Hypertensive Drugs

Question 0

Thiazide diuretic, that inhibits Na/Cl trransporter in distal convoluted tubule. First line for hypertension

Answer 0

Hydrochlorothiazide - SIMD: Metolazone, Indapamide; decrease Bp by 10-15mmHg

Question 1

Hypertensive patient with no comorbidities, what would be the bp goal of this patient?

Answer 1

Co comorbidities <130/80

Question 2

Feature of a Thiazide toxicity

Answer 2

HYPER GLUC - hyperGlycemia, hyperLipidemia, hyperUricemia and hyperCalcemia

Question 3

Loop diuretics that inhibits Na/K/2Cl transporter in thick ascending limb of Henle. Powerful diuresis and increase Ca excretion

Answer 3

Furosemide - SE: hypokalemic metabolic acidosis

Question 4

MOA of Clonidine and Methyldopa as CNS sympathetic outflow blockers

Answer 4

Activates a2 adrenergic receptors, decrease central sympathetic outflow

Question 5

SIMD of Hexamethonium an obsolete hypertensive drug

Answer 5

Trimethaphan - ganglionic blocker

Question 6

Nerve terminal blocker that irreversibly blocks the vesicular monoamine transporter (VMAT) used as an obsolete hypertensive agent

Answer 6

Reserpine - SIMD: Guanethidine; causes suicidal ideation

Question 7

Vasodilator, used for hypertension, heart failure and pre-eclampsia. May caused drug-induced lupus

Answer 7

Hydralazine - alters intracellular Ca metabolism thus relaxes arteriolar smooth muscle

Question 8

Medications that may cause drug-induced lupus

Answer 8

HIPP - Hydralazine, Isoniazid, Procainamide, Penicillamine

Question 9

Vasodilator, specific for arterioles decreasing afterload. Opens K+ channels in vascular smooth muscle, causing hyperpolarization thus relaxation and vasodilatation.

Answer 9

Minoxidil

Question 10

Notable side effect of Minoxidil

Answer 10

Hypertrichosis - it stimulates hair follicle at telogen phase to differentiate into growth follicles, anagen phase

Question 11

Non-dihydropyridine calcium channel blocker, used for angina, migraine and hypertension, SE: gingival hyperplasia, heart failure

Answer 11

Verapamil / Diltiazem - block voltage-gated L-Type calcium channels

Question 12

Dihydropyridine, calcium channel blocker which has more effect on vascular than cardiac used for angina and hypertension

Answer 12

Nifedipine - SIMD: Amlodipine, Nicardipine, Felodipine

Question 13

Parenteral vasodilator, for hypertensive emergency, acute heart failure, cardiogenic shock

Answer 13

Nitroprusside - SE: cyanide toxicity

Question 14

Dopamine agonist used as parenteral vaodilator for hypertensive emergency by causing arteriolar vasodilation of both afferent/efferent arterioles.

Answer 14

Fenoldopam

Question 15

True/False: ACE-Is/ARBs reduce aldosterone levels and cause potassium retention hence results to hyperkalemia

Answer 15

True

Question 17

ACE inhibitor for hypertension, heart failure, post-MI, diabetic nephropathy. Increases survival in heart failure, delays progression of diabetic nephropathy

Answer 17

Captopril - SIMD: Enalapril, Quinapril etc.

Question 18

Management for malignant hypertension:

Answer 18

Vasodilators: nitroprusside, fenoldopam or diazoxide combined with diuretics (furosemide) and beta-blockers to lower bp to 140-160/90-110

Question 19

Antidote for cyanide poisoning

Answer 19

Inhaled amyl nitrite + IV sodium nitrite + IV sodium thiosulfate

Question 20

ARB - used fir hypertension, heart failure and diabetic nephropathy. It blocks Angiotensin (AT1 receptor) in vascular smooth muscle. Dec aldosterone

Answer 20

Losartan - SIMD: Candesartan, Telmisartan, Irbesartan

Question 21

Angina can be corrected in two ways

Answer 21

A. Increasing oxygen delivery

B. Reducing oxygen requirement

Question 23

Angina of effort or classic angina, associated with atheromatous plaques that partially occlude 1 or more coronary arteries

Answer 23

Atherosclerotic Angina - 90% of angina cases

Question 24

Creasendo angina, immediate precursor of myocardial infarction

Answer 24

Unstable angina

Question 25

disease due to occupational exposure to nitrates alternating development of tolerance

Answer 25

Monday disease

Question 28

Ultrashort- acting nitrate, used in cyanide poisoning with methemoglobinemia as one of the side effects.

Answer 28

Amyl nitrite

Question 29

Short-acting nitrate, used for angina and acute coronary syndrome which may develop dangerous hypotension with PDE inhibitors

Answer 29

Nitroglycerin - releases nitric oxide, increases cGMP and relaxes smooth muscles

Question 30

Why do patients taking nitrates usually experience throbbing headaches?

Answer 30

Due to meningeal artery vasodilation

Question 31

Dihydropyridine calcium channel blocker used for angina and hypertension ( vascular>cardiac)

Answer 31

Nifedipine - SIMD: Amlodipine, Nicardipine

Question 32

Drugs that causes gingival hyperplasia?

Answer 32

Nifedipine, Cyclosporine, Phenytoin, Verapamil

Question 33

Current evidence: acute heart failure should be treated with ____ diuretics.

Answer 33

Loop diuretics

Question 34

Type of heart failure that present with orthopnea, PND, pulmonary congestion

Answer 34

Left heart failure

Question 35

Type of heart failure that presents with hepatomegaly, edema, engorged neck veins

Answer 35

Right heart failure

Question 36

Cardiac glycoside used for heart failure and nodal arrhythmias. It has a narrow therapeutic index

Answer 36

Digoxin - inhibits Na/K ATPase, increasing intracellular Ca, increaing cardia contractility

Question 37

Drugs with narrow therapeutic index

Answer 37

Warfarin, aminoglycosides, lithium, amphotericin B, carbamazepine, phenobarbital, phenytoin, vancomycin, theophylline, digoxin

Question 38

First line therapy for both systolic and diastolic failure

Answer 38

Diuretics

Question 39

Have a significant long term benefits and can reduce mortality in chronic failure

Answer 39

Spironolactone and Eplerenone

Question 40

It is the first line drugs for chronic heart failure

Answer 40

Angiotensin antagonist - ARBs have the same benefits with ACE inhibitors

Question 41

Vasodilators that has been shown to reduce mortality in african americans

Answer 41

Hydralazine and Isosorbide dinitrates

Question 43

Portion of ETC affected by cyanide

Answer 43

Complex IV (cytochrome oxidase)

Question 44

Refers ti accelerated form of severe hypertension associated with rising blood pressure and rapidly progressing end-organ damage

Answer 44

Malignant hypertension

Question 46

Rest angina, variant angina or Prinzmetal's angina, involves reversible spasm of coronaries, usually at site of plaques

Answer 46

Vasospastic angina - 10% of cases

Question 47

Renin antagonist that inhibits conversion of angiotensinon to angiotensin I. For hypertension

Answer 47

Aliskiren