Antihypertensives

Question 1

Beta-blockers ex

Answer 1

-olol: acebutolol, atenolol, nadolol, metoprolol, propranolol, pindolol, esmolol

Question 2

Beta blockers MOA

Answer 2

Decrease hearts excitability, decrease cardiac workload and oxygen consumption, and provide membrane stabilizing effects that contribute to other antiarrhythmic drug activity

Question 3

Beta blockers indications

Answer 3

Hypertension, angina, heart failure, cardiac arrhythmia, migraine, glaucoma, prevent myocardial reinfarction

Question 4

Beta blockers, must monitor

Answer 4

Heart rate

Question 5

Beta blocker side effects

Answer 5

Can mask signs of hypoglycemia, prevent epinephrine release, fast heart rate, sweating (diaphoresis), dizzy, headache, nausea, vomiting, diarrhea, bronchospasm, elderly at greater risk of side effects

Question 6

Beta-blockers restrictions

Answer 6

Not for ppl with heart blocks or asthma, hypotension, emphysema, sinus bradycardia

Question 7

Ace inhibitors ex

Answer 7

-pril: lisinopril, enalapril, quinapril, ramipril

Question 8

Ace inhibitors MOA

Answer 8

Work on lung and inhibit angiotensin 1 from converting into angiotensin 2, sodium and water aren’t retained

Question 9

Ace inhibitors side effects

Answer 9

Dry cough (general throat irritation), hypotension, hyperkalemia, first dose effect

Question 10

ARB’s use

Answer 10

Will get switched to these if ace inhibitors cause cough or other negative side effects

Question 11

ARB’s ex

Answer 11

-sartan: losartan, candesartan, Valsartan, olmesartan

Question 12

ARB’s side effects

Answer 12

Angioedema (painless swelling in lips), not for use during pregnancy, renal artery stenosis (narrowing of blood vessels that give blood to kidneys)

Question 13

CCB’s dihydropyridines ex and MOA

Answer 13

Work on blood vessels, -dipine: nifedipine, felodipine, amlodipine

Question 14

CCB’s phenylalkylamines MOA and ex

Answer 14

Work on heart, verapmil

Question 15

CCB’s Benzothiazepines ex and MOA

Answer 15

Work on heart, diltiazem (HR control)

Question 16

CCB’s side effects

Answer 16

Swelling in lower limbs, constipation

Question 17

Loop diuretics fact

Answer 17

Very powerful diuretics, and if mineral loss side effects are an issue, switch to thiazide diuretics

Question 18

Loop diuretics ex

Answer 18

-semide: furosemide, torsemide, bumetanide, ethacrynic acid (can give to ppl with sulfa allergy)

Question 19

Loop diuretics concerns

Answer 19

Loops lose everything (esp. calcium and potassium)

Question 20

Loop diuretics look out for

Answer 20

Ototoxicity and tinnitus

Question 21

Betaxolol indications

Answer 21

Glaucoma

Question 22

Timolol indication

Answer 22

Glaucoma

Question 23

Beta blockers precautions

Answer 23

Diabetes, thyrotoxicosis, peptic ulcer

Question 24

Beta blockers interactions

Answer 24

Antidepressants increase effect of beta blocker and cause bradycardia, NSAIDs decrease effect of beta blocker, loop diuretics increase risk of hypotension, clonidine increases risk of paradoxical hypertensive effect, cimetidine increases bet blocker serum levels and risk of toxicity, lidocaine increases beta blocker serum levels and risk of toxicity

Question 25

Blood pressure

Answer 25

Force of blood against artery walls

Question 26

Hypertension

Answer 26

High blood pressure that stays elevated over time

Question 27

Hypertensive emergency

Answer 27

Extremely high blood pressure that must be lowered immediately to prevent damage to target organs

Question 28

Hyponatremia

Answer 28

Low blood sodium level

Question 29

Isolated systolic hypertension

Answer 29

systolic blood pressure over 140, with diastolic blood pressure under 90

Question 30

Lumen

Answer 30

The space or opening within an artery

Question 31

Prehypertension

Answer 31

Systolic blood pressure between 120 and 139 or diastolic between 80 and 89

Question 32

Primary hypertension

Answer 32

Hypertension that has no known cause, aka essential or idiopathic hypertension

Question 33

Antihypertensives MOA

Answer 33

Vasodilation, which creates and increase in the lumen of the arterial blood vessels

Question 34

Secondary hypertension

Answer 34

Hypertension with a known cause , such as kidney disease

Question 35

Vasodilation

Answer 35

Increase in the diameter of the blood vessels, that, when widespread, results in a drop in blood pressure

Question 36

CCBs general MOA

Answer 36

Inhibit the movement of calcium ions across cell membranes and arterial muscle cells, which means there is less calcium available for the transmission of nerve impulses, so blood vessels are relaxed

Question 37

ARBs MOA

Answer 37

Block the binding of angiotensin 2 at various receptor sites in the vascular smooth muscle and adrenal gland

Question 38

Primary treatment for heart failure

Answer 38

Antihypertensives, most frequently, ACE inhibitors, ARBs, diuretics, and beta blockers

Question 39

Nitroprusside use

Answer 39

Hypertensive emergency, given IV

Question 40

Antihypertensives elderly consideration

Answer 40

Fainting and falling due to orthostatic hypotension

Question 41

General antihypertensive side effects

Answer 41

Fatigue, depression, dizziness, headache, syncope, upper respiratory infections, cough, abdominal pain, nausea, diarrhea, constipation, gastric irritation, and anorexia, rash, pruritus, dry mouth, tachycardia, hypotension, proteinuria, neutropenia

Question 42

ACE inhibitors contraindications

Answer 42

Impaired renal function, salt or volume depletion, bilateral stenosis, angioedema, pregnancy (cat C in 1st trimester and cat D in and and 3rd trimesters) and lactation

Question 43

ARBs contraindications

Answer 43

Impaired renal function, salt or volume depletion, bilateral stenosis, angioedema, pregnancy (cat C in 1st trimester and cat D in 2nd and 3rd trimester), and lactation

Question 44

CCBs contraindications

Answer 44

Sick sinus syndrome, 2nd or 3rd degree AV block (except with a functioning pacemaker), hypotension, ventricular dysfunction, or cardiogenic shock

Question 45

Antihypertensives precautions

Answer 45

Renal or hepatic impairment, electrolyte imbalances, lactation , pregnancy, elderly

Question 46

CCBs precautions

Answer 46

Heart failure, renal or hepatic impairment, pregnancy (cat C), lactation

Question 47

ACE inhibitors precautions

Answer 47

Sodium depletion, hypovolemia, coronary or cerebrovascular insufficiency, and in people on diuretics or dialysis

Question 48

ARBs precautions

Answer 48

Renal or hepatic dysfunction, hypovolemia, volume or salt depletion, people taking high doses of diuretics

Question 49

ACE inhibitors interactions

Answer 49

NSAIDs reduce effects of ACE inhibitors, higher risk of allergic reaction to allopurinol, increased or decreased plasma digoxin levels, increased effects of loop diuretics, increased serum lithium levels (possible toxicity), hypoglycemic agents and insulin increase risk of hypoglycemia, and elevated potassium serum level with potassium sparing diuretics

Question 50

Antihypertensives general interactions

Answer 50

MAOIs, antihistamines and sympathomimetic bronchodilators decrease effects of antihypertensives

Question 51

Enalapril interactions

Answer 51

Rifampin decreases enalapril effects

Question 52

CCBs interactions

Answer 52

Cimetidine and ranitidine increase CCB effect, increased effects and toxicity of theophylline, increased risk for digoxin toxicity, rifampin decreases CCB effect

Question 53

Losartan interactions

Answer 53

Fluconazole increases side effects, indomethacin decreases effects of losartan

Question 54

Centrally anti adrenergic drugs antihypertensive ex

Answer 54

Clonidine, guanabenz, guanfacine, methyldopa

Question 55

Peripherally acting anti adrenergic drugs antihypertensive ex

Answer 55

Doxazosin, prazosin, reserpine, terazosin,

Question 56

Alpha/beta adrenergic blocking drugs antihypertensive ex

Answer 56

Carvedilol, labetalol

Question 57

Direct renin inhibitors ex

Answer 57

Aliskiren

Question 58

Selective aldosterone receptor antagonists ex

Answer 58

Eplerenone