Calcium-Channel Blockers Quiz

True or false: Hypertension is defined as a sustained systolic blood pressure of greater than 120 mm Hg

True or false: Hypertension can lead to an increased incidence of renal failure, heart failure, and stroke

True or false: Effective pharmacologic lowering of blood pressure has been shown to prevent damage to blood vessels

True or false: There are three main drug classes recommended for the treatment of hypertension

True or false: Adding angiotensin receptor blockers is the next step after improving treatment with diuretics?

True or false: Beta blockers are added after improving angiotensin converting enzyme inhibitor or treatment?

True or false: Aldosterone antagonists and fixed doses of hydralazine and isosorbide dinitrate are initiated in patients with persistent symptoms despite optimal doses of angiotensin converting enzyme inhibitors and beta blockers?

True or false: Once a patient takes an angiotensin converting enzyme inhibitor or the optimal dose, and if the patient continues to experience symptoms, either can be replaced with sacubitril/valsartan?

True or false: Finally, digoxin and ivabradine are added to achieve symptomatic benefit only in patients undergoing optimal drug therapy for high frequency?

ACE inhibitors are not recommended as first-line treatment for hypertension in patients with a history of heart disease or diabetes, stroke, heart failure, myocardial infarction, or chronic kidney disease

ACE inhibitors work by increasing aldosterone secretion, resulting in increased sodium and water retention

Common side effects of ACE inhibitors include dry cough, rash, fever, altered taste, hypotension, and hyperkalemia

ARBs, beta-blockers, and diuretics are not other drug classes used to treat hypertension

The choice of medication for hypertension does not depend on its effect on overall cardiovascular morbidity and mortality

Placebo-controlled studies have shown ACE inhibitors to reduce cardiovascular events primarily due to their BP-lowering effect

ACE inhibitors are not recommended for compelling indications such as high coronary disease risk or history, diabetes, stroke, heart failure, myocardial infarction, and chronic kidney disease

ACE inhibitors' mechanism of action includes reducing aldosterone secretion, leading to decreased sodium and water retention

ACE inhibitors have been shown to reduce cardiovascular morbidity and mortality in a broad sense

ACE inhibitors do not impact both preload and afterload, reducing cardiac work

Side effects of ACE inhibitors do not include dry cough, rash, fever, altered taste, hypotension, and hyperkalemia

β-blockers are contraindicated in hypertensive patients with heart conditions like atrial fibrillation, previous myocardial infarction, angina pectoris, and chronic heart failure

Propranolol undergoes extensive first-pass metabolism and takes several weeks to develop full effects

Prazosin, doxazosin, and terazosin are α1 adrenoreceptor-blocking agents that decrease peripheral vascular resistance and lower arterial blood pressure by causing relaxation of both arterial and venous smooth muscle

Hydralazine and minoxidil are vasodilators that directly relax smooth muscles and are used for heart failure symptomatic relief

Sacubitril/valsartan is an alternative to ACE inhibitors or ARBs, while digoxin and Ivabradine are added only in patients with heart failure on optimal pharmacotherapy

Heart failure is classified into four stages, each requiring different treatment approaches and combination therapies

Diuretics are introduced first to manage symptoms of volume overload, followed by ACE inhibitors or ARBs, β-blockers, aldosterone antagonists, and hydralazine and isosorbide dinitrate, with Sacubitril/valsartan as an alternative to ACE inhibitors or ARBs, and digoxin and Ivabradine added only in optimal pharmacotherapy cases

Reversible bronchospastic diseases, second- and third-degree heart block, and severe peripheral vascular disease encourage the use of β-blockers

β-blockers may cause bradycardia, CNS side effects, and hypotension

Loop diuretics are used first in the treatment of heart failure, followed by ACE inhibitors or ARBs, β-blockers, aldosterone antagonists, and hydralazine and isosorbide dinitrate

Heart failure, or cardiac failure, is classified into four stages and treated with a combination of drugs

The treatment of heart failure involves the use of vasodilators, α1 adrenoreceptor-blocking agents, and loop diuretics

Calcium channel blockers should be avoided in high doses due to increased risk of myocardial infarction

Dihydropyridines have a greater affinity for vascular calcium channels than for calcium channels in the heart

Most calcium channel blockers have short half-lives after an oral dose

Constipation occurs in approximately 10% of patients treated with Verapamil

Verapamil should be avoided in patients with congestive heart failure or atrioventricular block

β-Blockers are a treatment option for hypertensive patients with concomitant heart disease or heart failure

Calcium channel blockers are classified into three chemical classes

Dizziness, headache, and fatigue caused by decreased blood pressure are more frequent with dihydropyridines

Dihydropyridines are particularly beneficial in treating hypertension

Sustained-release preparations of calcium channel blockers are available for longer-term treatment

Verapamil is a diphenylalkylamine calcium channel blocker

Benzothiazepines include Diltiazem as a calcium channel blocker

ACE inhibitors prevent the conversion of angiotensin I to angiotensin II, resulting in increased production of aldosterone and increased salt and water retention

ACE inhibitors have side effects such as dry cough and angioedema, and are contraindicated in pregnancy due to fetotoxicity

ARBs work by blocking the action of angiotensin II at its receptor, resulting in increased production of aldosterone and increased salt and water retention

Renin inhibitors, such as aliskiren, inhibit the production of angiotensin I from renin, making them a later intervention in the renin-angiotensin-aldosterone system than ACE inhibitors or ARBs

ARBs increase bradykinin levels and decrease nephrotoxicity in diabetes

Renin inhibitors, like ACE inhibitors and ARBs, are contraindicated during pregnancy

ACE inhibitors undergo hepatic metabolism, except for captopril and Lisinopril

Fosinopril requires dose adjustment in patients with renal impairment

Enalaprilat is available intravenously

ARBs have similar adverse effects to ACE inhibitors, but with increased risks of cough and angioedema

ARBs are not fetotoxic

Renin inhibitors, such as aliskiren, are a later intervention in the renin-angiotensin-aldosterone system than ACE inhibitors or ARBs