Antihypertensive Medications Quiz
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Questions and Answers

In managing diastolic hypertension, which of the following antihypertensive drugs is considered effective and widely used?

  • Thiazide diuretics
  • Calcium channel blockers (correct)
  • Sodium nitroprusside
  • Beta-blockers

    • Which characteristic is most associated with isolated systolic hypertension in elderly populations?

  • Increased arterial stiffness (correct)
  • Low sodium diet adherence
  • Frequent renal complications
  • Decreased pulse pressure

    • What is a common side effect of Thiazide diuretics when prescribed for hypertension?

  • Weight gain
  • Hyponatremia (correct)
  • Hyperkalemia
  • Hypoglycemia

    • Which medication is particularly noted for its potential renal protective effects in patients with hypertension?

    <p>ACE inhibitors</p> Signup and view all the answers

    What factor may influence treatment efficacy for hypertension in diverse populations?

    <p>All of the above</p> Signup and view all the answers

    What is a common side effect associated with the use of Aliskiren?

    <p>Angioedema</p> Signup and view all the answers

    Which medication is primarily indicated for managing hypertension emergencies in pregnancy?

    <p>Labetalol</p> Signup and view all the answers

    What contraindication is specifically associated with the use of diuretics?

    <p>Anuria</p> Signup and view all the answers

    Which of the following medications is known to potentially cause hepatotoxicity more than other beta-blockers?

    <p>Labetalol</p> Signup and view all the answers

    Which medication requires caution when taken with high-fat meals due to reduced absorption?

    <p>Aliskiren</p> Signup and view all the answers

    What is a common reflex response when using Apresoline for hypertension management?

    <p>Increased heart rate</p> Signup and view all the answers

    What class of antihypertensive has a contraindication related to asthma?

    <p>Beta-blockers</p> Signup and view all the answers

    Which condition is related to the contraindication of using beta-blockers in hypertensive treatment?

    <p>Severe PAD</p> Signup and view all the answers

    Which medication is particularly used for prehypertension but contraindicated in pregnancy?

    <p>Rasilez</p> Signup and view all the answers

    What potential drug interaction should be noted when using Aliskiren?

    <p>Inhibition when taken with grapefruit juice</p> Signup and view all the answers

    Which of the following statements about ACE inhibitors and ARBs in hypertensive patients with chronic kidney disease is correct?

    <p>ACE inhibitors are effective but need renal function monitoring.</p> Signup and view all the answers

    What is the recommended management for a patient with isolated systolic hypertension who also has psychiatric diseases?

    <p>Caution should be applied when using CCBs or α-blockers with certain antidepressants.</p> Signup and view all the answers

    In patients with renovascular disease and hypertension, the initial treatment is affected by which of the following considerations?

    <p>Care must be taken for ACE inhibitors or ARBs in certain renal artery conditions.</p> Signup and view all the answers

    Which medication combination is contraindicated in patients with severe peripheral artery disease?

    <p>β-blockers other than metoprolol</p> Signup and view all the answers

    Regarding management of hypertension in pregnancy, which medication is not recommended?

    <p>ACE inhibitors</p> Signup and view all the answers

    When managing diastolic hypertension in older patients, which of the following medications is preferred?

    <p>Calcium channel blockers</p> Signup and view all the answers

    Which statement regarding the efficacy of different antihypertensive classes in diverse populations is accurate?

    <p>Different populations may respond variably to certain antihypertensive agents.</p> Signup and view all the answers

    What is an important consideration when treating hypertension in non-DM CKD patients with proteinuria?

    <p>Combination therapy with ACE inhibitors or ARBs may be necessary and should be monitored.</p> Signup and view all the answers

    What is the recommended approach for managing resistant hypertension after using three antihypertensives at optimal doses?

    <p>Refer to a specialist after optimizing drug therapy</p> Signup and view all the answers

    Why should ACE inhibitors be avoided in black patients?

    <p>Angioedema risk is significantly increased</p> Signup and view all the answers

    What impact do NSAIDs generally have on blood pressure?

    <p>Cause a mild increase in blood pressure</p> Signup and view all the answers

    Which condition is contraindicated for the use of ACE inhibitors or ARBs?

    <p>Bilateral artery stenosis</p> Signup and view all the answers

    In managing isolated systolic hypertension, which combination of therapies is not recommended?

    <p>Hydralazine and a diuretic</p> Signup and view all the answers

    What factor may contribute to the reduced effectiveness of certain antihypertensive medications in black populations?

    <p>Genetic variations in drug metabolism</p> Signup and view all the answers

    What should be considered when prescribing medication to teens for hypertension?

    <p>Ensuring no unplanned pregnancies when using certain drugs</p> Signup and view all the answers

    Which specific antihypertensive therapy has safety concerns regarding use during pregnancy?

    <p>ACE inhibitors</p> Signup and view all the answers

    Among the following medications, which is the least preferred option for a patient with asthma and hypertension?

    <p>β-blocker</p> Signup and view all the answers

    What is a potential side effect of antihypertensive medications that may lead to exclusion from treatment trials?

    <p>Orthostatic hypotension</p> Signup and view all the answers

    In the context of renal implications, which population should be approached cautiously when prescribing antihypertensive medications?

    <p>Patients with bilateral renal artery stenosis</p> Signup and view all the answers

    What combination of antihypertensive agents can lead to increased renin and sympathetic activity?

    <p>Hydralazine and diuretic</p> Signup and view all the answers

    What is the appropriate recommendation for utilizing ARBs in African or black patients with hypertension?

    <p>Avoidance is suggested due to angioedema risk</p> Signup and view all the answers

    Which medication combination is specifically contraindicated due to increased risk of adverse effects?

    <p>ACEi and aliskiren</p> Signup and view all the answers

    Which medication is known to significantly elevate blood pressure when used in high doses?

    <p>Estrogen &gt;50mcg</p> Signup and view all the answers

    What is the potential adverse effect of intensive blood pressure reduction in diabetic patients?

    <p>Higher rates of myocardial infarction and stroke</p> Signup and view all the answers

    How is the effectiveness of ambulatory blood pressure monitoring viewed in the diagnosis of hypertension?

    <p>Preferred over clinic blood pressure measurements</p> Signup and view all the answers

    What class of antihypertensives is advised to be used in conjunction with caution due to potential side effects on heart function?

    <p>Calcium channel blockers like diltiazem</p> Signup and view all the answers

    What impact do hypertensive disorders of pregnancy have on future cardiovascular risk?

    <p>Increased risk of future cardiovascular disease</p> Signup and view all the answers

    What does the cohort study on antihypertensive therapy suggest regarding treatment effects based on patient age?

    <p>Older patients experience worse outcomes than younger patients</p> Signup and view all the answers

    What was the main finding regarding the impact of clinic, daytime, and nighttime systolic blood pressure in patients with hypertension?

    <p>Nighttime systolic blood pressure correlates highly with adverse cardiovascular events.</p> Signup and view all the answers

    Which class of medication was specifically compared in terms of major cardiovascular events and adverse effects?

    <p>Chlorthalidone versus hydrochlorothiazide</p> Signup and view all the answers

    What was the conclusion of the study regarding the use of felodipine for blood-pressure reduction in patients with non-diabetic chronic renal disease?

    <p>No additional benefit was observed from further blood-pressure reduction.</p> Signup and view all the answers

    What does the PRECISION-ABPM trial mainly investigate?

    <p>Blood pressure effects of ibuprofen, naproxen, and celecoxib in arthritis patients.</p> Signup and view all the answers

    What correlation was found between orthostatic hypotension and dementia in patients with specific neurological conditions?

    <p>Orthostatic hypotension is associated with an increased risk of dementia.</p> Signup and view all the answers

    What is a common side effect associated with the use of non-DHP calcium channel blockers like Verapamil?

    <p>Peripheral edema</p> Signup and view all the answers

    Which medication may lead to elevated levels of cyclosporin when taken together?

    <p>Verapamil</p> Signup and view all the answers

    Which statement about diltiazem is true?

    <p>It can lead to constipation.</p> Signup and view all the answers

    Which condition is a contraindication for the use of Verapamil?

    <p>Obstructive hypertrophic cardiomyopathy</p> Signup and view all the answers

    What is a significant effect of DHP calcium channel blockers like amlodipine?

    <p>They can cause tachycardia.</p> Signup and view all the answers

    What is the dosing recommendation for TIAZAC/XC cap to manage hypertension?

    <p>Once daily, 240mg</p> Signup and view all the answers

    What effect does digoxin have when taken with calcium channel blockers?

    <p>It leads to increased digoxin levels.</p> Signup and view all the answers

    Which statement about the interactions of Verapamil is accurate?

    <p>It increases the effects of cimetidine.</p> Signup and view all the answers

    What is a notable side effect related to using DHP calcium channel blockers?

    <p>Gingival hyperplasia</p> Signup and view all the answers

    What is a significant challenge in managing hypertension that is complicated by chronic kidney disease?

    <p>Double challenge of resistant hypertension</p> Signup and view all the answers

    Which factor is most important in evaluating the effectiveness of blood pressure monitoring devices?

    <p>Accuracy of the readings</p> Signup and view all the answers

    What crucial aspect is associated with the variability in blood pressure and its impact on cardiac risk?

    <p>Episodic hypertension</p> Signup and view all the answers

    What is a common characteristic associated with drug-related hypertension?

    <p>Use of certain medications</p> Signup and view all the answers

    Which aspect is frequently overlooked that might influence hypertension treatment outcomes?

    <p>Individual patient variability</p> Signup and view all the answers

    What role does lifelong physical activity play in relation to blood pressure?

    <p>It helps in reducing the risk of coronary heart disease.</p> Signup and view all the answers

    What is a critically important factor to consider when assessing the prognosis of hypertension?

    <p>Visit-to-visit blood pressure variability</p> Signup and view all the answers

    Why might the use of certain antihypertensive therapies lead to hospitalization in patients?

    <p>Severe hypotensive episodes</p> Signup and view all the answers

    Which statement about the prognosis related to hypertension is true?

    <p>Maximum systolic blood pressure has prognostic significance.</p> Signup and view all the answers

    What is the recommended daily dosage range for valsartan?

    <p>80-320mg daily</p> Signup and view all the answers

    Which of the following medications is a first-line treatment for diastolic hypertension?

    <p>Amlodipine</p> Signup and view all the answers

    What is a notable risk associated with candesartan use as indicated by a study?

    <p>Elevated cancer risk</p> Signup and view all the answers

    Which class of medication is identified as a second-line option for blood pressure control in heart failure with reduced ejection fraction (HFrEF)?

    <p>DHP calcium channel blockers</p> Signup and view all the answers

    Which of the following statements about the dosing of amlodipine is correct?

    <p>Amlodipine is effective in doses of 1-10mg daily.</p> Signup and view all the answers

    What concern exists regarding the interaction of amlodipine with certain drugs?

    <p>Potentiation of the effects of cyclosporine</p> Signup and view all the answers

    How is felodipine described in relation to its negative inotropic effects?

    <p>It has fewer negative inotropic effects than nifedipine.</p> Signup and view all the answers

    What is a recommended first-line treatment for hypertension in African or black patients that avoids ACE inhibitors?

    <p>Thiazide-like diuretics</p> Signup and view all the answers

    What is the risk associated with using ACE inhibitors in African or black patients?

    <p>Higher incidence of angioedema</p> Signup and view all the answers

    What is the preferred approach for managing resistant hypertension after the initial therapy fails?

    <p>Optimize drug therapy and assess patient adherence</p> Signup and view all the answers

    Which of the following medications should be avoided in patients with asthma?

    <p>Beta-blockers</p> Signup and view all the answers

    What combination of antihypertensive agents is known to potentially stimulate renin and sympathetic activity when used together?

    <p>Hydralazine and diuretics</p> Signup and view all the answers

    Which medication is noted for its potential to significantly increase blood pressure when combined with others?

    <p>Glucocorticoids</p> Signup and view all the answers

    What is the fourth agent option for resistant hypertension when three medications are used unsuccessfully?

    <p>Spironolactone</p> Signup and view all the answers

    Which agents are recommended to be used with caution in teenage patients during hypertension treatment?

    <p>ACE inhibitors and ARBs</p> Signup and view all the answers

    What class of antihypertensive medications is contraindicated for individuals who also have high-performance athletic activities?

    <p>Beta-blockers</p> Signup and view all the answers

    Which medication's interaction with high-fat meals should be considered due to potential absorption issues?

    <p>Aliskiren</p> Signup and view all the answers

    Study Notes

    Oral Antihypertensives: Summary/Guidelines Comparison Chart

    • Diuretics are a first-line treatment for hypertension, especially in individuals with diastolic hypertension, isolated systolic hypertension (ISH), left ventricular hypertrophy (LVH), or diabetes.
    • Thiazide-like diuretics are beneficial for patients with reduced creatinine clearance (CrCl) and are less effective in African Americans unless used with a thiazide.
    • Indapamide has minimal effects on lipids/glucose, possibly more effective than HCTZ in patients with reduced CrCl. Adverse events include headache and dizziness.
    • Hydrochlorothiazide (HCTZ) and Chlorthalidone are thiazide-type diuretics with similar benefits to HCTZ but with a higher risk of potassium (K+) loss, and possible increased risk of hip/pelvic fractures.
    • Spironolactone (Aldactone) is a potassium-sparing diuretic, first-line for heart failure, hypertension, and hyperaldosteronism. Adverse events include gynecomastia, menstruation irregularities, and gastrointestinal (GI) issues.

    B-Blockers

    • Cardio-selective: Bisoprolol and Metoprolol lower heart rate (HR) and are beneficial in heart failure (HFrEF), stable angina, and myocardial infarction (MI).
    • Non-selective: Propranolol, and others have a higher risk of adverse effects, including exacerbation of conditions, but are sometimes useful in specific cases. Adverse events can include headache, dizziness, cold extremities, and bronchospasm.
    • Contraindications for use include: severe asthma/COPD, peripheral artery disease (PAD), and second/third-degree heart block, decompensated heart failure.

    ACE Inhibitors (ACEi) and Angiotensin Receptor Blockers (ARBs)

    • ACEi: Lisinopril and Ramipril are first-line treatments for hypertension, particularly in diabetics, those with coronary artery disease (CAD), and those who have had a prior stroke/transient ischemic attack (TIA), and chronic kidney disease (CKD). A dry cough is a common adverse effect, especially among East Asians. Other adverse events include loss of taste, rash (especially with captopril), headache, dizziness, and blood pressure issues from diuretics.
    • ARBs: Irbesartan, Losartan, Valsartan, similar use as ACEi, sometimes preferred if ACEi intolerance. These drugs reduce cough risk but may cause other adverse events such as headache, dizziness, and hypotension.
    • Contraindications for use of both ACEi and ARBs: include bilateral renal artery stenosis, a history of angioedema, and pregnancy.

    Calcium Channel Blockers (CCB)

    • DHPs (dihydropyridines): Amlodipine and Felodipine are usually first-line choices for treating uncomplicated diabetes, and are also useful for treating stable angina and left ventricular hypertrophy (LVH). Adverse events include headache, dizziness, and peripheral edema, especially in females.

    • Non-DHPs (non-dihydropyridines): Diltiazem and Verapamil have a higher risk of negative inotropic & chronotropic effects, and are sometimes used for specific conditions such as atrial fibrillation (AF) and supraventricular tachycardia (SVT). Adverse events include headache, dizziness, and peripheral edema.

    • Other considerations: In some cases, multiple medications may be needed, and combinations of drugs might be used to manage blood pressure. It is crucial to monitor patients for adverse events and adjust treatment as needed. Consider initial therapy of choice, and second/third line therapy, including indications/contraindications, particularly for people with specific health conditions like diabetes, heart failure, or chronic kidney disease.

    • Important to note the potential for drug-drug interactions, such as increasing lithium or digoxin levels. The potential for some medications to be less effective in African Americans should be considered. Some medications are not recommended in pregnancy. Consult updated guidelines for the most current information.

    • Antihypertensive drug regimens are often more effective when taken in the morning. This, however, may need to be changed if the patient experiences dizziness or lightheadedness during the day.

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    Oral Antihypertensives Summary PDF

    Description

    Test your knowledge on antihypertensive medications and their effects with this quiz. Questions cover drug efficacy, side effects, and special considerations for diverse populations. Ideal for students and professionals in healthcare and pharmacy.

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