Chapter 11: Drugs Used in Hypertension

Question 1

Primary autonomic mechanism for blood pressure homeostasis; involves sensory input from carotid sinus and aorta to the vasomotor center and output via the parasympathetic and sympathetic motor nerves

Answer 1

Baroreceptor reflex

Question 2

Hypertension of unknown etiology; also called primary hypertension

Answer 2

Essential hypertension

Question 3

Hypotension on assuming upright posture; postural hypotension

Answer 3

Orthostatic hypotension

Question 4

Elevated blood pressure (usually above pretreatment levels) resulting from loss of antihypertensive drug effect

Answer 4

Rebound hypertension

Question 5

Hypertension caused by a diagnosable abnormality, eg, aortic coarctation, renal artery stenosis, adrenal tumor, etc.

Answer 5

Secondary hypertension

Question 6

Older patients of most races respond better to what antihypertensive drugs?

Answer 6

Diuretics = β blockers > ACE inhibitors.

Question 7

African Americans of all ages respond better to

Answer 7

Diuretics = CCB

They respond less well to ACE inhibitors.

Question 8

What diuretic blocks the NaK2Cl transporter in thick ascending limb?

Answer 8

Furosemide

Toxicity:
Hypokalemia, hypovolemia, ototoxicity

Question 9

What diuretic blocks the Na+/Cl− transporter in distal convoluted tubule?

Answer 9

Hydrochlorothiazide, chlorthalidone

Toxicity:
Hypokalemia, hyperglycemia, hyperuricemia, hyperlipidemia

Question 10

Centrally acting-sympathoplegic which acts as an agonist at α2 receptors (in CNS this results in decreased SANS outflow)

Answer 10

Clonidine

Toxicity:
Sedation, danger of severe rebound hypertension if suddenly stopped

Question 11

Centrally acting-sympathoplegic prodrug converted to methylnorepinephrine in CNS, with effects like clonidine

Answer 11

Methyldopa

Toxicity:
Sedation, induces hemolytic antibodies

Question 12

Ganglion blocker-sympathoplegic.

Obsolete prototype nicotinic ACh receptor blocker in ganglia (blocks all ANS transmission).

Answer 12

Hexamethonium

Question 13

Postganglionic neuron blockers that blocks vesicular pump (VMAT) in adrenergic neurons

Answer 13

Reserpine

Question 14

Selective α1 blocker that reduces peripheral vascular resistance, prostatic smooth muscle tone

Answer 14

Prazosin

Question 15

Prototype nonselective β blocker which reduces cardiac output and possible secondary reduction in renin release

Answer 15

Propranolol

Question 16

Calcium channel blockers acting as prototype L-type calcium channel blockers (combine moderate vascular effect with weak cardiac effect)

Answer 16

Dihydropyridines (e.g. Nifedipine)

Toxicity:
Constipation; risk of myocardial infarction from prompt- release nifedipine

Question 17

CCBs with greater cardiodepressant effects

Answer 17

Non-dihydropyridines (Verapamil, diltiazem)

Question 18

Renin inhibitor/antagonist

Toxicity: Angioedema, renal impairment

Answer 18

Aliskiren

Question 19

Angiotensin antagonists that reduces angiotensin II synthesis

Answer 19

ACE inhibitors

Toxicity:
Cough • hyperkalemia • teratogen

Question 20

Angiotensin antagonists that blocks AT1 receptors

Answer 20

Angiotensin II receptor blockers (ARBs)

Toxicity:
Hyperkalemia • teratogen

Question 21

Toxicities of thiazides:

Answer 21

HYPER-GLUC

G-lycemia
L-ipidemia
U-ricemia
C-alcemia

Question 22

Countercurrent multiplier

Answer 22

Loop of Henle

Question 23

Countercurrent exchanger

Answer 23

Vasa recta

Question 24

Toxicities of Loop diuretics:

Answer 24

OH-DANG!

O-totoxicity
H-ypokalemia
D-ehydration
A-llergy to sulfa
N-ephritis
G-out

Question 25

What drugs are used to control blood pressure in pheochromocytoma?

Answer 25

1. Phenoxybenzamine
2. Phentolamine
3. Labetalol

Question 26

What medications may cause drug-induced lupus?

Answer 26

“It’s HIPP to have LUPUS!”

1. Hydralazine
2. Isoniazid
3. Procainamide
4. Penicillamine

Question 27

CCB symptoms:

Dihydropyridine vs. Non-Dihydropyridine

Answer 27

Gingival Hyperplasia

“NapaCa-Pangit ng gingiVa mo”

1. Nifedipine
2. Cyclosporine
3. Phenytoin
4. Verapamil

Question 28

Effects of electrolyte imbalance on ECG:

Answer 28

1. HyperKalemia: peaked T-waves
2. HypoKalemia: T-wave inversion
3. HyperCalcemia: decreased PR-interval
4. HypoCalcemia: increased PR-interval