antihypertensives

Question 1

has C/I of
* Anuric pts (avoid in renal dysfxn– SCr >1.5 or CrCL < 30 ml/min bc they lose effectivenes)
* Sulfa allergy
* Gout

Answer 1

thiazide diuretics

Question 2

has SE of
* Low Na,K, Mg. High Ca
* Hyperuricemia, hyperglycemia, hyperlipidemia
* Hypotension, impotence, azotemia

Answer 2

thiazide diuretics

Question 3

which class has the Ceiling effect– increasing dose does not increase BP lowering effect

Answer 3

thiazide diuretics

Question 4

which class should you use cautiously w/ NSAIDs, digoxin, lithium, antidiabetic meds

Answer 4

thiazide diuretics

Question 5

which class should you monitor BUN/SCr and K levels after initiation and w/ dosage titrations

Answer 5

thiazide diuretics

Question 6

which class of vasodilators has C/I of 2nd/3rd heart block, decompensated heart failure, asthma/COPD

Answer 6

beta blockers

Question 7

which class causes hypo-kalemia vs hyper-kalemia

Answer 7

• thiazide diuretics= low K
• ARBs & ACEs= high K

Question 8

which types of meds cause LE edema vs reflex tachy

Answer 8

• RAAS inhibitors– edema
• vasodilators (DHP-CCB, alpha blockser, centrals)– reflex tachy

Question 9

MOA of thiazide diuretics

Answer 9

less blood volume by stopping Na/water reabsorption at DCT
lower Ca excretion

Question 10

4 ways beta blockers work

Answer 10

• decrease CO
• inhibit NE to cause vasodilation
• Block renin release
• block alpha-1 receptors

Question 11

4 ways beta blockers work

Answer 11

• decrease CO
• inhibit NE to cause vasodilation
• Block renin release
• block alpha-1 receptors

Question 12

which class may mask tachy sx of hypoglycemia in DM by causing bradycardia

Answer 12

beta blockers

Question 13

which 2 meds must be tapered inorder to prevent HYPERTENSIVE CRISIS?

Answer 13

• clonidine over 2-4 days
• beta blockers over 1-2 wks

Question 14

inhibits AG II creation, aldosterone & has diuretic effect
increases bradykinin & decrease endothelin

Answer 14

ACEinhibitors

Question 15

hx of what 4 conditions calls for use of ACEs

Answer 15

• DM
• old MI
• CHF
• nephropathy

Question 16

which class should be avoided in bilateral renal stenosis because the increased creatinine doesnt return to normal after starting the med?

Answer 16

ACE

Question 17

3 C/I of ACEs

Answer 17

• pregnancy
• bilateral renal stenosis
• h/o angioedema

Question 18

SE of
* hypotension
* azotemia/renal insufficiency
* high K
* hyperuricemia

(not comprehensive list)

Answer 18

ACEs

Question 19

ACEs have 2 important drug reactions. name them

Answer 19

NSAIDs and lithium

Question 20

how do ARBS work

Answer 20

similar to ACEs but binds/blocks AG II receptors and does not increase bradykinin

Question 21

how do CCBs work? DHP vs non-DHP

Answer 21

block L type Ca channels in vascular smooth muscle to block constriction
Non-DHP has negative inotropic & chronotropic effects

Question 22

C/I of CHF, 2nd/3rd heard block

Answer 22

CCB

Question 23

SE of
* peripheral edema
* hypotension, HA, dizziness
* constipation
& interacts with statins

Answer 23

CCBs

Question 24

blocks renin release from JG cells of DCT

Answer 24

renin inhibitors

Question 25

alpha blockers MOA

Answer 25

alpha blockade causes peripheral arterial dilation

Question 26

which class isnt first line but could be a helpful add on in pts w/ HTN + benign prostatic hypertrophy

Answer 26

alpha blockers

Question 27

C/I of erectile dysfunction medication use

Answer 27

alpha blockers

Question 28

SE of * 1st dose syncope and hypotension, * peripheral edema * reflex tachy * congestion * vivid dreams

Answer 28

alpha blockers

Question 29

which class is advised to be have the 1st dose taken at bedtime d/t the 1st dose syncope & hypotension

Answer 29

alpha blockers

Question 30

Centrally acting; reduce sympathetic tone by acting as alpha-2 adrenergic agonist; used short term only

Answer 30

clonidine

Question 31

you should combine ____ w/ a diuretic to minimize edema

Answer 31

clonidine

Question 32

which centrally acting drug is effective in resistant HTN & CKD and HTN emergencies

Answer 32

clonidine

Question 33

which medication has an oral & patch formulation

Answer 33

clonidine

Question 34

Relaxes vascular smooth muscle by increasing concentrations of nitric oxide

Answer 34

hydralazine | direct vasodilator

Question 35

opens K+ channels in vascular smooth muscle

Answer 35

minoxidil | direct vasodilator

Question 36

use direct vasodilators w/ BB to minimize ______

Answer 36

reflex tachycardia

Question 37

use direct vasodilators w/ loop diuretics to minimize ____

Answer 37

edema

Question 38

sole C/I of minoxidil & hydralazine

Answer 38

acute MI

Question 39

SE of * DILE * serum sickness like rxn * hemolytic anemia * glomerulonephritis syndrome

Answer 39

hydralazine

Question 40

SE of * facial hirsutism * pericardial effusion

Answer 40

minoxidil