Or 
Filtrate to blood?
What is the purpose of this secretion?

Answer 8

Blood to filtrate.
This secretion is for the purpose of disposing of certain substances not yet in the filtrate including: drugs, excess potassium, urea, uric acid.
This also helps to control PH.

Question 9

Which part of the kidney is the most active reabsorber?

What is reabsorbed?

Answer 9

Proximal convoluted tubule.

• glucose
• amino acids
• sodium (in exchange for H+)

Question 10

How much is the filtrate volume reduced due to reabsorption in the proximal convoluted tubule?

Answer 10

65%

Question 11

Which part of the kidney is where H2O is reabsorbed?

Answer 11

Descending Loop of Henle

Question 12

Which part of the kidney are Na+ and Cl- actively reabsorbed?

Answer 12

Ascending loop of Henle

Question 13

Describe the affects of aldosterone on the kidneys.

Answer 13

Aldosterone stimulates the kidneys to secrete K+ into the urine in exchange for Na+ in the distal convoluted tubule.

Question 14

What are the 3 chemical movements initiated by aldosterone?

Answer 14

Increase of sodium reabsorption
Increase of potassium secretion
Increase in H2O reabsorption (secondary to sodium reabsorption)

Question 15

Explain the mechanism of ADH in regards to kidney function.

Answer 15

ADH causes the pores of the collecting duct to open, causing H2O to rush out, thereby concentrating the urine.

Question 16

What are the 2 types of chronic hypertension?

Answer 16

Primary (no identifiable cause)

Secondary (identifiable cause)

Question 17

List 3 consequences of chronic hypertension.

Answer 17

Heart disease
Disney disease
Stroke

Question 18

List the 3 mechanisms the body uses to regulate BP

Answer 18

1. Baroreceptors in the aortic arch and carotid sinus (sympathetic response)
2. Renal regulation - through filtrate and sodium reabsorption
3. Renin-angiotensin-aldosterone system (RAAS) (plays a more significant role in hypovolemia as opposed to someone who is normotensive)
   * RAAS is a slow system (hours to days)

Question 19

What are the effects of angiotensin II?

Answer 19

Vasoconstriction

Renal retention of water and sodium (aldosterone)

Question 20

What are the 3 types of diuretics? How do they work?

Answer 20

Loop diuretic
Thiazides
Potassium sparing diuretics

They work by blocking reabsorption of Na+ and Cl-

Question 21

Where do loop diuretics have their effect?

Answer 21

Ascending loop of Henle

Question 22

List 4 adverse effects of loop diuretics.

Answer 22

Dehydration
Hyponatremia
Hypokalemia
Reflex tachycardia

Question 23

Why are beta blockers commonly prescribed with loop diuretics?

Answer 23

Because reflex tachycardia is a common reaction due to the sudden lowering of blood pressure.

Question 24

How do thiazides differ from loop diuretics?

Name a thiazide?

Answer 24

Similar mechanism, except they block reabsorption in the distal convoluted tubule.
Hydrochlorothiazide

Question 25

What is the mechanism of potassium losing diuretics?

Answer 25

Inhibit the effect of aldosterone in the distal convoluted tubule.

Question 26

Name a beta blocker

Answer 26

Metoprolol

Question 27

Name a alpha 1 blocker

Answer 27

doxazosin

Question 28

Give an example of a alpha+beta blocker

Answer 28

labetalol

Question 29

Where are alpha-2 receptors found and what happens when they are activated?

Answer 29

They are found in pre-synaptic neurons in the CNS
Activation inhibits the release of norepinephrine

• they are typically activated by norepinephrine, causing a negative feedback loop
• drugs that are alpha-2 agonists inhibit sympathetic outflow to the PNS

Question 30

Name 3 calcium channel blockers

Answer 30

Verapamil
Diltiazem
Nifedipine

Question 31

How does nifedipine differ from the other calcium channel blockers?

Answer 31

No cardiac effects at therapeutic doses.

May cause reflex tachycardia

Question 32

What are side effects of ACE inhibitors?

Answer 32

Hyperkalemia
Angioedema
Cough

Question 33

Name 2 examples of ACE inhibitors

Answer 33

captopril

enalapril

Question 34

Name an example of an ARB.

Answer 34

Losartan

Question 35

What are direct acting vasodilators?

Answer 35

Drugs that specifically target arteries, not veins.

Question 36

Name 2 examples of direct acting vasodilators.

Answer 36

Hydralazine

Minoxidil