Anti-Hypertension Drug Therapy

Question 1

Most patient will require more than

Answer 1

one BP medication to reach goal BP

Question 2

Initial Therapy

Answer 2

Thiazide-type diuretics
Angiotensin-converting enzyme (ACE)inhibitors/angiotensinII receptor blockers (ARBs)
Calcium channel blockers

Question 3

First line therapy for HF and HTN

Answer 3

diuretics

Question 4

reduces extracellular flid

Answer 4

diuretics

Question 5

ADR for Diuretics

Answer 5

electrolyte imbalance

Question 6

drug interactions diruetics

Answer 6

protentional additive hypotensive effects with other drugs that lower BP

Question 7

Diuretics’ MOA

Answer 7

Blockade of sodium and chloride reabsorption

Question 8

Diuretics site of action

Answer 8

Proximal tubule produces greatest diuresis

Question 9

Diuretics adverse effects

Answer 9

Hypovolemia
Acid-base imbalance
Electrolyte imbalances

Question 10

Classifications of Diuretics

Answer 10

Thiazide diuretics
Loop diuretics
Potassium sparing diuretics

Question 11

Loop Diuretic Example

Answer 11

Furosemide, bumetanide, torsemide

Question 12

Potassium-Sparing Diuretics useful response

Answer 12

Useful responses
Modest increase in urine production
Substantial decrease in potassium excretion

Question 13

Potassium-Sparing Diuretics are rarely used

Answer 13

Rarely used alone for therapy

Question 14

Potassium-Sparing Diuretics example

Answer 14

Amiloride,triamterene,spironolactone, andeplerenone

Question 15

Potassium-Sparing Diuretics act on

Answer 15

Primary used in combination with a loop or thiazide diuretic

Question 16

Potassium-Sparing Diuretics primary used in combination with

Answer 16

combination with a loop or thiazide diuretic

Question 17

Potassium-Sparing Diuretics monitor

Answer 17

serum potassium

Question 18

Spironolactone is a

Answer 18

Aldosterone antagonist

Question 19

Spironolactone MOA

Answer 19

Blocks aldosterone in the distal nephron
Retention of potassium
Increased excretion of sodium

Question 20

Spironolactone Uses

Answer 20

Edematous states
Heart failure (decreases mortality in severe failure)
Primary hyperaldosteronism
Premenstrual syndrome
Polycystic ovary syndrome
Acne in young women

Question 21

Spironolactone ADR

Answer 21

Hyperkalemia
Benign and malignant tumors
Endocrine effects

Question 22

Interactions

Answer 22

Thiazide and loop diuretics

Agents that raise potassium levels

Question 23

ACE Effects and MOA

Answer 23

Reduce levels of angiotensin II

Increase levels of bradykinin

Question 24

ACE Use

Answer 24

HTN, HF, MI, diabetic and non-diabetic nephropathy; prevention of MI, stroke, and death in patients at high CV risk

Question 25

ACE ADR

Answer 25

diuretics, anti-HTN agents, drugs that raise potassium, lithium, NSAIDs.

Question 26

ACE Interactions

Answer 26

diuretics, anti-HTN agents, drugs that raise potassium, lithium, NSAIDs.

Question 27

Angiotensin II Receptor Blocker MOA

Answer 27

``` Block access of angiotensin II Cause dilation of arterioles and veins Prevent angiotensin II from inducing pathologic changes in cardiac structure Reduce excretion of potassium Decrease release of aldosterone Increase renal excretion of sodium and water Do not inhibit kinase II Do not increase levels of bradykinin ```

Question 28

Angiotensin II Receptor Blockers use

Answer 28

Therapeutic uses: HTN, HF, MI, diabetic nephropathy, patient unable to tolerate ACE inhibitors, may prevent development of diabetic retinopathy

Question 29

Angiotensin II Receptor Blockers ADR

Answer 29

angioedema, fetal harm, renal failure

Question 30

Angiotensin II Receptor Blockers benefit

Answer 30

Lower incidence of cough

Question 31

CCB are drugs that

Answer 31

Drugs that prevent calcium ions from entering cells

Question 32

CCB greatest impact is on the

Answer 32

Greatest impact on heart and blood vessels

Question 33

CCB used to treat

Answer 33

Used to treat hypertension, angina pectoris, and cardiac dysrhythmias

Question 34

CCB is also known as

Answer 34

calcium antagonists and slow channel block`ers

Question 35

Types of calcium channel blockers

Answer 35

Dihydropyridines | non-Dihydropyridines

Question 36

dihydropyridines example

Answer 36

nifedipine, isradipine, felodipine, nicardipine, nisoldipine, lacidipine, and amlodipine

Question 37

non-dihydropyridines example

Answer 37

verapamil and diltiazem

Question 38

Dihydropyridines are

Answer 38

Potent vasodilators

Question 39

Dihydropyridines little or no

Answer 39

Little or no negative effect upon cardiac contractility or conduction.

Question 40

Dihydropyridines use to treat

Answer 40

Use to treat hypertension or chronic stable angina.

Question 41

Dihydropyridines are longer-

Answer 41

Longer-acting agents are generally safer and are increasingly preferred.

Question 42

Non-dihydropyridines use

Answer 42

Uses: HTN, chronic stable angina, cardiac arrhythmias, proteinuria reduction

Question 43

Non-dihydropyridines less potent

Answer 43

Less potent vasodilation

Question 44

Non-dihydropyridines greater

Answer 44

depression effect on cardiac condution and contractility

Question 45

Dihydropyridines SE

Answer 45

headache, lightheadedness, flushing, and dose-dependent edema

Question 46

Non-dihydropyridines SE

Answer 46

dose-dependent constipation, bradycardia and worsening cardiac output

Question 47

Non-dihydropyridines CI

Answer 47

pt beta blockers or who have heart failure with reduced ejection fraction , sick sinus syndrome, and second- or third-degree atrioventricular block