Antihypertensives

Question 1

MOA diuretics

Answer 1

1) Decrease BP via decrease in BV, preventing kidney Na+/H2O reabsorption at distal diluting tubule
2) decrease urine calcium excretion

Question 2

Indication diuretics

Answer 2

1st line HTN, edema

Question 3

S/E diuretics

Answer 3

hyponatremia, hypokalemia, hypomagnesium, hypercalemia, increase cholesterol, hyperurcemia, hyperglycemia

Question 4

Caution diuretics

Answer 4

DM, gout

Question 5

C/I diuretics

Answer 5

sulfa allergy

Question 6

MOA Loop

Answer 6

Inhibit transport across thick ascending limb of loop of hence–> increased excretion of H2O, Na, Cl, K+ at proximal and distal tubule

Question 7

Strongest diuretic

Answer 7

loop

Question 8

Indication loop

Answer 8

HTN, CHF with severe edema, hypercalcemia, mild renal disease

Question 9

S/E Loop

Answer 9

volume depletion, hypokalemia, hyponatremia, hypocalcemia, hyperuricemia, hypochloremic metabolic alkalosis, hyperglycemia

Question 10

C/I Loop

Answer 10

Sulfa allergy

Question 11

MOA potassium sparing diuretic

Answer 11

inhibit aldosterone-mediated Na/H20 absorption–> K+ spared

Question 12

When best to use potassium sparing diuretic

Answer 12

with loop to save potassium

Question 13

Indication potassium sparing

Answer 13

Edema
Ascites
HF
HTN
Primary aldosteronism
PCOS

Question 14

S/E potassium sparing

Answer 14

hyperkalemia, gynecomastia with spironolactone

Question 15

C/I potassium sparing

Answer 15

renal failure, hyponatremia

Question 16

MOA ACEi

Answer 16

1) Decrease preload/afterload via decrease synthesis of AG2/aldosterone production
2) Potentiates other vasodilators (bradykinin, PG, NO)
3) Increase exercise tolerance

Question 17

What happens when ACEi combined with thiazide

Answer 17

synergistic and cardioprotective

Question 18

Indications ACEi

Answer 18

HTN esp. diabetic nephropathy
CHF
MI

Question 19

S/E ACEI

Answer 19

1st dose hypotension, azotemia/renal insufficiency (Cr>3, CrCl<30), hyperkalemia, cough and angioedema, neutropenia

Question 20

C/I ACEi/ARB

Answer 20

pregnancy

Question 21

MOA ARB

Answer 21

block AG2 effects (not production)

Question 22

Indication for ARB

Answer 22

use if patient cannot tolerate BB/ACEi

Question 23

C/I ARB

Answer 23

renal disease

Question 24

MOA CCB Dihydropyridines

Answer 24

potent vasodilators

Question 25

MOA CCB Non-Dihydropyridines

Answer 25

affect contractility and conduction, potent vasodilator, decrease vascular permeability

Question 26

Indication CCB

Answer 26

``` HTN Angina Raynaud Achalasia Prinzmetal Angina ```

Question 27

S/E CCB

Answer 27

HA, dizzy, lightheaded, flushing, peripheral edema, weakness, bradycardia

Question 28

Verapamil S/E

Answer 28

constipation

Question 29

Caution CCB

Answer 29

With BB CHF with ventricular systolic dysfunction 2nd/3rd HB

Question 30

MOA vasodilators

Answer 30

direct vascular SM relaxation

Question 31

Indication vasodilators

Answer 31

HTN

Question 32

S/E vasodilators

Answer 32

tachycardia, peripheral neuritis, HA, blood dyscrasia, rash, SJS, palpitation, electrolyte imbalance

Question 33

Caution vasodilators

Answer 33

CAD, mitral valve disease