Anti HTN

Question 1

Contraindications for thiazides diuretics

Answer 1

Hyperuricemia, gout, sulfa allergy

Question 2

ADRs for thiazides diuretics

Answer 2

Hypo Na, Mg, K
Hyperglycemia
Inc cholesterol
Sexual dysfunction

Question 3

DDIs for thiazides

Answer 3

Dec by NSAIDs

Increases lithium levels

Question 4

Examples of thiazides

Answer 4

Hydrochlorothiazide
Chlorothalidone
Chlorothiazide
Indapamide
Metolazone

Question 5

Loop diuretics MOA

Answer 5

Block Na reabsorption in ascending loop of Henle, powerful natriuresis

Question 6

Loop diuretics precautions

Answer 6

Profound diuresis

Monitor fluids, renal function, electrolyte status

Question 7

Contraindications for loop diuretics

Answer 7

Sulfa allergy

Question 8

ADRs for loop diuretics

Answer 8

Hypo Ca and K
Renal affects
Hyperglycemia hyperuricemia 
Pancreatitis, hepatic damage
Sexual dysfunction ototoxicity

Question 9

DDIs for loops

Answer 9

Dec by NSAIDs

Inc lithium levels

Question 10

Loop diuretics examples

Answer 10

Furosemide
Toresemide
Bumetanide
Ethacrynic acid

Question 11

K sparing diuretics MOA

Answer 11

Block reabsorption of Na in collecting duct but reduce K secretion into urine

Question 12

Precautions of K sparing diuretics

Answer 12

Can cause hyperkalemia

Question 13

ADRs of K sparing diuretics

Answer 13

HypoNa
Inc BUN/Cr
Jaundice
H/a
N/v/d

Question 14

DDIs K sparing diuretics

Answer 14

ACE inhibitors-hyperkalemia
NSAIDs
Lithium

Question 15

Examples of K sparing diuretics

Answer 15

Spironolactone
Amiloride
Triamterene

Question 16

ACE inhibitor MOA

Answer 16

Blocks conversion of angiotensin I to angiotensin II (vasoconstrictor) and blocks degradation of bradykinin (a vasodilator) to reduce peripheral vascular resistance

Question 17

Precautions of ACE inhibitors

Answer 17

Can cause renal failure if b/l renal artery stenosis

Question 18

CI for ACE inhibitors

Answer 18

Angioedema
B/l renal stenosis
PREGNANCY

Question 19

ADRs for ACE inhibitors

Answer 19

Nonproductive cough 
Rash
Angioedema
Hyperkalemia
Dec renal function

Question 20

DDIs for ACE inhibitors

Answer 20

Effects inc with diuretics
Hyperkalemia w/ K sparing drugs
Inc lithium levels
Dec by NSAIDs

Question 21

Examples of ACE inhibitors

Answer 21

Enalapril
Quinacrine
Benazapril

Question 22

ARB MOA

Answer 22

Blocks binding of angiotensin II to its receptors in vascular smooth muscle to cause vasodilation

Question 23

ADRs for ARBs

Answer 23

Similar to ACE:
Rash
Angioedema
Hyperkalemia
URI

Question 24

Examples of ARBs

Answer 24

Losartan

Valsartan

Question 25

CCB MOA

Answer 25

Blocks Ca ion channels in plasma membrane of smooth muscle to vasodilate

Question 26

CI for Verapamil and diltiazem

Answer 26

Hypotension Cardiogenic shock Sick sinus syndrome 2nd or 3rd degree heart block

Question 27

ADRs for CCBs

Answer 27

``` Constipation Bradycardia Flushing CHF, heart block, hypotension Reflex tachycardia Syncope and heart block and sinus arrest for nifedipine ```

Question 28

DDIs for verapamil and diltiazem

Answer 28

Digoxin Amiodarone Azoles Others

Question 29

Examples of DHP CCBs

Answer 29

Amlodipine Delodipine Israpidine Nicardipine

Question 30

Examples of non-DHP CCBs

Answer 30

Diltiazem | Verapamil

Question 31

Precautions for beta blockers

Answer 31

Reflex tachycardia | Need cardio selective in DM and bronchospastic dz

Question 32

CI for beta blockers

Answer 32

``` Sinus bradycardia 2nd or 3rd degree heart block Heart failure Cardiogenic shock Sick sinus syndrome Peripheral artery dz ```

Question 33

ADRs for beta blockers

Answer 33

``` Bradycardia CHF Hypotension Broncho constriction Sexual dysfunction Will mask sxs of hypoglycemia ```

Question 34

DDIs for beta blockers

Answer 34

Digoxin | CCBs

Question 35

Examples of non selective beta blockers

Answer 35

Propranolol Nadolol Timolol

Question 36

Examples of cardioselective beta blockers

Answer 36

``` Atenolol Metoprolol Betaxolol Bisoprolol Nebivulol ```

Question 37

Beta blockers with ISA activity- less bradycardia

Answer 37

Acebutolol Penbutolol Pindolol

Question 38

Alpha and beta blocker examples

Answer 38

Carvedilol | Labetalol

Question 39

Alpha 1 blocker MOA

Answer 39

Blocks vasoconstriction of peripheral vascular smooth muscle | Can increase heart rate and contractility and fluid retention

Question 40

Precautions for alpha blockers

Answer 40

Orthostatic hypotension and syncope so give at night

Question 41

ADRs of alpha blockers

Answer 41

Orthostatic hypotension Sexual dysfunction Reflex tachycardia Dry mouth

Question 42

Examples of alpha blockers

Answer 42

All end in azosin Doxazosin Terazosin Prazosin

Question 43

Centrally acting agents used for

Answer 43

Refractory HTN after other agents fail

Question 44

Precautions for centrally acting agents

Answer 44

Avoid rapid withdrawal to avoid rebound HTN a Caution in elderly Avoid TCA use CNS depression

Question 45

Centrally acting agents

Answer 45

Clonidine Methyl dopa Guanethidine and reserpine

Question 46

Centrally acting agent that can cause Coombs positive hemolytic anemia

Answer 46

Methyl dopa

Question 47

ADRs of direct vasodilators

Answer 47

Reflex tachycardia Angina Myocardial ischemia

Question 48

Examples of direct vasodilators

Answer 48

Hydralazine Minoxidil Sodium nitroprusside Diazoxide

Question 49

Unique ADRS for hydralazine

Answer 49

Lupus like syndrome

Question 50

Cyanide toxicity is concern is which drug

Answer 50

Sodium nitroprusside

Question 51

Direct renin inhibitor

Answer 51

Aliskiren

Question 52

Combo products

Answer 52

Benazapril and amlodipine Benazapril and HCTZ Bisopril and HCTZ

Question 53

IV options for hypertensive emergency

Answer 53

``` Beta blockers Nitros Hydralazine Dopamine receptor agonists good for renal dysfunction CCBs ACE inhibitor ```

Question 54

Thiazides diuretics MOA

Answer 54

Block NaCl reabsorption at distal convoluted tubules; cell membrane alteration