Antihypertensives

Question 1

Patients that suffer from heart failure or have had MIs in the past do better with with what 2 medications?

Answer 1

ACE–i

beta-blockers

Question 2

What Diabetic anti-hypertensives ward off further renal damage (2)?

Answer 2

ACEi

ARBs

Question 3

Hydralazine, labetalol, methyldopa, nifedipine can all be used for what kind of HTN?

Answer 3

HTN in pregnancy

“Hide La baby from Meth and Knifes”

Question 4

ARBs, CCBs, thiazide diuretics, cardio-selective β-blockers can all be used for what type of HTN?

Answer 4

Asthma HTN

Question 5

What 2 anti-hypertensive drugs should be avoided in asthmatics?

Answer 5

Avoid non-selective β-blockers to prevent β2-receptor–induced broncho-constriction.

Avoid ACE inhibitors to prevent confusion between drug or asthma related cough

Question 6

What is 1 consideration when using Beta Blockers for treating HTN in Diabetics

Answer 6

.

β-blockers can mask hypoglycemia symptoms

Question 7

ACEinhibitors/ARBs,

Ca²⁺ channel blockers,

thiazide diuretics,

β-blockers

can all be used to treat what kind of HTN

Answer 7

HTN w/ DM

Question 8

β blockers must beused cautiously in pts with ______ and contraindicated in ________.

Answer 8

decompensated HF

cardiogenic shock

Question 9

In HF, ARBs may be combined with what neprilysin inhibitor?

Answer 9

sacubitril

Question 10

Diuretics, ACEinhibitors/ARBs, β-blockers, aldosterone antagonists can be used for what kind of HTN?

Answer 10

HTN w/ HF

β-blockers (in compensated HF only)

Question 11

What is the MOA for:

Amlodipine, clevidipine, nicardipine, nifedipine, nimodipine

Answer 11

Calcium channel blockers

(dihydropyridines, act on vascular smooth muscle)

Question 12

What is the MOA for:

diltiazem, verapamil

Answer 12

Calcium channel blockers

(non-dihydro pyridines ,act on heart)

Question 13

This class of antihypertensive blocks calcium channels in cardiac and smooth muscle to

decrease contractility.

Answer 13

ARBs

Question 14

Dihydropyridines (except _____) treat: hypertension, angina (including vasospastic type), Raynaudphenomenon.

Answer 14

nimodipine

Question 15

Adverse effects of

Non dihydropyridine: Gingival Hyperplasia, cardiac depression, AV-block, hyperprolactinemia ( mostly by ____), constipation

Answer 15

verapamil

Question 16

Increases cGMP smooth muscle relaxation.

Vasodilates arterioles >veins;

afterload reduction.

Answer 16

Hydralizine

Question 17

Frequently co-administered with a β-blocker to prevent reflex tachycardia.

Answer 17

Hydralazine

Question 18

Compensatory tachycardia (contraindicated in angina/CAD), fluid retention, headache, angina, drug-induced lupus

Answer 18

Hydralazine

Question 19

Treat with labetalol, clevidipine, fenoldopam, nicardipine, nitroprusside

Answer 19

Hypertensive emergency

Question 20

Dopamine D1 receptor agonist → vasodilator.

Lower BP, Increase natriuresis (pee Na)

Can cause hypotension and tachycardia.

Answer 20

Fenoldopam

Question 21

Type of Drug class

Nitroglycerin,

isosorbidedinitrate,

isosorbidemononitrate

Answer 21

Nitrates

((use with caution; they lower R side venous return to heart; some patients are pre-load dependent))

Question 22

Dilate veins >> arteries.

↓ preload (R heart venous return)

Answer 22

Nitrates

Question 23

Vasodilate by ↑ NO in vascular smooth muscle in ↑ cGMP and smooth muscle relaxation.

Answer 23

Nitrates

Question 24

Contraindicated in right ventricular infarction, hypertrophic cardiomyopathy, and with concurrent PDE-5 inhibitor use.

Answer 24

Nitrates

Question 25

What are the 4 myocardial O₂ consumption (MVO₂) determinants :

Answer 25

end-diastolic volume, BP, HR, contractility.

Question 26

# This medication Inhibits the late phase of inward sodium current thereby reducing diastolic wall tension and oxygen consumption. Does not affect heart rate or blood pressure

Answer 26

Ranolazine

Question 27

# This medication is a Short acting vasodilator (arteries = veins) ↑cGMP via direct release of NO

Answer 27

Nitroprusside

Question 28

# This medication Can cause cyanide toxicity | (by releasing cyanide)

Answer 28

Nitroprusside

Question 29

# This medication prevents degradation of natriuretic peptides: angiotensin II & substanceP → ↑vasodilation, ↓ECF volume

Answer 29

Sacubitril

Question 30

# This medication is Used in combination with **valsartan (an ARB)** to treat **HFrEF**.

Answer 30

Sacubitril

Question 31

# This medication is contraindicated with ACE inhibitors due to angioedema.

Answer 31

Sacubitril

Question 32

# This medication is a Direct inhibition of Na+/K+ ATPase Presents with blurry yellow vision, hyperkalemia, and fatigue

Answer 32

DIgoxin

Question 33

# This medication is an indirect inhibition of Na+/Ca2+ exchanger.

Answer 33

Digoxin

Question 34

# This medication ↑ [Ca²⁺]_{intracellular} → **positive inotropy**. Stimulates **vagus** nerve ↓HR

Answer 34

Digoxin

Question 35

# This medication is indicated for ## Footnote HF ( to ↑ contractility) Atrial fibrillation ( to **↓ conduction** at AV node and **depression** of SA node)

Answer 35

Digoxin

Question 36

# The following is the management for what medication toxicity? * Give anti-[Medication] **Fab** fragments * Start Mg²⁺ infusion * Slowly normalize K+ (via Insulin + D5W)

Answer 36

Digoxin toxicity

Question 37

# What medication can cause these Adverse effects: * Cholinergic effects (nausea, vomiting, diarrhea), * blurry yellow vision (think van Glow), * arrhythmias, * AV block.

Answer 37

Digoxin

Question 38

Hyperkalemia indicates a poor prognosis when taking what medication?

Answer 38

DIgoxin

Question 39

Digoxin functions via binding to open ____ binding sites of which transporter? (permissive for drug binding at ), drugs that displace drug from tissue-binding sites, (eg: verapamil, amiodarone, quinidine).

Answer 39

K⁺ binding sites on the Na⁺/K⁺ ATPase (hence hypokalemia while on Digoxin increases risk for toxicity which results in hyperkalemia – Note digoxin is sometimes used with anti-hypertensive medication that causes hypokalemia)

Question 40

Medication is contraindicated if taking: verapamil, amiodarone, quinidine

Answer 40

Digoxin (s/t lowering digoxin clearance)

Question 41

# What medication can cause these Adverse effects: Luminous phenomena/visual brightness, hypertension, bradycardia

Answer 41

Ivabradine

Question 42

Used for Chronic stable angina in patients who **cannot take β-blockers**. ChronicHFrEF

Answer 42

Ivabradine

Question 43

# What class of medication are: Quinidine, Procainamide, Disopyramide

Answer 43

Class 1A Anti-arr Na⁺ Channel Blockers

Question 44

# What class of medication are: Lidocaine, MexileTine.

Answer 44

Class 1B anti- arr Na⁺ channel blockers

Question 45

Flecainide, Propafenone

Answer 45

class 1C anti-arry (tight) Na⁺ channel blockers

Question 46

Metoprolol, propranolol, esmolol, atenolol, timolol, carvedilol. (MEP, CAT)

Answer 46

Class 2 anti arryth beta blockers

Question 47

Amiodarone, Ibutilide, Dofetilide, Sotalol

Answer 47

Class 3 anti-arryth K⁺ channel blockers

Question 48

Diltiazem, Verapamil

Answer 48

class 4 anti-arry Calcium channel blockers

Question 49

Adenosine's effects blunted by what 2 meds/substances?

Answer 49

**adenosine receptor antagonists** theophylline caffeine

Question 50

Drug of choice in diagnosing/ terminating certain forms of SVT.

Answer 50

Adenosine

Question 51

↑ K+ out of cells hyperpolarizing the cell and ↓I_Ca, decreasing AV node conduction.

Answer 51

Adenosine

Question 52

Adverse effects: include flushing, hypotension, chestpain, **_sense of impending doom_**, bronchospasm

Answer 52

Adenosine | (A-doom-osine)

Question 53

Effective in torsades de pointes and digoxin toxicity.

Answer 53

Magnesium

Question 54

for subarachnoid hemorrhage (prevents cerebral vasospasm).

Answer 54

Nimodipine

Question 55

For hypertension, angina, atrial fibrillation/flutter

Answer 55

Non-dihydropyridines: Diltiazem, Verapamil

Question 56

Nicardipine, clevidipine can specifically be used for

Answer 56

hypertensive urgency or emergency

Question 57

\_\_\_ cause peripheral edema, flushing, dizziness. \_\_\_\_ cause cardiac depression, AVblock, constipation

Answer 57

Dihydropyridine Non-dihydropyridine hyperprolactinemia (verapamilk)