HTN - Chap 10

Question 1

to what class of drugs do clonidine and methyldopa belong?

Answer 1

alpha 2 selective agonists

Question 2

what are the two ways you can manage rebound increase in bp due to cessation of clonidine?

Answer 2

reinstitute clonidine therapy OR administer alpha blockers such as phentolamine

Question 3

true or false: clonidine and methyldopa can cause sedation.

Answer 3

true

Question 4

hexamethonium and trimethaphan are members of which class of drugs?

Answer 4

ganglion-blocking drugs

Question 5

what is the most common example of a drug that depletes the adrenergic nerve terminals of its NE stores?

Answer 5

reserpine

Question 6

what are the two most common examples of drugs that deplete and block release of the stores of NE? (and thus can lower BP)

Answer 6

guanethidine, and guanadrel; note that these drugs are POSTGANGLIONIC SYMPATHETIC nerve terminal blockers

Question 7

in the simplest of terms, what does tyramine do?

Answer 7

causes the release of stored NE - remember that this along with MAOi can lead to hypertensive crisis - also remember that tyramine is eaten up by MAO so with the MAOi it is given an extra “life support”

Question 8

to what class of drugs do prazosin, doxazin, and terazosin belong to?

Answer 8

alpha 1 selective antagonist

Question 9

to what class of drugs do phentolamine and phenoxybenzamine belong to?

Answer 9

nonselective alpha blockers

Question 10

true or false: non selective alpha blockers are of no value in htn treatment

Answer 10

true

Question 11

which class of drugs is really known to cause orthostatic hypotension?

Answer 11

alpha 1 blockers

Question 12

which class of drugs is useful to treat benign prostatic hyperplasia?

Answer 12

alpha 1 blockers

Question 13

metoprolol, atenolol, both belong to what specific group of beta blockers?

Answer 13

selective beta 1 blockers

Question 14

which class of drugs reduces angiotensin levels by reducing renin release from the kidneys?

Answer 14

beta blockers

Question 15

v/d can act by what 4 mechanisms? release of _______; opening of ____ channels (effectively causing what?), blockade of ____ channels, and activation of _____ receptors.

Answer 15

nitric oxide; potassium (hyperpolarization); calcium; dopamine (d1)

Question 16

what is special about the use of the drug minoxidil?

Answer 16

the compensatory responses require concomitant use of diuretics and beta blockers

Question 17

what is the common side effect of minoxidil?

Answer 17

hirsutism

Question 18

what is THE prototype dihydropyridine?

Answer 18

nifedipine

Question 19

to what class of drugs do the following belong? amlodipine, felodipine, and isradipine.

Answer 19

dihydropyridine ccbs

Question 20

how does the ccb diazoxide work?

Answer 20

it opens K+ channels thus causing hyperpolarization and relaxation of the smooth muscle.

Question 21

what is the only vasodilator that works by activation of d1 (dopamine) receptors?

Answer 21

fenoldopam.

Question 22

ACE inhibitors do what to angiotensin II blood concentration levels? to endogenous v/d of the kinin family?

Answer 22

decrease; increase

Question 23

what is the most common side effect of taking an ACE inhibitor?

Answer 23

cough - to avoid this, choose an ARB

Question 24

which two drugs are absolutely contraindicated during pregnancy?

Answer 24

ACE inhibitor and ARB

Question 25

what is the newest anti htn drug that works by inhibiting renin’s action on angiotensinogen called?

Answer 25

aliskiren - it reduces the formation of angiotensin 1

Question 26

what are two of the toxicities of aliskiren?

Answer 26

HA and diarrhea

Question 27

remember the usual steps (of stepped cared) for treatment of htn: 1. lifestyle changes 2. diuretics (thiazide) 3. ? 4. ?

Answer 27

3. sympatholegic (beta blocker) 4. ace inhibitors 5. v/d

Question 28

what is typically the first v/d chosen in terms of treatment for htn?

Answer 28

ccb

Question 29

true or false: polypharmacy minimizes toxicities while producing additive or supra-additive therapeutic effects

Answer 29

true

Question 30

older pts tend to do better on what class of meds?

Answer 30

diuretics and beta blockers

Question 31

african americans tend to respond best to which two classes of anti htn meds?

Answer 31

diuretics and ccb

Question 32

what is the main concern with htn emergency?

Answer 32

end organ damage