Antihypertensive Drugs and Lifestyle Management

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Questions and Answers

What is the recommended BMI target for weight reduction in hypertension management?

< 22

< 20

< 30

< 25 (correct)

Which of the following is NOT a contraindication for RAAS blockers?

Asthma (correct)

Lactation

Bilateral renal artery stenosis

Pregnancy

What common side effect is associated with ACE inhibitors?

Weight gain

Hyperkalemia

Dry cough (correct)

Headaches

Which class of drugs is characterized by suffixes like 'sartan'?

ARBs Signup and view all the answers

When managing hypertension, what is a recommended dietary modification?

Increase potassium intake Signup and view all the answers

Which of the following antihypertensive classes should never be combined for the same patient?

ARBs and ACE inhibitors Signup and view all the answers

What effect do both ACE inhibitors and ARBs have on blood pressure?

Vasodilation and salt & water excretion Signup and view all the answers

Which of these is an add-on drug for hypertension management?

Mineralocorticoid antagonist MRA Signup and view all the answers

What is the main mechanism of action of B-Blockers?

Block B receptors in heart and blood vessels Signup and view all the answers

Which of the following is NOT a common side effect of B-Blockers?

Gingival hyperplasia Signup and view all the answers

Which type of B-Blocker is known for being cardio selective?

Atenolol Signup and view all the answers

What effect do Dihydropyridines have as Calcium Channel Blockers?

Vasodilation Signup and view all the answers

Which condition is contraindicated when using B-Blockers?

Heart failure Signup and view all the answers

Which of the following is a side effect specific to Calcium Channel Blockers?

Ankle edema Signup and view all the answers

Which of the following best describes the effect of Non-dihydropyridines?

Decrease heart rate and contractility Signup and view all the answers

What is a primary contraindication for Calcium Channel Blockers?

Sick sinus syndrome Signup and view all the answers

What is the primary mechanism of action of mineralocorticoid receptor blockers?

Block aldosterone receptors Signup and view all the answers

Which of the following is a side effect associated with thiazide diuretics?

Hyperuricemia Signup and view all the answers

What condition should be approached with caution when prescribing MRA and potassium-sparing diuretics?

Severe renal failure Signup and view all the answers

Which of the following drugs is an example of a loop diuretic?

Furosemide Signup and view all the answers

What type of drug is Prazosin classified as?

Alpha antagonist Signup and view all the answers

Which of the following is a characteristic side effect of MRA and potassium-sparing diuretics?

Hyperkalemia Signup and view all the answers

What effect do loop diuretics primarily have on blood volume?

Decrease blood volume Signup and view all the answers

What should be monitored closely when prescribing an alpha antagonist like doxazosin?

First-dose hypotension Signup and view all the answers

Which side effect is specifically associated with ACE inhibitors?

Cough Signup and view all the answers

What is a contraindication for the use of ARBs?

Severe renal artery stenosis Signup and view all the answers

What mechanism do diuretics primarily use to lower blood pressure?

Decreased blood volume Signup and view all the answers

Which side effect is commonly associated with beta-blockers?

Bradycardia Signup and view all the answers

What condition is a contraindication for the use of Spironolactone?

Severe hepatic failure Signup and view all the answers

What defines a hypertensive emergency?

Blood pressure greater than 180/110 mmHg with evidence of acute hypertensive organ damage. Signup and view all the answers

Which medication is NOT appropriate for heart failure management according to the provided content?

Negative inotropic CCBs Signup and view all the answers

In the case of acute stroke, what is the target blood pressure reduction during thrombolytic therapy?

Below 180/105 mmHg Signup and view all the answers

Which medication is contraindicated in pregnancy for managing hypertension?

RAAS blockers Signup and view all the answers

Which condition requires ICU admission and IV medication for management?

Preeclampsia. Signup and view all the answers

Which class of medication is recommended from the start for managing coronary artery disease?

Beta-blockers Signup and view all the answers

Which are the appropriate treatments for hypertension in chronic kidney disease?

Loop diuretics and monitoring of potassium levels Signup and view all the answers

What is the recommended blood pressure target for patients with acute intracerebral hemorrhage?

140-160 mmHg within 6 hours Signup and view all the answers

Study Notes

Lifestyle Management

Healthy diet emphasizes low fat, high fiber, and potassium while restricting sodium intake.
Weight reduction should target a BMI of less than 25.
Smoking cessation is crucial for managing hypertension.
Alcohol intake should be minimized to moderate levels.
Regular moderate-intensity exercise like walking or cycling is recommended.
Stress management techniques should be employed for overall wellness.

Antihypertensive Drugs Overview

Four main classes of antihypertensive drugs: RAAS blockers, beta blockers, calcium channel blockers, and diuretics.
Additional drug options include mineralocorticoid antagonists (MRA), alpha blockers, direct vasodilators, and centrally acting drugs.

RAAS Blockers (ACEIs and ARBs)

ACE Inhibitors (ACEIs): Suffix "pril" (e.g., Captopril, Enalapril).
- Mechanism: Inhibit ACE, preventing conversion of angiotensin I to II.
- Effects: Vasodilation and promote salt/water excretion.
- Side effects: Dry cough, angioedema, hyperkalemia.
- Contraindicated in pregnancy, lactation, bilateral renal artery stenosis.
Angiotensin II Receptor Blockers (ARBs): Suffix "sartan" (e.g., Losartan).
- Mechanism: Block angiotensin II receptors, resulting in vasodilation.
- Can be used if patients cannot tolerate ACEIs.

Beta Blockers

Suffix "lol" indicates this drug class with various types: non-selective, cardio-selective, and vasodilating.
- Non-selective: Propranolol affects both B1 and B2 receptors.
- Cardio-selective: Examples include metoprolol, atenolol.
- Vasodilating: Includes carvedilol and nebivolol.
- Mechanism: Block B receptors in heart and blood vessels, affecting heart rate and blood vessel dilation.
- Side effects: Bradycardia, bronchospasm, erectile dysfunction.
- Contraindicated in heart block, asthma, and acute heart failure.

Calcium Channel Blockers

Two classes: dihydropyridines (e.g., Amlodipine) and non-dihydropyridines (e.g., Verapamil, Diltiazem).
- Mechanism: Inhibit calcium channels leading to vasodilation.
- Dihydropyridines mainly cause peripheral effects; non-dihydropyridines also reduce heart rate.
- Side effects: Ankle edema, gingival hyperplasia, bradycardia.

Diuretics

Types include loop diuretics (e.g., furosemide) and thiazide/thiazide-like diuretics.
- Mechanism: Promote salt and water excretion to reduce blood volume and peripheral resistance.
- Side effects: Electrolyte imbalances, such as hypokalemia and hyperuricemia.

Mineralocorticoid Receptor Blockers (MRA) and Potassium-Sparing Diuretics

Examples: Spironolactone, Eplerenone.
- Mechanism: Block aldosterone receptors, increasing sodium and water excretion while retaining potassium.
- Side effects: Hyperkalemia, gynecomastia, teratogenic effects.
- Precautions needed with concurrent use of RAAS blockers due to hyperkalemia risk.

Alpha Antagonists

Examples: Prazosin, doxazosin, Tamsulosin.
- Mechanism: Block alpha-1 receptors leading to vasodilation and reduced peripheral resistance.
- Used for resistant hypertension and benign prostatic hyperplasia.
- Side effects: Orthostatic hypotension, reflex tachycardia.

Management of Hypertensive Emergencies

Defined as blood pressure greater than 180/110 mmHg with acute organ damage signs.
Requires immediate intervention and ICU admission if acute hypertensive organ damage (HMOD) is present.
Common acute HMOD conditions: heart failure, pulmonary edema, myocardial infarction, encephalopathy.
Management includes IV medications like nitroglycerin and protective measures for target organs.

Hypertension in Specific Populations

Chronic Kidney Disease (CKD): Prefer loop diuretics; careful monitoring of potassium levels.
Coronary Artery Disease (CAD): Beta-blockers are preferred from initial treatment.
Heart Failure: RAAS blockers, beta-blockers, and MRAs are recommended; avoid negative inotropic CCBs.
Pregnancy: Methyl dopa and labetalol are preferred; RAAS blockers are contraindicated.
Acute Stroke: Blood pressure should be carefully regulated, particularly for thrombolytic therapy candidates.

Comparison of Important Classes of Antihypertensives

RAAS Blockers: (ACEIs and ARBs) reduce vasoconstriction and can provoke hyperkalemia and cough.
Beta Blockers: Decrease heart rate and may mask hypoglycemia symptoms; contraindicated in asthma.
Calcium Channel Blockers: Cause vasodilation; non-dihydropyridines can lead to bradycardia.
Diuretics: Effective in reducing blood volume; can cause hypokalemia or hypercalcemia with certain types.
Add-on Therapies: MRAs can cause gynecomastia; alpha blockers may lead to hypotension.

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Description

This quiz covers essential concepts related to lifestyle management for hypertension and an overview of antihypertensive drugs. It includes dietary recommendations, exercise, and the classification and mechanisms of various medications. Test your knowledge on maintaining healthy blood pressure through both lifestyle choices and pharmacology.