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Questions and Answers
What is the definition of hypertension?
What are the potential consequences of sustained arterial hypertension?
What can effective pharmacologic lowering of blood pressure prevent?
How many main drug classes are recommended for the treatment of hypertension?
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What is the purpose of adding beta blockers after improving angiotensin converting enzyme inhibitors therapy?
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When should sacubitril/valsartan be considered for replacement of angiotensin converting enzyme inhibitors or optimal doses?
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What is the purpose of adding digoxin and ivabradine in patients undergoing optimal drug therapy for high frequency?
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Which type of patients are primarily prescribed β-blockers?
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What is a condition that discourages the use of β-blockers?
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Which drug undergoes extensive first-pass metabolism and may take several weeks to develop full effects?
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What are the potential side effects of β-blockers?
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Which drugs competitively block α1 adrenoceptors, decreasing peripheral vascular resistance and lowering arterial blood pressure?
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What do direct-acting smooth muscle relaxants like hydralazine and minoxidil do?
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How is heart failure classified?
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What side effect can minoxidil treatment cause?
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In heart failure patients on optimal therapy, what drugs may be added for symptomatic benefit?
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Which class of drugs is recommended as first-line treatment for hypertension in patients with a high risk of coronary disease, diabetes, stroke, heart failure, myocardial infarction, or chronic kidney disease?
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What does the ACE enzyme produce that is blocked by ACE inhibitors?
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Which of the following is a common side effect of ACE inhibitors?
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What is the mechanism of action of ARBs (angiotensin II receptor blockers)?
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Which group of drugs reduce both cardiac preload and afterload, decreasing cardiac work?
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What is the primary function of medications that lower blood pressure?
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In patients with chronic kidney disease, which class of drugs is associated with improved cardiovascular outcomes and reduced mortality?
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What is a common side effect of ARBs (angiotensin II receptor blockers)?
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Which of the following is a common side effect of beta-blockers?
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What is the primary function of ACE inhibitors in reducing blood pressure?
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Which group of drugs are recommended for blood pressure management based on their proven ability to reduce blood pressure?
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What do CCBs (calcium channel blockers) work to reduce in order to lower blood pressure?
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Which class of drugs prevents the conversion of angiotensin I to angiotensin II?
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Which class of drugs blocks the action of angiotensin II at its receptor?
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Which class of drugs is contraindicated during pregnancy?
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Which class of drugs is orally bioavailable and undergoes hepatic conversion to active metabolites?
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Which class of drugs is more attractive therapy for hypertensive diabetics due to lower nephrotoxicity?
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Which drug in the class of ACE inhibitors is available intravenously?
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Which class of drugs is used in combination therapy with ACE inhibitors or ARBs for treating hypertension and heart failure?
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Which class of drugs is used in the treatment of acute coronary syndrome, including acute myocardial infarction?
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Which class of drugs is used in the treatment of hypertensive pregnant women?
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Which class of drugs is used in the treatment of heart failure with preserved ejection fraction?
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Which class of drugs is used in the prevention of cardiovascular events in patients with chronic kidney disease?
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Which class of drugs is used in the treatment of heart failure in patients with a history of valvular heart disease?
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Which class of calcium channel blockers (CCBs) has a much greater affinity for vascular calcium channels than heart calcium channels?
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What is the only member of the Diphenylalkylamines class of CCBs approved in the US?
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Which adverse effect is more frequent with dihydropyridines?
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Which drug class primarily decreases blood pressure by reducing cardiac output?
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Which type of patients are β-Blockers a treatment option for?
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Why should high doses of short-acting CCBs be avoided?
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What effect should Verapamil be avoided for in patients with congestive heart failure or atrioventricular block?
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What is the primary adverse effect associated with Verapamil?
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Study Notes
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β-blockers are primarily used in hypertensive patients with heart disease, such as supraventricular tachyarrhythmia, previous myocardial infarction, angina pectoris, and chronic heart failure
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Conditions that discourage β-blocker use include reversible bronchospastic diseases, second- and third-degree heart block, and severe peripheral vascular disease
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Propranolol undergoes extensive first-pass metabolism and may take several weeks to develop full effects
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β-blockers may cause bradycardia, CNS side effects (fatigue, lethargy, insomnia, hallucinations), and hypotension
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Prazosin, doxazosin, and terazosin competitively block α1 adrenoceptors, decreasing peripheral vascular resistance and lowering arterial blood pressure
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Direct-acting smooth muscle relaxants like hydralazine and minoxidil dilate blood vessels
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Heart failure is classified into four stages, and treatment varies from diuretics for volume overload to polytherapy for persistent symptoms
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Minoxidil treatment can cause hypertrichosis and is used topically for male pattern baldness
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In heart failure patients on optimal therapy, Sacubitril/valsartan, digoxin, and Ivabradine may be added for symptomatic benefit.
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Calcium channel blockers (CCBs) are recommended for hypertensive patients with diabetes or angina.
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High doses of short-acting CCBs should be avoided due to increased risk of myocardial infarction.
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CCBs are divided into three chemical classes: Diphenylalkylamines (Verapamil), Benzothiazepines (Diltiazem), and Dihydropyridines (Nifedipine, Amlodipine, etc.).
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Verapamil is the only member of the Diphenylalkylamines class approved, while Diltiazem is the only member of the Benzothiazepines class approved in the US.
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Dihydropyridines have a much greater affinity for vascular calcium channels than heart calcium channels, making them beneficial in treating hypertension.
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Most CCBs have short half-lives (3-8 hours after oral doses), but sustained-release preparations are available for once-daily dosing.
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Adverse effects include constipation (approximately 10% with Verapamil), dizziness, headache, and fatigue (more frequent with dihydropyridines).
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Verapamil should be avoided in patients with congestive heart failure or atrioventricular block due to its negative inotropic effect.
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β-Blockers (Propranolol, Metoprolol, Esmoprolol) are a treatment option for hypertensive patients with concomitant heart disease or heart failure.
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β-Blockers primarily decrease blood pressure by reducing cardiac output.
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Description
Test your knowledge about calcium-channel blockers, a recommended treatment option for hypertensive patients with diabetes or angina. Learn about the classes of calcium-channel blockers and their potential risks and benefits.
