Calcium-Channel Blockers Quiz
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Questions and Answers

What is the definition of hypertension?

  • Sustained systolic blood pressure of greater than 140 mm Hg (correct)
  • Sustained systolic blood pressure greater than 120 mm Hg
  • Sustained diastolic blood pressure of greater than 100 mm Hg
  • Sustained diastolic blood pressure of greater than 80 mm Hg

    • What are the potential consequences of sustained arterial hypertension?

  • Lower risk of heart failure
  • Reduced risk of coronary disease
  • Decreased incidence of renal failure
  • Increased incidence of renal failure, coronary disease, heart failure, stroke, and dementia (correct)

    • What can effective pharmacologic lowering of blood pressure prevent?

  • Decreased mortality rates only
  • Damage to blood vessels and increased morbidity
  • Damage to blood vessels and substantially reduce morbidity and mortality rates (correct)
  • Reduced toxicity in most patients

    • How many main drug classes are recommended for the treatment of hypertension?

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

    What is the purpose of adding beta blockers after improving angiotensin converting enzyme inhibitors therapy?

    <p>To achieve optimal heart rate control</p> Signup and view all the answers

    When should sacubitril/valsartan be considered for replacement of angiotensin converting enzyme inhibitors or optimal doses?

    <p>When the patient continues to experience symptoms despite optimal doses of angiotensin converting enzyme inhibitors and beta blockers</p> Signup and view all the answers

    What is the purpose of adding digoxin and ivabradine in patients undergoing optimal drug therapy for high frequency?

    <p>To treat symptoms only in patients with optimal heart rate control</p> Signup and view all the answers

    Which type of patients are primarily prescribed β-blockers?

    <p>Patients with supraventricular tachyarrhythmia and previous myocardial infarction</p> Signup and view all the answers

    What is a condition that discourages the use of β-blockers?

    <p>Reversible bronchospastic diseases</p> Signup and view all the answers

    Which drug undergoes extensive first-pass metabolism and may take several weeks to develop full effects?

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

    What are the potential side effects of β-blockers?

    <p>CNS side effects and hypotension</p> Signup and view all the answers

    Which drugs competitively block α1 adrenoceptors, decreasing peripheral vascular resistance and lowering arterial blood pressure?

    <p>Prazosin, doxazosin, and terazosin</p> Signup and view all the answers

    What do direct-acting smooth muscle relaxants like hydralazine and minoxidil do?

    <p>Dilate blood vessels</p> Signup and view all the answers

    How is heart failure classified?

    <p>Into four stages based on the type of heart failure</p> Signup and view all the answers

    What side effect can minoxidil treatment cause?

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

    In heart failure patients on optimal therapy, what drugs may be added for symptomatic benefit?

    <p>Sacubitril/valsartan, digoxin, and Ivabradine</p> Signup and view all the answers

    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?

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

    What does the ACE enzyme produce that is blocked by ACE inhibitors?

    <p>Angiotensin II</p> Signup and view all the answers

    Which of the following is a common side effect of ACE inhibitors?

    <p>Dry cough</p> Signup and view all the answers

    What is the mechanism of action of ARBs (angiotensin II receptor blockers)?

    <p>Block the vasoconstrictor angiotensin II</p> Signup and view all the answers

    Which group of drugs reduce both cardiac preload and afterload, decreasing cardiac work?

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

    What is the primary function of medications that lower blood pressure?

    <p>Prevent cardiovascular events</p> Signup and view all the answers

    In patients with chronic kidney disease, which class of drugs is associated with improved cardiovascular outcomes and reduced mortality?

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

    What is a common side effect of ARBs (angiotensin II receptor blockers)?

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

    Which of the following is a common side effect of beta-blockers?

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

    What is the primary function of ACE inhibitors in reducing blood pressure?

    <p>Decrease aldosterone secretion</p> Signup and view all the answers

    Which group of drugs are recommended for blood pressure management based on their proven ability to reduce blood pressure?

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

    What do CCBs (calcium channel blockers) work to reduce in order to lower blood pressure?

    <p>Cardiac preload and afterload</p> Signup and view all the answers

    Which class of drugs prevents the conversion of angiotensin I to angiotensin II?

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

    Which class of drugs blocks the action of angiotensin II at its receptor?

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

    Which class of drugs is contraindicated during pregnancy?

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

    Which class of drugs is orally bioavailable and undergoes hepatic conversion to active metabolites?

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

    Which class of drugs is more attractive therapy for hypertensive diabetics due to lower nephrotoxicity?

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

    Which drug in the class of ACE inhibitors is available intravenously?

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

    Which class of drugs is used in combination therapy with ACE inhibitors or ARBs for treating hypertension and heart failure?

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

    Which class of drugs is used in the treatment of acute coronary syndrome, including acute myocardial infarction?

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

    Which class of drugs is used in the treatment of hypertensive pregnant women?

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

    Which class of drugs is used in the treatment of heart failure with preserved ejection fraction?

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

    Which class of drugs is used in the prevention of cardiovascular events in patients with chronic kidney disease?

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

    Which class of drugs is used in the treatment of heart failure in patients with a history of valvular heart disease?

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

    Which class of calcium channel blockers (CCBs) has a much greater affinity for vascular calcium channels than heart calcium channels?

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

    What is the only member of the Diphenylalkylamines class of CCBs approved in the US?

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

    Which adverse effect is more frequent with dihydropyridines?

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

    Which drug class primarily decreases blood pressure by reducing cardiac output?

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

    Which type of patients are β-Blockers a treatment option for?

    <p>Hypertensive patients with concomitant heart disease</p> Signup and view all the answers

    Why should high doses of short-acting CCBs be avoided?

    <p>Increased risk of myocardial infarction</p> Signup and view all the answers

    What effect should Verapamil be avoided for in patients with congestive heart failure or atrioventricular block?

    <p>Negative inotropic effect</p> Signup and view all the answers

    What is the primary adverse effect associated with Verapamil?

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

    Study Notes

    • β-blockers are primarily used in hypertensive patients with heart disease, such as supraventricular tachyarrhythmia, previous myocardial infarction, angina pectoris, and chronic heart failure

    • Conditions that discourage β-blocker use include reversible bronchospastic diseases, second- and third-degree heart block, and severe peripheral vascular disease

    • Propranolol undergoes extensive first-pass metabolism and may take several weeks to develop full effects

    • β-blockers may cause bradycardia, CNS side effects (fatigue, lethargy, insomnia, hallucinations), and hypotension

    • Prazosin, doxazosin, and terazosin competitively block α1 adrenoceptors, decreasing peripheral vascular resistance and lowering arterial blood pressure

    • Direct-acting smooth muscle relaxants like hydralazine and minoxidil dilate blood vessels

    • Heart failure is classified into four stages, and treatment varies from diuretics for volume overload to polytherapy for persistent symptoms

    • Minoxidil treatment can cause hypertrichosis and is used topically for male pattern baldness

    • In heart failure patients on optimal therapy, Sacubitril/valsartan, digoxin, and Ivabradine may be added for symptomatic benefit.

    • Calcium channel blockers (CCBs) are recommended for hypertensive patients with diabetes or angina.

    • High doses of short-acting CCBs should be avoided due to increased risk of myocardial infarction.

    • CCBs are divided into three chemical classes: Diphenylalkylamines (Verapamil), Benzothiazepines (Diltiazem), and Dihydropyridines (Nifedipine, Amlodipine, etc.).

    • Verapamil is the only member of the Diphenylalkylamines class approved, while Diltiazem is the only member of the Benzothiazepines class approved in the US.

    • Dihydropyridines have a much greater affinity for vascular calcium channels than heart calcium channels, making them beneficial in treating hypertension.

    • Most CCBs have short half-lives (3-8 hours after oral doses), but sustained-release preparations are available for once-daily dosing.

    • Adverse effects include constipation (approximately 10% with Verapamil), dizziness, headache, and fatigue (more frequent with dihydropyridines).

    • Verapamil should be avoided in patients with congestive heart failure or atrioventricular block due to its negative inotropic effect.

    • β-Blockers (Propranolol, Metoprolol, Esmoprolol) are a treatment option for hypertensive patients with concomitant heart disease or heart failure.

    • 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.

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