Anti-hypertensive Medications Quiz
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Questions and Answers

What is a common side effect of 1st generation non-selective beta blockers?

  • Hypotension (correct)
  • Shortness of breath
  • Hyperkalemia
  • Hypertension

Which condition should beta blockers be contraindicated in?

  • Migraine
  • Hypertension
  • Diabetes (correct)
  • Glaucoma

What type of beta blocker is nebivolol classified as?

  • 1st generation non-selective
  • 3rd generation non-selective
  • 2nd generation cardioselective
  • 3rd generation selective (correct)

What is the primary action of ACE inhibitors?

<p>Inhibits angiotensin II formation (C)</p> Signup and view all the answers

Which side effect is associated with ARBS?

<p>Hyperkalemia (A)</p> Signup and view all the answers

What is a potential contraindication for the use of loop diuretics?

<p>Anuria (A)</p> Signup and view all the answers

Which of the following medications is considered a K+ sparing diuretic?

<p>Spironolactone (A)</p> Signup and view all the answers

What is a common indication for the use of thiazide diuretics?

<p>Hypertension (D)</p> Signup and view all the answers

What is a significant side effect of non-dihydropyridine calcium channel blockers?

<p>Constipation (A)</p> Signup and view all the answers

Which enzyme do carbonic anhydrase inhibitors target?

<p>Carbonic anhydrase (B)</p> Signup and view all the answers

What condition could lead to the use of carvedilol?

<p>Heart failure (B)</p> Signup and view all the answers

Which statement about the side effects of diuretics is true?

<p>Loop diuretics can lead to hypokalemia. (B)</p> Signup and view all the answers

Which indication is specific to beta blocker use?

<p>Migraine prophylaxis (B)</p> Signup and view all the answers

What is the role of dihydropyridines in hypertension management?

<p>Cause vasodilation (C)</p> Signup and view all the answers

Flashcards

What are beta blockers?

Beta blockers, also known as beta-adrenergic blocking agents, are medications that block the effects of adrenaline (epinephrine) and noradrenaline (norepinephrine) on the heart and blood vessels.

What are first-generation non-selective beta blockers?

First-generation non-selective beta blockers block both beta-1 and beta-2 receptors. Beta-1 receptors are found in the heart, and beta-2 receptors are found in the lungs and other tissues.

How do first-generation non-selective beta blockers affect the heart?

First-generation non-selective beta blockers block beta-1 receptors in the heart, leading to decreased heart rate, decreased force of contraction, and slowed conduction through the AV node.

What are the side effects of first-generation non-selective beta blockers in the airways?

First-generation non-selective beta blockers block beta-2 receptors in the airways, leading to bronchoconstriction, which can worsen asthma and COPD.

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What are second-generation cardioselective beta blockers?

Second-generation cardioselective beta blockers preferentially block beta-1 receptors in the heart over beta-2 receptors in the lungs. This means they are less likely to cause bronchospasm

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How do third-generation non-selective beta blockers affect the body?

Third-generation non-selective beta blockers block beta-1 receptors in the heart, causing decreased heart rate, decreased force of contraction, and slowed conduction through the AV node. They also block beta-2 receptors in the lungs, causing bronchoconstriction, and alpha-1 receptors in vascular smooth muscle, causing vasodilation.

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What are RAAS inhibitors?

RAAS inhibitors work to lower blood pressure by blocking the renin-angiotensin-aldosterone system (RAAS). This system is a vital part of regulating blood pressure by controlling the volume of blood in your body and the constriction of blood vessels.

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How do ACE inhibitors work?

ACE inhibitors (the 'prils') prevent the conversion of angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor, meaning it narrows blood vessels. ACE inhibitors reduce the production of angiotensin II, resulting in vasodilation (widening of blood vessels) and lower blood pressure.

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How do ARBs work?

ARBs (the 'sartans') block the binding of angiotensin II to its receptors (AT1). This prevents angiotensin II from causing vasoconstriction, aldosterone release, and other effects that contribute to high blood pressure.

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How do loop diuretics work?

Loop diuretics (the strongest diuretics) inhibit the sodium-potassium-chloride (NKCC) co- transporter in the ascending limb of the loop of Henle. This prevents the reabsorption of sodium, potassium, and chloride, leading to increased urine output and decreased blood volume.

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How do thiazide diuretics work?

Thiazide diuretics inhibit the sodium-chloride (NaCl) co- transporter in the early distal convoluted tubule. This prevents the reabsorption of sodium and chloride, leading to increased urine output and decreased blood volume.

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How do carbonic anhydrase inhibitors work?

Carbonic anhydrase inhibitors inhibit the carbonic anhydrase enzyme, which is involved in the production of bicarbonate, a key player in the reabsorption of sodium. Blocking this enzyme reduces sodium reabsorption, leading to increased urine output and decreased blood volume.

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How do potassium-sparing diuretics work?

Potassium-sparing diuretics block sodium reabsorption and potassium excretion in the collecting duct. They can be used to reduce blood pressure and also to prevent or treat low potassium levels.

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How do calcium channel blockers work?

Calcium channel blockers block calcium channels, which are responsible for the flow of calcium into cells. Calcium plays a role in the contraction of muscles, including heart muscle and smooth muscle cells in blood vessels. By blocking these channels, calcium channel blockers can reduce the force of heart contractions, relax blood vessels, and lower blood pressure.

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How do dihydropyridines work?

Dihydropyridines (such as amlodipine) selectively block calcium channels in vascular smooth muscle. This results in vasodilation, reducing resistance to blood flow and lowering blood pressure.

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How do non-dihydropyridines work?

Non-dihydropyridines (such as verapamil and diltiazem) block calcium channels in the heart, particularly in the SA and AV nodes. This slows the heart rate and conduction through the AV node, leading to decreased heart rate and reduced blood pressure.

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Study Notes

Anti-hypertensive Medications

  • Beta-Blockers: Reduce heart rate, AV conduction, and contractility by blocking beta-1 receptors. Beta-2 receptor blockade can cause bronchoconstriction.

    • First Generation (Non-selective): Propranolol, timolol, nadolol.

  • Side Effects: Hypotension, arrhythmias, sexual dysfunction, GI disturbances, bronchospasms, bradycardia, masking hypoglycemia.

  • Indications: Arrhythmias, hypertension, glaucoma (timolol), migraine prophylaxis (propranolol).

  • Contraindications: Asthma, COPD, AV block, cardiogenic shock, diabetes, hepatic/renal impairment, Raynaud's phenomenon, hypotension.

    • Second Generation (Cardio-selective): Atenolol, bisoprolol, metoprolol.

  • Side Effects: Depression, erectile dysfunction, arrhythmias, fatigue, dizziness, masking hypoglycemia, bradycardia.

  • Indications: Hypertension, angina, arrhythmias, heart failure, glaucoma.

  • Contraindications: Asthma, COPD, Raynaud's phenomenon, AV block, cardiogenic shock, hepatic/renal impairment, diabetes.

    • Third Generation (Non-selective): Carvedilol, labetalol.

  • Action: Blocks beta-1 & beta-2 receptors, and alpha-1 receptors causing vasodilation and decreased blood pressure.

  • Side Effects: Bradycardia, bronchoconstriction, hypotension, fatigue, dizziness, diarrhea.

  • Indications: Hypertension, pregnancy, heart failure (carvedilol).

  • Contraindications: Asthma, COPD, AV block, cardiogenic shock, Raynaud's phenomenon, hepatic/renal impairment, diabetes, bradycardia, hypotension.

    • Third Generation (Selective): Nebivolol, betaxolol.

  • Action: Blocks beta-1 receptors. Nebivolol increases nitric oxide (vasodilator). Betaxolol blocks calcium channels.

  • Side Effects: Hypotension, fatigue, sexual dysfunction, dizziness.

  • Indications: Hypertension, angina, heart failure (nebivolol).

  • Contraindications: Pregnancy, diabetes, AV block, cardiogenic shock, asthma, COPD, hepatic/renal impairment, Raynaud's phenomenon.

RAAS Inhibitors

  • ACE Inhibitors: (Prils) Inhibit the ACE enzyme, preventing angiotensin II formation, causing vasodilation and reduced blood pressure. Bradykinin is not inhibited, leading to more vasodilation.

  • Side Effects: Dry cough, hyperkalemia, angioedema.

  • Indications: Hypertension, heart failure.

  • Contraindications: Pregnancy, hyperkalemia.

  • ARBs: (Sartans) Inhibit AT1 receptors, reducing angiotensin II effects and aldosterone release leading to decreased sodium reabsorption and potassium excretion.

  • Side Effects: Hyperkalemia, dizziness, leg swelling, headaches.

  • Indications: Hypertension, congestive heart failure, diabetic nephropathy.

  • Contraindications: Pregnancy, hyperkalemia.

Diuretics

  • Loop Diuretics: (Furosemide, torsemide) Inhibit NKCC in the ascending limb of the loop of Henle, reducing sodium, potassium, and chloride reabsorption, promoting water loss.

  • Side Effects: Hypovolemia, hypocalcemia, hypokalemia, hyperuricemia.

  • Indications: Hypertension, congestive heart failure, liver cirrhosis, kidney disease.

  • Contraindications: Pregnancy, anuria, hypokalemia.

  • Thiazides: (Hydrochlorothiazide, chlorothiazide) Inhibit NaCl reabsorption in the distal convoluted tubule.

  • Side Effects: Hypovolemia, hypercalcemia, hyperlipidemia, erectile dysfunction, photosensitivity.

  • Indications: Hypertension, congestive heart failure, diabetes insipidus.

  • Contraindications: Pregnancy, gout, anuria.

  • Carbonic Anhydrase Inhibitors: (Acetazolamide) Inhibit carbonic anhydrase enzyme, reducing sodium reabsorption.

  • Side Effects: Metabolic acidosis, hypokalemia.

  • Indications: Hypertension, glaucoma, congestive heart failure, metabolic alkalosis.

  • Contraindications: Pregnancy, hypokalemia, metabolic acidosis.

  • Potassium-Sparing Diuretics: (Spironolactone, amiloride) Act in the collecting duct to reduce sodium reabsorption and potassium excretion.

  • Side Effects: Hypotension, gastrointestinal upset.

  • Indications: Congestive heart failure, liver disease, preventing hypokalemia.

  • Contraindications: Anuria, renal insufficiency, pregnancy, hypotension.

Calcium Channel Blockers

  • Dihydropyridines: (Amlodipine, felodipine) Block calcium channels in vascular smooth muscle, causing vasodilation.

  • Side Effects: Peripheral edema, swollen gums, headaches, dizziness, flushing.

  • Indications: Hypertension, angina pectoris.

  • Contraindications: Heart failure, hypotension.

  • Non-dihydropyridines: (Verapamil, diltiazem) Block calcium channels in the heart (SA and AV nodes), slowing AV conduction, decreasing force, and heart rate.

  • Side Effects: Bradycardia, AV block, arrhythmia (verapamil—constipation).

  • Indications: Hypertension, arrhythmias, stable angina.

  • Contraindications: Heart failure, hypotension, beta blockers.

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Description

Test your knowledge on anti-hypertensive medications, focusing on beta-blockers. This quiz includes details on first and second generation beta-blockers, their indications, side effects, and contraindications. Ideal for students in pharmacology or healthcare-related fields.

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