Pharmacology of Diuretics and ACE Inhibitors
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Questions and Answers

What is a common toxic effect associated with aliskiren?

  • Hyperkalemia (correct)
  • Sedation
  • Cough
  • Renal impairment
  • Which of the following are considered teratogenic?

  • Clonidine
  • Methyldopa
  • Aliskiren (correct)
  • Losartan (correct)
  • What is the primary mechanism of action for angiotensin receptor blockers (ARBs)?

  • Block AT1 angiotensin receptors (correct)
  • Increase bradykinin levels
  • Inhibit renin activity
  • Activate α2 adrenoceptors
  • Which disease is treated with centrally acting sympathoplegics like clonidine?

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

    What is a notable side effect of methyldopa?

    <p>Hemolytic anemia</p> Signup and view all the answers

    Which medication does not typically increase bradykinin levels?

    <p>Angiotensin receptor blockers</p> Signup and view all the answers

    Which of the following statements is true regarding the toxicity of ARBs?

    <p>They cause less cough than ACE inhibitors</p> Signup and view all the answers

    Which of the following effects is NOT reduced by centrally acting sympathoplegics?

    <p>Heart rate</p> Signup and view all the answers

    What type of transporter does reserpine block in noradrenergic nerves?

    <p>Vesicular amine transporter</p> Signup and view all the answers

    What is a potential toxicity associated with reserpine?

    <p>Psychiatric depression</p> Signup and view all the answers

    Which drug is used to replace norepinephrine in vesicles?

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

    What condition is primarily treated with α blockers such as prazosin?

    <p>Benign prostatic hyperplasia</p> Signup and view all the answers

    What is a side effect of terazosin?

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

    Which β blocker selectively blocks β1 receptors?

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

    What effect does guanadrel have on norepinephrine?

    <p>It replaces it in vesicles</p> Signup and view all the answers

    Which of the following drugs is indicated for hypertension management?

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

    Which of the following drugs is a nonselective beta blocker?

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

    What effect do dihydropyridines like nifedipine primarily have?

    <p>Block vascular calcium channels</p> Signup and view all the answers

    What is the main action of verapamil and diltiazem?

    <p>Block L-type calcium channels</p> Signup and view all the answers

    What type of vasodilation does hydralazine induce?

    <p>Arteriolar vasodilation</p> Signup and view all the answers

    Which drug is known for causing hypertrichosis as a side effect?

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

    What is an important adverse effect associated with hydralazine?

    <p>Lupus-like syndrome</p> Signup and view all the answers

    Which agent is classified as a parenteral vasodilator?

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

    What is the primary mechanism of action of nitroprusside?

    <p>Nitric oxide release</p> Signup and view all the answers

    What is the primary mechanism of action of thiazide diuretics?

    <p>Block Na/Cl transporter in the renal distal convoluted tubule</p> Signup and view all the answers

    Which statement correctly describes the effects of loop diuretics?

    <p>They have a greater efficacy than thiazides.</p> Signup and view all the answers

    What is a common clinical application of spironolactone?

    <p>Heart failure</p> Signup and view all the answers

    Which of the following is a known toxicity associated with ACE inhibitors?

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

    What therapeutic effects do ACE inhibitors provide?

    <p>Lower angiotensin II levels</p> Signup and view all the answers

    Which pharmacokinetic property is most associated with ACE inhibitors?

    <p>They are generally taken orally.</p> Signup and view all the answers

    What is the potential effect of blocking the aldosterone receptor with spironolactone?

    <p>Decreased sodium retention</p> Signup and view all the answers

    In which condition are thiazides typically used as a treatment?

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

    Study Notes

    Diuretics

    • Thiazides (Hydrochlorothiazide, Chlorthalidone): Block Na/Cl transporter in distal convoluted tubule, reducing blood volume and exhibiting vascular effects.
    • Loop Diuretics (Furosemide): Block Na/K/2Cl transporter in the loop of Henle, offering higher efficacy compared to thiazides, used for severe hypertension and heart failure.
    • Potassium-Sparing Diuretics (Spironolactone, Eplerenone): Block aldosterone receptors, leading to increased sodium excretion and decreased potassium loss, important for conditions like aldosteronism and heart failure.

    Angiotensin-Converting Enzyme (ACE) Inhibitors

    • Captopril and Others: Inhibit angiotensin-converting enzyme, reducing angiotensin II, vasoconstriction, and aldosterone secretion, significant in managing hypertension and heart failure.
    • Side Effects: Cough, angioedema, hyperkalemia, renal impairment, and teratogenic effects.

    Angiotensin Receptor Blockers (ARBs)

    • Losartan and Others: Block AT1 angiotensin receptors, mimicking effects of ACE inhibitors without increasing bradykinin, used for hypertension and heart failure.
    • Side Effects: Similar to ACE inhibitors but with reduced incidence of cough.

    Renin Inhibitor

    • Aliskiren: Directly inhibits renin, thereby reducing angiotensin I, II, and aldosterone levels, effective for hypertension.
    • Side Effects: Hyperkalemia, renal impairment, and potential teratogenic effects.

    Sympathoplegics, Centrally Acting

    • Clonidine: Activates α2 adrenoceptors to reduce central sympathetic outflow and norepinephrine release, indicated for hypertension and drug withdrawal.
    • Methyldopa: Similar mechanism as clonidine with added use in pregnancy but can cause sedation and hemolytic anemia.

    Sympathetic Nerve Terminal Blockers

    • Reserpine: Blocks amine transporter in noradrenergic nerves, leading to depletion of neurotransmitter stores and reduced sympathetic cardiovascular effects; seldom used for hypertension due to psychiatric side effects.
    • Guanethidine and Guanadrel: Interfere with norepinephrine release, leading to similar effects as reserpine, but can cause severe orthostatic hypotension.

    Alpha Blockers

    • Prazosin, Terazosin, Doxazosin: Selectively block α1 adrenoceptors, prevent vasoconstriction, and reduce prostatic smooth muscle tone, used for hypertension and benign prostatic hyperplasia.
    • Side Effects: Orthostatic hypotension.

    Beta Blockers

    • Metoprolol and Others: Primarily block β1 receptors to reduce heart stimulation and renin secretion; carvedilol also blocks α receptors and nebivolol enhances nitric oxide release.
    • Clinical Uses: Hypertension, heart failure, and coronary disease.

    Vasodilators

    • Calcium Channel Blockers (Verapamil, Diltiazem): Nonselective blockers that reduce heart rate and vascular resistance; used for hypertension and arrhythmias.
    • Dihydropyridines (Nifedipine, Amlodipine): Preferentially block vascular calcium channels to reduce vascular resistance; indicated for hypertension and angina.
    • Hydralazine: Causes nitric oxide release leading to vasodilation; important for hypertension management but can cause lupus-like syndrome.
    • Minoxidil: Opens potassium channels in vascular smooth muscle, reducing vascular resistance, also used for hair loss but can cause hypertrichosis.

    Parenteral Agents

    • Nitroprusside: Releases nitric oxide, providing powerful vasodilation, primarily utilized in hypertensive emergencies.

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    Description

    This quiz focuses on the pharmacological aspects of diuretics, including thiazides, loop diuretics, and potassium-sparing diuretics. It also covers angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, discussing their mechanisms, uses, and side effects. Test your knowledge on cardiovascular pharmacotherapy!

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