18 Questions
Which antihypertensive agent is recommended as first-line therapy for adults with stage 1 hypertension and a blood pressure goal of less than 130/80 mm Hg?
Angiotensin-Converting Enzyme Inhibitors (ACEIs)
What is a common adverse drug reaction associated with Angiotensin-Converting Enzyme Inhibitors (ACEIs)?
Hyperkalemia
Which patient population is more prone to experiencing angioedema as a side effect of Angiotensin-Converting Enzyme Inhibitors (ACEIs)?
African Americans
What is the main contraindication for using Angiotensin-Converting Enzyme Inhibitors (ACEIs)?
Pregnancy
Which condition warrants close potassium monitoring when a patient is on Angiotensin-Converting Enzyme Inhibitors (ACEIs)?
Renal impairment
What is a notable drug interaction consideration for Angiotensin-Converting Enzyme Inhibitors (ACEIs) regarding food intake?
No significant interaction with food
What is a precaution associated with Angiotensin Converting Enzyme blockers (ACEIs)?
High risk of acute renal failure in patients with severe bilateral renal artery stenosis
Which statement about Angiotensin Receptor Blockers (ARBs) is true?
Considered as a suitable alternative for patients who develop angioedema with ACEIs
What is the mechanism of action of Calcium Channel Blockers (CCBs) like amlodipine and nifedipine?
Relax smooth muscle in the arteries to decrease total peripheral resistance and lower blood pressure
Which of the following statements regarding ACEIs is true?
ACEIs have less risk of acute renal failure in patients with severe bilateral renal artery stenosis
What differentiates Angiotensin Receptor Blockers (ARBs) from ACE Inhibitors (ACEIs) in terms of side effects?
ACEIs are less likely to cause angioedema than ARBs
Why are Angiotensin Receptor Blockers (ARBs) considered a suitable alternative for some patients who develop issues with ACE Inhibitors (ACEIs)?
Because they have a lower risk of causing angioedema compared to ACEIs
Which diuretic is preferred over HCTZ according to the ACC/AHA 2017 guideline?
Chlorthalidone
What is a common adverse effect associated with thiazide and thiazide-like diuretics?
Hyperglycemia
Which diuretic type is indicated for hypertension management in patients with heart failure and chronic kidney disease?
Loop diuretics
What electrolyte abnormality is loop diuretics commonly associated with?
Hypokalemia
Which diuretic can be safely used in patients allergic to sulfa moieties?
Ethacrynic acid
What is a precaution when using thiazides in patients with impaired renal function?
Regularly monitor serum creatinine levels
Study Notes
Antihypertensive Therapy
- For adults with stage 1 hypertension, first-line therapy with a blood pressure goal of less than 130/80 mm Hg involves the use of antihypertensive agents.
Angiotensin-Converting Enzyme Inhibitors (ACEIs)
- A common adverse drug reaction associated with ACEIs is angioedema.
- Patients with a history of angioedema are more prone to experiencing angioedema as a side effect of ACEIs.
- The main contraindication for using ACEIs is bilateral renal artery stenosis.
- Patients on ACEIs require close potassium monitoring, especially those with kidney disease or heart failure.
- Food intake can reduce the bioavailability of ACEIs, making dosing adjustments necessary.
- A precaution associated with ACEIs is hyperkalemia.
- ACEIs can cause fetal toxicity, making them contraindicated in pregnancy.
Angiotensin Receptor Blockers (ARBs)
- ARBs have a similar mechanism of action to ACEIs but do not inhibit the breakdown of bradykinin, which reduces the incidence of angioedema.
- ARBs are considered a suitable alternative for patients who develop issues with ACEIs, such as angioedema or cough.
- The mechanism of action of ARBs involves blocking the activation of angiotensin II receptors.
Calcium Channel Blockers (CCBs)
- The mechanism of action of CCBs like amlodipine and nifedipine involves relaxation of vascular smooth muscle, reducing peripheral resistance and blood pressure.
Diuretics
- The 2017 ACC/AHA guideline recommends chlorthalidone over HCTZ due to its longer duration of action.
- A common adverse effect associated with thiazide and thiazide-like diuretics is hypokalemia.
- Loop diuretics are indicated for hypertension management in patients with heart failure and chronic kidney disease.
- Loop diuretics are commonly associated with hypokalemia.
- Ethacrynic acid is a diuretic that can be safely used in patients allergic to sulfa moieties.
- Thiazides should be used with caution in patients with impaired renal function due to the risk of acute kidney injury.
Learn about important precautions to consider when using Angiotensin Converting Enzyme Inhibitors (ACEIs), including avoiding concurrent administration with certain medications and in women of childbearing age. Understand why ACEIs are not recommended as a first-line antihypertensive for black individuals with isolated hypertension.
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