diuretics 2

Question 1

MoA of Hydralazine

Answer 1

Increases Ca2+ release and cGMP
levels.
Acts on arteries and arterioles = vasodilation = decrease BP but reflex tachycardia

Question 2

clinical uses of Hydralazine

Answer 2

1) Short term Tx of severe Hypertension during pregnancy.
2) Heart failure. Reduces afterload

Question 3

AE of Hydralazine

Answer 3

°Oedema.
°Headache.
°SLE like sx.
°Reflex tachycardia

Question 4

Contraindications of Hydralazine

Answer 4

Angina and coronary
artery disease

Question 5

Beta blocker used in the management of Hypertension

Answer 5

Labetalol

Question 6

MoA of Labetalol

Answer 6

B1, B2 and A1
antagonist (more
vasoconstriction)

Question 7

Clinical uses of Labetalol

Answer 7

Hypertensive patients
with either angina,
heart failure or post MI.

Question 8

AE of Labetalol

Answer 8

• CV depression (Bradycardia)
• fatigue,
• sexual dysfunction,
• increase LDL and triglycerides,
• bronchoconstriction.

Question 9

Contraindications of Labetalol

Answer 9

1) Can mask hypoglycaemia sx in
diabetics.
2) Asthmatic patients
*SAFE IN PEGNANCY

Question 10

α-1 blockers used in the tx of Hypertension

Answer 10

Doxazosin
Prazosin
Terazosin

Question 11

Clinical uses of α-1 blockers

Answer 11

improve symptoms of BPH: Improve urine flow

Question 12

AE of α-1 blockers

Answer 12

°Postural hypotension.
°Reflex tachycardia.
°Urinary incontinence.
°Impotence.

Question 13

A2 agonists examples

Answer 13

Methyldopa

(decreases Bp)

Question 14

MoA of Methyldopa (A2 agonist)

Answer 14

Less TPR and HR

Question 15

clinical uses of Methyldopa

Answer 15

Used for Hypertension during
pregnancy
(not used anymore due to the sever AE)

Question 16

AE of Methyldopa

Answer 16

Sedation, depression, dry mouth, less
libido, parkinsonian syndromes,
hyperprolactinaemia, bradycardia, sinus
arrest… that’s why it is not used
anymore.
Might also cause haemolytic anaemia

Question 17

MoA of Nitroprusside

Answer 17

Releases NO -> vasodilations of arterial
and venous smooth muscles

Question 18

Clinical uses of Nitroprusside

Answer 18

Hypertensive Emergencies (IV administration)

Question 19

AE of Nitroprusside

Answer 19

Prolonged use may cause thiocyanate accumulation and toxicity (weakness, nausea, inhibition of thyroid function)

Question 20

D1 agonists

Answer 20

Fenoldopam

Question 21

MoA of Fenoldopam

Answer 21

Coronary, peripheric and splachnic vasodilation.
* Increases natriuresis, decreases bp

Question 22

Clinical uses of Fenoldopam

Answer 22

• Short term of severe hypertension in
  hospital –> Improves renal perfusion.
  (Similar effects to IV nitroprusside but lacks
  thiocyanate toxicity but slower onset/offset)

Question 23

Endothelin receptor
antagonists. EXAMPLES

Answer 23

Bosentan
Ambrisentan
Sitaxentan

-entan

Question 24

MoA of Endothelin receptor
antagonists.

Answer 24

Antagonizes endothelin receptors =
vasodilation, proliferation inhibition

Question 25

AE of Endothelin receptor antagonists.

Answer 25

* Headache, * flushing, * hypotension. * Hepatoxic, * endothelins might affect the development of the cardiorespiratory system.

Question 26

PDE V inhibitor

Answer 26

Sildenafil

Question 27

MoA of Sildenafil

Answer 27

PD4 inhibitor -> inhibits cGMP breakdown→pulmon ary artery relaxation

Question 28

Clinical uses of Sildenafil

Answer 28

°Erectile dysfunction °Pulmonary Arterial Hypertension (PAH)

Question 29

AE of Sildenafil

Answer 29

* Headache, * flushing, * dyspepsia (indigestion), * **cyanopia (blue vision)**. * Risk of life-threatening hypotension in patients taking Nitrates

Question 30

Contraindication of Sildenafil

Answer 30

patients w/ high risk of **Hypotnesion** + nitrates (will cause hypotension)