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Questions and Answers
What is the definition of hypertension?
What is the definition of hypertension?
- Sustained diastolic blood pressure of less than 90 mm Hg
- Sustained systolic blood pressure of greater than 140 mm Hg (correct)
- Sustained systolic blood pressure of less than 140 mm Hg
- Sustained diastolic blood pressure of greater than 90 mm Hg
What are the potential consequences of sustained arterial hypertension?
What are the potential consequences of sustained arterial hypertension?
- Decreased incidence of coronary disease
- Lower risk of stroke
- Reduced risk of renal failure
- Increased risk of heart failure (correct)
What is the purpose of effective pharmacologic lowering of blood pressure?
What is the purpose of effective pharmacologic lowering of blood pressure?
- To increase morbidity and mortality rates
- To prevent damage to blood vessels (correct)
- To enhance the incidence of renal failure
- To raise the risk of serious toxicity
Why is knowledge of antihypertensive mechanisms and sites of action important?
Why is knowledge of antihypertensive mechanisms and sites of action important?
What is the primary benefit of Dihydropyridines in treating hypertension?
What is the primary benefit of Dihydropyridines in treating hypertension?
Which class of calcium channel blockers has a higher incidence of adverse effects such as constipation?
Which class of calcium channel blockers has a higher incidence of adverse effects such as constipation?
Why should high doses of short-acting calcium channel blockers be avoided?
Why should high doses of short-acting calcium channel blockers be avoided?
Which class of calcium channel blockers is particularly beneficial in treating hypertension?
Which class of calcium channel blockers is particularly beneficial in treating hypertension?
What is the primary mechanism through which β-Blockers reduce blood pressure?
What is the primary mechanism through which β-Blockers reduce blood pressure?
Which calcium channel blocker should be avoided in patients with congestive heart failure or atrioventricular block?
Which calcium channel blocker should be avoided in patients with congestive heart failure or atrioventricular block?
What is the purpose of adding beta-blockers after improving the treatment with ACE inhibitors or ARBs?
What is the purpose of adding beta-blockers after improving the treatment with ACE inhibitors or ARBs?
What is the next step if a patient continues to experience symptoms despite optimal doses of ACE inhibitors and beta-blockers?
What is the next step if a patient continues to experience symptoms despite optimal doses of ACE inhibitors and beta-blockers?
When should sacubitril/valsartan be considered in the treatment process?
When should sacubitril/valsartan be considered in the treatment process?
What are the final medications added to achieve symptomatic benefit in patients undergoing optimal pharmacologic therapy for high frequency?
What are the final medications added to achieve symptomatic benefit in patients undergoing optimal pharmacologic therapy for high frequency?
What is the purpose of adding mineralocorticoid receptor antagonists (spironolactone/eplerenone) in patients with persistent symptoms?
What is the purpose of adding mineralocorticoid receptor antagonists (spironolactone/eplerenone) in patients with persistent symptoms?
When should diuretics be added in the treatment process for patients with persistent symptoms?
When should diuretics be added in the treatment process for patients with persistent symptoms?
What is the reason for starting aldosterone antagonists in patients with continuing symptoms despite optimal doses of ACE inhibitors and beta-blockers?
What is the reason for starting aldosterone antagonists in patients with continuing symptoms despite optimal doses of ACE inhibitors and beta-blockers?
When would sacubitril/valsartan be considered as a replacement for ACE inhibitors or ARBs?
When would sacubitril/valsartan be considered as a replacement for ACE inhibitors or ARBs?
Which class of drugs blocks the conversion of angiotensin I to angiotensin II?
Which class of drugs blocks the conversion of angiotensin I to angiotensin II?
Which ACE inhibitor does not undergo hepatic conversion and is preferred in severe hepatic impairment?
Which ACE inhibitor does not undergo hepatic conversion and is preferred in severe hepatic impairment?
Which class of drugs blocks the effects of angiotensin II on the body?
Which class of drugs blocks the effects of angiotensin II on the body?
Which class of drugs is fetotoxic?
Which class of drugs is fetotoxic?
Which class of drugs is contraindicated during pregnancy?
Which class of drugs is contraindicated during pregnancy?
Which ACE inhibitor does not require dose adjustment in patients with renal impairment?
Which ACE inhibitor does not require dose adjustment in patients with renal impairment?
What is the first-line treatment for hypertension recommended for patients with a history of coronary disease, diabetes, stroke, heart failure, myocardial infarction, or chronic kidney disease?
What is the first-line treatment for hypertension recommended for patients with a history of coronary disease, diabetes, stroke, heart failure, myocardial infarction, or chronic kidney disease?
What is the primary action of ACE inhibitors in the body?
What is the primary action of ACE inhibitors in the body?
Which medication class affects both cardiac preload and afterload, reducing cardiac work?
Which medication class affects both cardiac preload and afterload, reducing cardiac work?
What is a common side effect of ACE inhibitors?
What is a common side effect of ACE inhibitors?
Which medication class is recommended for treating hypertension based on evidence from placebo-controlled studies that they reduce cardiovascular events?
Which medication class is recommended for treating hypertension based on evidence from placebo-controlled studies that they reduce cardiovascular events?
What is the primary action of ARBs in the body?
What is the primary action of ARBs in the body?
Which medication class is recommended for patients with a history of coronary disease, diabetes, stroke, heart failure, myocardial infarction, or chronic kidney disease based on the text?
Which medication class is recommended for patients with a history of coronary disease, diabetes, stroke, heart failure, myocardial infarction, or chronic kidney disease based on the text?
Which medication class is known to cause hypotension in hypovolemic states as a common side effect?
Which medication class is known to cause hypotension in hypovolemic states as a common side effect?
For which condition are beta-blockers recommended as a first-line treatment according to the text?
For which condition are beta-blockers recommended as a first-line treatment according to the text?
Which class of medication is primarily beneficial in hypertensive patients with heart disease, including supraventricular tachyarrhythmia, previous myocardial infarction, angina pectoris, and chronic heart failure?
Which class of medication is primarily beneficial in hypertensive patients with heart disease, including supraventricular tachyarrhythmia, previous myocardial infarction, angina pectoris, and chronic heart failure?
Which type of medication undergoes extensive first-pass metabolism, is orally active, and takes several weeks to develop its full effects?
Which type of medication undergoes extensive first-pass metabolism, is orally active, and takes several weeks to develop its full effects?
Which class of medication blocks α1 adrenoceptors, decreasing peripheral vascular resistance and lowering arterial blood pressure?
Which class of medication blocks α1 adrenoceptors, decreasing peripheral vascular resistance and lowering arterial blood pressure?
Which class of medication relaxes smooth muscle, decreasing peripheral vascular resistance and increasing cardiac output?
Which class of medication relaxes smooth muscle, decreasing peripheral vascular resistance and increasing cardiac output?
What medication is initiated for relief of volume overload symptoms in the classification of heart failure stages?
What medication is initiated for relief of volume overload symptoms in the classification of heart failure stages?
Which medication can replace ACE inhibitors or ARBs for symptomatic benefit in patients who remain symptomatic despite optimal doses of these medications?
Which medication can replace ACE inhibitors or ARBs for symptomatic benefit in patients who remain symptomatic despite optimal doses of these medications?
What medication is added for symptomatic benefit only in patients already on optimal heart failure pharmacotherapy?
What medication is added for symptomatic benefit only in patients already on optimal heart failure pharmacotherapy?
What is a common adverse effect of β-blockers?
What is a common adverse effect of β-blockers?
What is a common adverse effect of α-adrenoreceptor–blocking agents?
What is a common adverse effect of α-adrenoreceptor–blocking agents?
Study Notes
- The primary therapeutic benefits of β-blockers are in hypertensive patients with heart disease, including supraventricular tachyarrhythmia, previous myocardial infarction, angina pectoris, and chronic heart failure.
- β-blockers undergo extensive first-pass metabolism, are orally active, and take several weeks to develop their full effects.
- Common adverse effects of β-blockers include bradycardia, CNS side effects (fatigue, lethargy, insomnia, hallucinations), and hypotension.
- α-adrenoreceptor–blocking agents like prazosin, doxazosin, and terazosin block α1 adrenoceptors, decreasing peripheral vascular resistance and lowering arterial blood pressure.
- Direct-acting vasodilators such as hydralazine and minoxidil relax smooth muscle, decreasing peripheral vascular resistance and increasing cardiac output.
- Heart failure can be classified into four stages; as it progresses, polytherapy is initiated, starting with loop diuretics for relief of volume overload symptoms.
- ACE inhibitors or ARBs are added after diuretic optimization, followed by β-blockers, aldosterone antagonists, and hydralazine/isosorbide dinitrate.
- Sacubitril/valsartan can replace ACE inhibitors or ARBs for symptomatic benefit in patients who remain symptomatic despite optimal doses of these medications.
- Digoxin and ivabradine are added for symptomatic benefit only in patients already on optimal heart failure pharmacotherapy.
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Description
Test your knowledge about calcium-channel blockers, a recommended treatment option in hypertensive patients with diabetes or angina. Learn about the classes of calcium-channel blockers and their potential risks and benefits.
