hypertension

Question 1

name 3 thiazide diuretics

Answer 1

hydrochlorothiazide
chlorothiazide
metolazone (thiazide like diuretic)

Question 2

what do you have to monitor with thiazides?

Answer 2

serum K!

Question 3

where do thiazides work and what do they do?

Answer 3

on the descending tubule and increase Na/H2O excretion

Question 4

what are loops good for?

Answer 4

acute pulm edema and hypercalcemia

Question 5

are loops good for HTN?

Answer 5

nope. too fast acting, and too much risk for hypovolemia (good for HTN w/ kidney dysfunction)

Question 6

name 4 loops

Answer 6

furosemide, bumetanide, ethacrynic acid, torsemide

Question 7

name 3 K sparing diuretics

Answer 7

spironolactone, triamterene, amiloride hydrochloride

Question 8

in what way are K sparing diuretics helpful for HTN?

Answer 8

they are great combo drugs with thiazides (name them!) to help prevent hypokalemia

Question 9

what is an osmotic agent?

Answer 9

mannitol

Question 10

what is mannitol good for?

Answer 10

good for increased ICP, and to keep urine flowing in acute renal failure

Question 11

what is a carbonic anhydrase inhibitor?

Answer 11

acetazolamide

Question 12

what is acetazolamide and what is it used for?

Answer 12

carbonic anydrase inhibitor diuretic

tx of glaucoma, mountain sickness

Question 13

name 4 CCBs

Answer 13

diltiazam, verapamil, amlodipine, nifedipine

Question 14

how do CCBs work? what do they do?

Answer 14

they block Ca channels causing vascular relaxation and dilation of arterioles (not veins)

Question 15

what is a side effect of verapamil?

Answer 15

constipation esp in elderly

first degree AV blocks (dose dependent)

Question 16

what are some side effects of the dihydropyridines?

Answer 16

headache, dizziness, flushing, peripheral edema, palpitations (due to the vasodilation)

Question 17

who should you definitely not use CCBs on? why?

Answer 17

CHF pts because of negative inotropic effects (shitty contractile strength)

Question 18

who respond really well to CCBs?

Answer 18

black people

Question 19

if you have a pt on warfarin or digoxin, and you want to use a CCB, which ones should you use?

Answer 19

dihydropyridines (show little interaction w/ other cardio drugs)

Question 20

what are better for HTN? dihydropiridines or other CCBs?

Answer 20

dihydro’s bc they have greater affinity for vascular Ca channels than heart Ca channels (low side effect profile)

Question 21

name 5 ACE inhibitors

Answer 21

lisinopril, captopril, benazepril, enalapril, quinapril

Question 22

who should NOT get an ACE inhibitor?

Answer 22

pregnant pts
anyone taking an ARB
black patients

Question 23

how do ACEs reduce BP?

Answer 23

blocks angiotensin II (vasodilates both arterioles and veins) and decreases aldosterone (decreased Na and H2O retention)

Question 24

whats an annoying side effect of an ACE?

Answer 24

dry cough…try an ARB if this occurs

Question 25

whats a kinda bad side effect of an ACE?

Answer 25

hyperkalemia -- DONT use K supplements or K sparing diuretics

Question 26

name two angiotensin II receptor blockers

Answer 26

Losartan, valsartan

Question 27

who should get an ACE I as a FIRST LINE tx?

Answer 27

adults with chronic kidney disease

Question 28

name 3 B blockers

Answer 28

Propranolol, atenolol, metoprolol

Question 29

what are ARBs pretty good for?

Answer 29

pt's with CKD pt's who dont tolerate ACEs (cough) decreasing nephrotoxicity esp in DM pts

Question 30

what are some side effects of ARBS

Answer 30

hyperkalemia BAD for pregnant mothers BAD in combo with ACEs

Question 31

which beta blocker is non selective?

Answer 31

propranolol (acts on B1 and B2 receptors)

Question 32

which B blockers are selective of B1 receptors?

Answer 32

atenolol and metoprolol

Question 33

which B blocker is CONTRAINDICATED in asthma?

Answer 33

propanolol! non selective, also blocks B2 bronchodilation

Question 34

what are B blockers really good for?

Answer 34

fantastic for post MI + HTN

Question 35

name 3 alpha blockers

Answer 35

doxazosin, prazosin, terazosin

Question 36

how do alpha blockers work?

Answer 36

block alpha 1 receptors and decrease PVR and relax arterial and venous smooth muscle

Question 37

what do alpha blockers cause (in a bad way)?

Answer 37

reflex tachycardia and syncope

Question 38

name 2 peripheral sympathetic inhibitor agents

Answer 38

guanethidine, reserpine

Question 39

name 3 central sympatholytic action drugs

Answer 39

clonidine, guanabenz, methyldopa