At what point should medication be implemented in a hypertensive patient? - ANS If their BP is
>140/90 or >130/80 that is not fixed by non pharmacological therapy
If a hypertensive patient has no comorbidities what is the typical first line pharmacological
treatment? - ANS Ace (or ARB), a CCB, or thiazide diuretic
What is the first line pharmacological treatment for a diabetic hypertensive patient? - ANS ACE
(or ARB) avoid use of others first due to risk of kidney damage
What is the most commonly used category of medicine for HTN? - ANS Thiazide diuretics
Why is ACE the first line over ARB? - ANS Angiotensin 2 production is stopped in ACE inhibitors
whereas ARBs just try to block the receptor sites
How do you know a drug is an ACE inhibitor? - ANS It ends in -pril
What causes a cough with an ACE inhibitor? - ANS The buildup of bradykinin
What are the two main effects of an ACE inhibitor? - ANS Stops vasoconstriction (stops
angiotension 2 production)
Excretes Na and H2O (Decreases aldosterone production)
What is a big contraindication for someone who may start ACE inhibitors? - ANS Pregnancy or
bilateral renal artery stenosis
Whenever you give an antihypertensive or diuretic drug what do you need to watch closely
especially with a first dose? - ANS Their BP, we do not want them to get hypotensive
Do ACE inhibitors decrease mortality in HTN and CHF patients? - ANS Yes
How do you tell a drug is an ARB? - ANS It ends in -sartan
What two effects does an ARB not have that and ACE has? - ANS No cough and less likely to
have hyperkalemia
What patients cannot take aliskiren? - ANS Diabetics (renal impairment) or people on ACEs or
ARBs (stops RAAS too much)
, Where does Aliskiren work? - ANS Renin inhibitor- stops angiotensinogen for turning to
angiotensin 1
What is the difference between a non-dihydropyridine CCB and dihydropyridine CCB? - ANS
Non-dihydropyridines slow heart rate and decrease contractility
What do dihydropyridine CCBs end in? - ANS -dipine
How do CCB's work? - ANS Decreases contractibility of the vessels therefore decreasing
vasoconstriction and increasing vasodilation
What are the two nondihydropyridines? - ANS Verapamil
Diltiazem
What additional use does a nondihydropyridine have that dipydropyridines don't? - ANS They
can be used for arrhythmias (afib)
What two medicines can you not give with dihydropyridines? - ANS Digoxin and betablockers
Oddest CCB side effect? - ANS Gingival hyperplasia
What do aldosterone blockers end in? - ANS -one
Who would you not give an aldosterone blocker to? - ANS A hyperkalemic patient
Beta blockers end in what? - ANS -lol
What effects do beta blockers have on the CV system? - ANS Decreased HR, contractility, and
vasoconstriction
Why are beta blockers not used in diabetics? - ANS They mask the signs of hypoglycemia
What is the drug of choice for HTN pregnant patients? - ANS Methyldopa
Why are alpha 1 adrenergic blockers no longer used for HTN? What are they used for? What
two are there? - ANS They increase mortality
BPH
Doxazosin and Prazosin
What is the MOA of hydralazine? - ANS Relaxes arterioles
What is a dangerous adverse effect of hydralazine? - ANS lupus like syndrome
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