Diuretics - 1st line Anti-hypertensive

Question 1

Which diuretics are 1st line anti-hypertensive?

Answer 1

Thiazides

Question 2

Where do we use Loop D. in HTN?

Answer 2

Severe HTN + CHF + renal dysfunction (edema)

Question 3

DOC resistant HTN

Answer 3

Spironolactone

Question 4

Which vasodilators decrease preload?

Answer 4

Veno-dilators - Nitrates

Question 5

Which vasodilators decrease after load?

Answer 5

CCB
KCO
Hydralazine

Question 6

Which vasodilators decrease pre and after load?

Answer 6

Mixed ones - STRONGEST
Diuretics
ACEi
ARBs
PDEi (Amrinone, Milrinone)
alfa-1 blockers
3rd gen beta blockers
fenoldapam

Question 7

MOA of Sodium Nitroprusside?

Answer 7

Increase NO - Guanyl cyclase - Cyclic GMP => Vasodilation (Mixed)
VERY STRONG, SHORTER, FASTER

Question 8

Use of SNP?

Answer 8

HTN EMERGENCY - IV, SHORT STRONG AND FAST

Question 9

Which anti-hypertensive drug is photosensitive?

Answer 9

SNP
comes in black/brown bottles
Oxidizes in presence of light

Question 10

Risk of SNP?

Answer 10

Sudden hypo-TN
Reflex tachycardia
Cyanide toxicity

Question 11

Which drug used for HTN emergency causes cyanide toxicity?

Answer 11

SNP

Question 12

MOA Hydralazine?

Answer 12

PDE inhibitor
KC opener

Question 13

Use of Hydralazine?

Answer 13

HTN (safe in pregnancy)
CHF

Question 14

Which anti-hypertensive drug has risk of SLE?

Answer 14

Hydralazine

Question 15

Name KC Openers

Answer 15

Minoxidil
Diazoxide
Nicorandil

Question 16

Which KCO is a prodrug?

Answer 16

Minoxidil
active form minoxidil sulfate

Question 17

Which KCO drug is used in insulinoma?

Answer 17

Diazoxide

Question 18

Which KCO drug causes hirsutism?

Answer 18

Minoxidil sulfate - Toni needs it topically

Question 19

Which KCO drug is used in angina?

Answer 19

Nicorandil

Question 20

Which type of Ca channel is present in blood vessels?

Answer 20

L-type - causes VD
(T-type in epilepsy)

Question 21

MOA CCBs

Answer 21

Vasodilation + Inhibit heart conduction system = decrease HR

Question 22

Which CCBs are used in SVT?

Answer 22

Verapamil and Diltiazem

Question 23

CCBs which are safe in pregnancy?

Answer 23

Dihydropyridines - Nifedipine

Question 24

CCBs which are safe in asthma?

Answer 24

Verapamil and Diltiazem

Question 25

Which CCB has risk of tachycardia?

Answer 25

Nifedipine - short - sudden/fast acting causes reflex tachycardia

Question 26

Which CCB is C/I in arrythmia and Angia pts?

Answer 26

Nifedipine - shorter action, risk of increased HR

Question 27

Uses of CCBs?

Answer 27

HTN - 1st line Prinz metal/Vasospastic angina Peripheral vascular disease Tocolytic - Best

Question 28

DOC PVD and Prin metal angina?

Answer 28

CCBs - Verapamil, Diltiazem, Nifedipine

Question 29

CCBs are safe in?

Answer 29

PVD Asthma Pregnancy DM Dyslipidemia

Question 30

Longer acting routine use DHPs?

Answer 30

Amlodipine Cilnidipine

Question 31

Which DHP has high lipid solubility?

Answer 31

Nimodipine (finding nimo in brain) Used for decreasing neurological complications in pts with Stroke

Question 32

DHPs DOC for EMERGENCY HTN?

Answer 32

Nicardipine (and Clevidipine)

Question 33

MC S/E of DHPs?

Answer 33

Ankle edema Constipation Urinary retention Headache

Question 34

MC S/E of Amlodipine?

Answer 34

Ankle edema

Question 35

MC S/E of Verapamil?

Answer 35

Constipation

Question 36

MOA of Metyrosine?

Answer 36

Decrease synthesis of catecholamines

Question 37

Which Adrenergic neuron blocker has risk of suicidal tendency in HTN?

Answer 37

Reserpine - decreases storage of catecholamines

Question 38

Which Adrenergic neuron blocker decrease release of catecholamines used in HTN?

Answer 38

Guanethidine Bretylium

Question 39

Name central sympatholytic drugs? (Central alfa-2 agonists)

Answer 39

Clonidine Methyldopa

Question 40

DOC HTN urgency?

Answer 40

Clonidine S/E Rebound HTN

Question 41

Which anti-HTN drug increases nor-adr receptor sensitivity?

Answer 41

Clonidine Stop drug slowly

Question 42

Which anti HTN medication safe in pregnancy causes positive combs test?

Answer 42

Methyldopa (also causes hemolytic anemia)

Question 43

Which anti-HTN drug increases sleep and decreases stress?

Answer 43

Clonidine - Cental alfa-2 agonist

Question 44

Which alfa agonist act like sympatholytics?

Answer 44

Central alfa-2 agonist

Question 45

DOC rebound HTN due to Clonidine withdrawl?

Answer 45

Phentolamine (non-selective alfa blocker)

Question 46

Which are best anti-HTN in IHD/angina/MI pts?

Answer 46

beta-blockers

Question 47

Name Clonidine congeners

Answer 47

Lofexidine - opioid withdrawal Dexmedetomidine - Sedative Tizanidine - Muscle relaxant

Question 48

Best anti-HTN for diabetics and dyslipidemia pts?

Answer 48

ARBs and ACEi

Question 49

Best anti-HTN for MI/angina pts?

Answer 49

beta-blockers

Question 50

Best anti-HTN for asthma pts?

Answer 50

CCBs

Question 51

Best anti-HTN for CHF pts?

Answer 51

ARBs and ACEi

Question 52

Best anti-HTN for pregnancy?

Answer 52

Labetalol

Question 53

Anti HTN CI in pregnany?

Answer 53

Diuretics ACEi AT1-antagonist Non-selective beta blockers SNP (avoided)

Question 54

DOC chronic HF?

Answer 54

ARBs/ARNI

Question 55

Best antihypertesive in asthma patients?

Answer 55

CCBs

Question 56

Best antihypertesive in diabetics and dyslipidemia?

Answer 56

ARBs & ACEi

Question 57

Best antihypertesive in angina CHF pts?

Answer 57

Beta-blockers

Question 58

Best dipin for emergency HTN?

Answer 58

Nicardipine

Question 59

Best dipine for neurologic patient?

Answer 59

Nimodipin -finding Nemo in brain

Question 60

MC S/E of beta blockers?

Answer 60

Bronchoconstriction

Question 61

MC S/E of Verapamil?

Answer 61

Constipation

Question 62

Which beta blocker is cardio selective?

Answer 62

Metoprolol

Question 63

DOC congenital lung QT syndrome?

Answer 63

Propranolol beta blockers

Question 64

DOC torsades de pointes and QT prolongation?

Answer 64

Mg

Question 65

Digitalis drug use?

Answer 65

SVT in CHF

Question 67

DOC terminating acute SVT attacks?

Answer 67

Adenosine - given 50ml NS bolus right after adenosine injection

Question 68

SVT + Asthma DOC?

Answer 68

Verapamil (Adenosine causes bronchoconstriction)

Question 69

DOC Atrial flutter

Answer 69

Beta blockers