Hypertension & Antihypertensive Drugs

Question 1

Ways of lowering blood pressure by reducing cardiac output include?

Answer 1

1. Beta blockers
2. Calcium channel antagonists

Question 2

Ways of lowering blood pressure by reducing plasma volume include?

Answer 2

Use of diuretics

Question 3

Ways of lowering blood pressure by reducing total peripheral resistance?

Answer 3

1. Vasodilators
2. Alpha 1 adrenergic receptor antagonists
3. ACE inhibitors

Question 4

What type of antihypertensive is hydrochlorothiazide?

Answer 4

Thiazide diuretics

Question 5

What type of antihypertensive is indapamide?

Answer 5

Thiazide diuretics

Question 6

What type of antihypertensive is polythiazide?

Answer 6

Thiazide diuretics

Question 7

What type of antihypertensive is hydrofulmethiazide?

Answer 7

Thiazide diuretics

Question 8

What type of antihypertensive is metolazone?

Answer 8

Thiazide diuretics

Question 9

What type of antihypertensive is chlortalidone?

Answer 9

Thiazide diuretics

Question 10

What is used as monotherapy for mild to moderate hypertension?

Answer 10

Thiazide diuretics

Question 11

Describe the mechanism of action of thiazides

Answer 11

They control hypertension in part by inhibiting reabsorbtion of sodium and chloride ions from the DCT in the kidneys by blocking thiazide-sensitive NaCl symporter. This leads to decreased GFR which is compensated by an increase in sodium and water uptake in the proximal tubule.

Question 12

In thiazide therapy what can be included to prevent long term hypokalemia which increases mortality?

Answer 12

Include potassium sparing diuretics in therapy

Question 13

…….. is most efficacious in “low-renin” or volume expanded forms of hypertension?

Answer 13

Thiazide diuretics

Question 14

Which American demographic are thiazides most effective on?

Answer 14

African-American

Question 15

Systemic effects of ACE inhibitors include reduction in…?

Answer 15

1. Total peripheral resistance
2. Systolic and diastolic pressure
3. Mean arterial pressure
4. Aldosterone secretion
5. Cardiac remodeling

Question 16

Systemic effects of ACE inhibitors include increase in…?

Answer 16

1. Regional blood flow in vascular beds
2. Large artery compliance

Question 17

What are prodrugs?

Answer 17

Drugs that must be biotransformed for activity by esterases.

Question 18

Examples of active molecule ACE inhibitors include?

Answer 18

1. Captopril
2. Lisinopril
3. Enalaprilat

Question 19

Examples of “prodrug” ACE inhibitors include?

Answer 19

1. Enalapril
2. Fosinopril
3. Quinapril
4. Ramipril

Question 20

Which drug class is the initial choice for mild to moderate hypertension?

Answer 20

ACE inhibitors

Question 21

The drug class of choice for hypertension due to diabetes mellitus is?

Answer 21

ACE inhibitors

Question 22

Which american demographic are ACE inhibitors more effective on?

Answer 22

Caucasians

Question 23

Which class of drugs is excellent for patients with hypertension secondary to CHF, arrhythmias and kidney disease?

Answer 23

ACE inhibitors

Question 24

The efficacy of ACE inhibitors is enhanced by ?

Answer 24

Diuretics

Question 25

Example of competitive type 1 angiotensin II receptor antagonist is ?

Answer 25

Losartan

Question 26

What type of receptor antagonist is valsartan?

Answer 26

Non-competitive type 1 angiotensin II receptor antagonist

Question 27

What type of receptor antagonist is Candesartan

Answer 27

Non-competitive type 1 angiotensin II receptor antagonist

Question 28

What type of receptor antagonist is Irbesartan ?

Answer 28

Non-competitive type 1 angiotensin II receptor antagonist

Question 29

Which class of drugs is used for prevention of re-stenosis after angioplasty?

Answer 29

Type 1 angiotensin II receptor antagonist

Question 30

Which class of drugs is excellent for inhibiting cell growth?

Answer 30

Type 1 angiotensin II receptor antagonist

Question 31

Which of these beta blockers readily enters and is unable to enter the CNS. Propranolol and sotalol?

Answer 31

Propranolol readily enters, sotalol does not enter

Question 32

Alpha methyl dopa is a prodrug, converted to ….. in the brain?

Answer 32

Alpha methyl norepinephrine

Question 33

The action of alpha methyl dopa is prolonged with ?

Answer 33

Renal insufficiency

Question 34

Examples of centrally acting sympatolytics include?

Answer 34

1. Clonidine 2. Alpha methyl dopa 3. Guanfacine 4. Guanabenz

Question 35

Examples of peripherally acting sympatolytics?

Answer 35

1. Metyrosine 2. Guanethidine 3. Bretylium 4. Reserpine

Question 36

Examples of calcium channel antagonists include?

Answer 36

1. Verapamil 2. Diltiazem

Question 37

…… directly inhibits cardiac chronotropy effective in low-renin hypertension effective in African-Americans and elderly and does not cause fluid retention??

Answer 37

Calcium channel antagonists

Question 38

Examples of direct acting vasodilators include?

Answer 38

1. Hydralazine 2. Minoxidil

Question 39

Can hydralazine and minoxidil be used as monotherapy?

Answer 39

No!

Question 40

Hydralazine and minoxidil are only used in?

Answer 40

Severe or refractory hypertension