General

Question 1

Antihypertensives

Answer 1

Agents that interfere with the activity of the Peripheral sympathetic nervous system

Question 2

Diuretics in HTN therapy

Answer 2

can be used as monotherapy or adjunctive

augments actions of all antihypertensives

decrease mortality in pts w/ HTN

pts w/ “volume dependent” (low renin level) show better responses!

Question 3

2 major classes of drugs used to treat HTN

Answer 3

1. diuretics

2. antihypertensives

Question 4

diuretics plus _______ are the best tolerated drugs

Answer 4

ACEIs

Question 5

alpha1 blockers

Answer 5

advantages:
- -improve lipid profile and insulin resistance
- -good in physically active pts
- -relieve urinary symptoms in BPH pts

• *Prototypical pts:
• -elderly pts w/ BPH and normal CV function
• -young physically active pts
• -African American pts w/ no success w/ other drugs

disadvantages:

• -not good as monotherapy
• -increased incidence of HF

Caution:
–First dose Orthostatic HTN

Question 6

Beta Blockers

Answer 6

Advantages:
--secondary protection in CAD
--useful in HTN pts w/....
.......tachycardia
.......high CO
.......high renin
.......hyperthyroidism
.......migraine
.......glaucoma
.......stage fright
--Bisoprolol=standard treatment w/ ACEI and diuretics (34% mortality benefit)

Disadvantages:

• -less effective in elderly and AA
• -multiple side effects and contraindications (especially 1st and 2nd generation BBs)
• -Should not be discontinued abruptly

Question 7

ACEIs

Answer 7

Advantages:
–Good for all degrees of HTN
–especially good in pts w/ high renin levels
(young people and caucasians)
–increase efficacy of diuretics
–thiazide + ACEI good even in low-renin HTN
–initial drug used for HTN in DIABETICS (followed by CCB added on)
–may preserve renal function in non-DN
–initial anti-HTN in pts prone to HF

Disadvantages:

• -hyperkalemia
• -pregnancy

Question 8

Dihydropyridine CCBs

Answer 8

Advantages:

• -HTN and CAD treatment
• -more powerful and preferred for treatment of HTN than non-dyhydropyridines (unless short-acting)
• -Very effective in elderly and AA w/ low-renin HTN
• -safe for diabetics

Disadvantages:

• -not as trusted as ACEIs, diuretics, and BBs
• -may increase risk of CAD or HF