Meds

Question 1

Thiazide Diuretics (3)

Answer 1

Chlorothiazide
Chlorthalidone
Hydrochlorothiazde

Question 2

Thiazide MOA

Answer 2

Inhibit sodium and chloride reabsorption in the THICK LOOP OF HENLE and EARLY DISTAL TUBULE
–> this increases urine volume causing a decrease in plasma volume

Question 3

Thiazide- how does it affect the heart?

Answer 3

Decreases cardiac output and lowers stroke volume and lowers BP

Question 4

Adverse effects of Thiazides (5)

Answer 4

Hypokalemia
hypomagnesemia
Hyperglycemia
Hyperuricemia
Hyperlipidemia

Question 5

Ace Inhibitors

Answer 5

captopril
enalapril
Lisinopril
Benazepril
Fosinopril
Ramipril
Quinapril
Moexepril

Question 6

MOA of ACE

Answer 6

block the enzyme that converts ANgiotensin I to angiotensin II.

Question 7

What is angiotensin II?

Answer 7

principal pressor in the RAAS responsible for vasoconstriction, synthesis, and release of aldosterone cardiac stimulation and renal absorption of sodium

Question 8

What happens when Angiotensin II is blocked by ACE?

Answer 8

Vascular resistance is decreased and the secretion of aldosterone is decreased– decreased water and sodium retention

Question 9

Adverse effects of ACE?

Answer 9

cough
hypotension
Rash
Angioedema
HYPERKALEMIA

Question 10

Contraindication fo ACE?

Answer 10

PTs with renal artery stenosis d/t risk of renal failure

Question 11

ACE inhibitors Clinical use?

Answer 11

First-line drug for HTN
reduce proteinuria 
slow progression of neuropathy
good for HTN CHF or HTN and DM
Post MI

Question 12

ARBS

Answer 12

Candesartan
Eprosartan
Irbesartan
Losartan
Olmesartan
Telmisartan
Varsartan

Question 13

MOA of ARBS

Answer 13

INHIBITS/BLOCKS angiotensin II RECEPTOR!

Question 14

MOA difference between ARBS And ACE?

Answer 14

ARB- block receptor

Ace- blocks enzyme

Question 15

Adverse effcts of ARBs

Answer 15

Hyperkalemia
Fatigue
Headache
Dizziness
Insomnia
SINUS CONGESTION

Question 16

ARBs are contraindicated for which patients?

Answer 16

PT with renal artery stenosis

Question 17

Why do some patients need ARB over ACE?

Answer 17

PT cannot tolerate ACE cough s/e

Question 18

Indication of ARBS

Answer 18

HTN and CHF but not approved for post MI

Question 19

Calcium Channel ANTAGONISTS

Answer 19

Amlodipine
Felodipine
Isradipine
Nicardipine
NIfedipine
Verapamil
Bepridil

Question 20

MOA of Calcium Channel ANTAGONISTS

Answer 20

Block L type calcium channels and decrease calcium entry into vascular and cardiac cells this results in reduced CONTRACTILITY in CARDIAC AND VASCULAR MUSCLE

Question 21

Calcium Channel ANTAGONISTS decrease…

Answer 21

Arteriolar dilation and decreased BP

Question 22

Why are CCB contraindicated with HF PT?

Answer 22

bc they also inhibit calcium in cardciac tissue and SLOW conduction of AV node this can decrease contractility and make HF worse

Question 23

clinical use of CCB?

Answer 23

PT with Angina and HTN

Question 24

Why should Nifedipine not be used for HTN Txt?

Answer 24

BC short-acting Nifedipine can cause increased risk of MI bc of reflex tachycardia

Question 25

What are the three classes of Calcium channel ANTAGONISTS?

Answer 25

1. Diphenyalkylamines 2. Benzothiazepines 3. Dihydriopyridine

Question 26

Verapamil belongs to which class of CCB?

Answer 26

Diphenyalkylamines --> vascular and cardiac activity | Txt- HTN Angina and SVT

Question 27

Diltiazem belongs to which class of CCB?

Answer 27

Benzothiazepines-->vascular and cardiac activity | Txt- HTN Angina and SVT

Question 28

Nifedipine belongs to which class of CCB?

Answer 28

Dihydropyridine

Question 29

Nifidipine

Answer 29

greater affinity for calcium channels in the VASCULAR system than in the heart and they provide vasodilation BUT ARE NOT effective in decreasing AV node conduction TXT ANGINA AND HTN

Question 30

SE of Diphenyalkylamine

Answer 30

Constipation Bradycardia Heart block Worsen CHF

Question 31

SE of Benzothiazepines?

Answer 31

Bradycardia | Worsen CHF

Question 32

SE of Dihydropyridine ?

Answer 32

Headache Flushing Peripheral edema Increased angina MI

Question 33

Beta Blockers

Answer 33

``` Acebutolol Atenolol Betaxolol Metoprolol Nadolol Penbutolol Prpanolol Carvedilol Labetolol ```

Question 34

MOA of BB

Answer 34

NEGATIVE CHRONOTROPE decrease contractility and CO block receptors on kidneys and reduce the release of renin

Question 35

SE of BB

Answer 35

``` bronchoconstriction peripheral vasoconstriction brady exacerbation of HF fatigue depression sleep disturbance ```

Question 36

Contraindication for BB

Answer 36

PVD Asthma COPD

Question 37

BB careful with diabetics because...

Answer 37

BB decrease the normal sympathetic response to hypoglycemia

Question 38

Alpha 1 Receptor Blockers

Answer 38

Doxazosin Terazosin Prazosin

Question 39

MOA of alpha 1

Answer 39

reduce arterial pressure by blocking the peripheral post synaptic alpha 1 receptors and decrease total peripheral resistance

Question 40

SE of Alpha 1 Recpetor Blcokers

Answer 40

FIRST DOSE SYNCOPE Dizziness drowsiness headaches CNS - think head

Question 41

Which drug can be used for BPH?

Answer 41

TERAZOSIN

Question 42

Alpha 2 AGONISTS

Answer 42

Clonidine guanabenz methyldopa guanfacine

Question 43

MOA of Alpha 2 AGONISTS

Answer 43

STIMULATE alpha 2 receptors in the brainstem decreasing sympathetic outflow to the heart kidneys and peripheral vasculature NO NOREEPINEPHRINE

Question 44

SE of alpha 2 AGONISTS

Answer 44

``` Think CNS sedation dry mouth drowsiness constipation and abd pain decreased lipido and impotence RASH WITH PATCH ```

Question 45

Can you abruptly stop alpha 2 agonists?

Answer 45

NO rebound HTN can occur must be tapered

Question 46

Which medication can be used for PT that is pregnant and has HTN?

Answer 46

Methyldopa