Medication options

Question 1

How does Angiotensin II increase BP?

Answer 1

1. Systemic vasoconstriction
2. Aldosterone release - increases Na + H2O reabsorption

Question 2

MOA of ACE-I:

Answer 2

1. Inhibits ACE
2. Reduces angiotensin II production
3. Reduces BP

Question 3

MOA ARB:

Answer 3

1. Blocks angiotensin II from binding to its receptor
2. Reduces BP

Question 4

S/E - ACE-I (mainly):

Answer 4

1. Dry cough
2. Angioedema

Question 5

S/E both ACE-I & ARBs:

Answer 5

1. Hyperkalemia
2. Hyponatremia
3. Acute renal failure (in patients with severe bilateral renal artery stenosis)

Question 6

CI of ACE-I & ARBs in specific population group:

Answer 6

1. 2nd & 3rd trimester of pregnancy - fetotoxicity

Question 7

MOA of B-Blockers:

Answer 7

1. Block action of epinephrine
2. By preventing it from binding to the beta-adrenergic receptor
3. Reduces HR
4. Promotes vasodilation

Question 8

NB uses of B-blockers for HPT pt with other co-morbidities:

Answer 8

1. IHD
2. CCF

Question 9

S/E of B-blockers:

Answer 9

1. Increased lipid & cholesterol levels
2. Worsen of depression Sx
3. Bronchospasm - make asthma and COPD worse
4. Hyperkalemia

Question 10

MOA of CCB:

Answer 10

1. Block Ca entry into smooth mm.
2. Smooth muscle relaxation
3. Vasodilation
4. Lowers BP

Question 11

Classes of CCBs:

Answer 11

1. Dihydropyridines - Amlodipine, Nifedipine
2. Non-dihydropyridines - Verapamil

Question 12

Which class of CCBs are most commonly used to treat hypertension because of their strong systemic vasodilatory effect?

Answer 12

Dihydropyridines

Question 13

S/E of CCBs:

Answer 13

1. Flushing
2. Dizziness
3. Reflex tachycardia
4. Constipation
5. Edema of the feet

Question 14

All CCBs should be avoided in which patients?

Answer 14

1. CCF with a reduced ejection fraction

Question 15

Non-dihydropyridine CCBs should not be routinely combined with:

Answer 15

1. Beta-blockers
2. Because of the risk of bradycardia & heart block

Question 16

2 main classes of diuretics and site of action:

Answer 16

1. Thiazides & thiazide-like diuretics - distal convoluted tubules
2. Loop diuretics - Loop of Henle

Question 17

Which is the preferred - HCTZ (thiazide) or Chlorthalidone (thiazide-like)?

Answer 17

1. Chlorthalidone
2. Prolonged half-life
3. Proven ability to reduce CVD

Question 18

S/E of thiazide diuretics:

Answer 18

1. Increase - Ca, uric acid, lipids, glucose
2. Decrease - K & Na

Question 19

S/E of loop diuretics:

Answer 19

1. Decrease - K, Na & Ca

Question 20

Thiazides should generally be avoided in patients with a history of:

Answer 20

1. Acute gout
2. Uric acid kidney stones