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Which drug has been recently demonstrated to improve mortality and morbidity in patients with severe (Class IV) heart failure?
Which drug has a nonselective beta-blocker and alpha1 blocking effect?
Which drug has the potential to dramatically decrease mortality in Class II and III heart failure patients?
Which drug may worsen heart failure initially?
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Which drug is technically a diuretic?
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Which drug inhibits aldosterone effects on the collecting ducts?
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Which drug promotes hyperkalemia?
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Which drug is an aldosterone antagonist?
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Which drug has a receptor binding to guanylate cyclase-A and cGMP production as its MOA?
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Which drug has been shown to have elevated lab values in heart failure patients for BNP (B-type naturetic peptide)?
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Which drug is a positive inotropic drug?
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Which drug inhibits cell membrane NA/K-ATPase and has an inverse relationship with extracellular K+?
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Which receptor do antipsychotic drugs primarily block?
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Which of the following is a side effect of antipsychotic drugs?
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Which atypical antipsychotic is known for causing dangerous blood dyscrasias in about 2% of patients?
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Which atypical antipsychotic is a partial dopamine agonist?
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Which typical antipsychotic is considered a relatively 'clean' D2 antagonist with a half-life of approximately 20 hours?
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Which atypical antipsychotic is associated with metabolic syndrome and weight gain?
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Which mood stabilizer is becoming the standard against which other atypical antipsychotics are judged?
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Which receptor does lithium carbonate bind with modest affinity?
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Which adverse effect is associated with the use of mood stabilizers and atypical antipsychotics combinations?
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What should be carefully monitored due to the potential for severe side effects?
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What can antipsychotic drugs and mood stabilizers cause if not carefully monitored?
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Which neurotransmitter system does lithium carbonate have minimal extrapyramidal effects on?
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Which diuretic is usually recommended as the first line therapy for mild and moderate hypertension?
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Which anticonvulsant has a wider therapeutic window and faster onset than lithium?
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Which drug is known for its potential to cause aplastic anemia and agranulocytosis?
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Which calcium channel blocker is relatively selective for smooth muscle and is commonly used for hypertension and angina?
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Which diuretic is effective in renal failure and is often used for severe hypertension?
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Which antipsychotic drug is commonly used in combination with fluoxetine for bipolar depression?
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Which antihypertensive drug class is known for its ability to deplete the body of sodium stores?
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Which anticonvulsant drug is known for its potential to cause congenital neural tube defects and should not be used in pregnant women?
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Which antihypertensive drug class is often used in combination with other agents and may result in a 10-15mmHg drop in blood pressure when used alone?
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Which antipsychotic drug is known to be used as a potentiating agent for antidepressants and to help prevent switches to mania in bipolar patients treated with antidepressants?
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Which antihypertensive drug class is particularly effective in African-Americans and the elderly?
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Which anticonvulsant drug is known to double the concentration of lamotrigine?
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Which of the following drugs is contraindicated in pregnancy?
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Which drug combination has been shown to decrease mortality in heart failure, but is not as effective as ACEIs?
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Which drug is most effective when combined with venodilators and is known to have minimal effects on venous capacitance?
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Which drug combination is used to reduce symptoms of congestion in heart failure?
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Which drug is rapidly hydrolyzed to NO and CN, and is indicated for short-term therapy in acute heart failure?
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Which diuretic is particularly important to monitor for diuretic-induced hypokalemia when taken with cardiac glycosides?
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Which drug class should seldom be used alone in heart failure, as it may cause adverse neurohormonal activation due to volume depletion?
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Which drug is used intravenously in acute heart failure to reduce ventricular filling pressures?
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Which receptor subtype for angiotensin II is blocked by 'Sartan' drugs?
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Which drug is known to have an unknown mechanism of action, decreases SVR, and has minimal effects on venous capacitance?
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Which drug class is approved only for hypertension but has also been found beneficial for heart failure patients intolerant of ACE inhibitors?
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Which drug combination has been shown to decrease mortality in heart failure when combined with venodilators, but is not as effective as ACE inhibitors?
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Which antihypertensive drug class is generally not used in acute heart failure?
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Which antihypertensive drug class is known for causing dry cough, severe hypotension, and hyperkalemia?
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Which drug class is generally used in all patients with left ventricular (LV) systolic dysfunction, including those with no symptoms?
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Which antihypertensive drug class is particularly effective in reducing the risk of death due to slowing of cardiac remodeling and disease progression?
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Which antihypertensive drug class is used in heart failure to relieve dyspnea and prolong exercise tolerance?
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Which antihypertensive drug class is known for causing rebound hypertension?
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Which antihypertensive drug class is contraindicated in asthma and acute decompensated heart failure?
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Which antihypertensive drug class is particularly effective in African-Americans and the elderly?
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Which antihypertensive drug class is known for causing symptoms such as dry mouth, sedation, fatigue, and depression?
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Which antihypertensive drug class is used to reduce preload and afterload and decrease blood pressure?
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Which antihypertensive drug class is being replaced by tamsulosin due to side effects such as increased risk for heart failure and first-dose hypotension?
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Which antihypertensive drug class is known for dilating arterioles and decreasing systemic vascular resistance?
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Study Notes
Antipsychotic Drugs Overview
- Antipsychotic drugs block dopamine receptors, particularly the D2 receptor, and their clinical efficacy against positive symptoms correlates with D2 antagonism.
- Side effects of antipsychotic drugs include dysphoria, increased secretion of prolactin, galactorrhea in females, gynecomastia in males, loss of sex drive, impotence in males, weight gain, akathisia, hypotension, and failure to regulate body temperature.
- Typical antipsychotics include chlorpromazine, prochlorperazine, promethazine, thioridazine, fluphenazine, and haloperidol, with haloperidol being a relatively "clean" D2 antagonist with a half-life of approximately 20 hours.
- Atypical antipsychotics include pimozide, thiothixene, trifluoperazine, aripiprazole, clozapine, olanzapine, quetiapine, risperidone, and ziprasidone, with clozapine being more efficacious but causing dangerous blood dyscrasias in about 2% of patients.
- Aripiprazole is a partial dopamine agonist and is effective in treating schizophrenia, depression, and has a low incidence of side effects.
- Olanzapine, quetiapine, and risperidone are atypical antipsychotics with significant side effects, including metabolic syndrome and weight gain.
- Mood stabilizers include lithium carbonate, which is becoming the standard against which other atypical antipsychotics are judged, and valproic acid, divalproex, carbamazepine, and lamotrigine.
- Lithium carbonate binds D2 and 5HT2 with modest affinity, has minimal extrapyramidal effects, and can result in orthostatic hypotension and weight gain.
- Lithium carbonate has multiple and variable effects, including effects on electrolytes, neurotransmitter systems, and phosphoinositide signaling, and can cause adverse effects like tremor, hypothyroidism, renal dysfunction, cardiac conduction problems, and gastric distress.
- Mood stabilizers and atypical antipsychotics combinations can result in adverse effects such as mild cognitive impairment, edema, and weight gain.
- Atypical antipsychotics and mood stabilizers have a narrow therapeutic window and can cause acute side effects.
- Antipsychotic drugs and mood stabilizers have various mechanisms of action and adverse effects, and their use should be carefully monitored due to the potential for severe side effects.
Antihypertensive Drug Classes and Specific Drugs
- Alpha1 blockers like prazosin work by blocking post-synaptic alpha1 receptors, leading to decreased sympathetic nervous system (SNS) effects on vasculature, reducing preload and afterload, and decreasing blood pressure.
- Beta blockers, not first-line drugs, are used in combination with other classes and are useful in benign prostatic hyperplasia (BPH), although they are being replaced by tamsulosin due to side effects such as increased risk for heart failure, first-dose hypotension, and fatigue.
- Non-selective beta-blockers like propranolol have advantages such as being cheap and efficacious but are contraindicated in asthma and acute decompensated heart failure and have adverse effects on glycogenolysis and recovery from hypoglycemia.
- ACE inhibitors like enalapril and ARBs like losartan block the renin-angiotensin-aldosterone system, leading to decreased preload and afterload and reduced blood pressure, with predictable and mild side effects but the potential for cough, skin rashes, and acute renal failure.
- Arteriolar vasodilators like hydralazine dilate arterioles, decrease systemic vascular resistance, and may cause hypotension and side effects such as palpitations and headaches.
- Minoxidil and nitroprusside are arterial dilators, while nitroglycerin and reserpine are venodilators; nitroprusside can cause excessive hypotension and cyanide/thiocyanate toxicity.
- Central acting drugs like methyldopa and clonidine reduce sympathetic outflow, with methyldopa causing dry mouth, sedation, fatigue, depression, and sexual dysfunction, while clonidine can cause drowsiness and rebound hypertension.
- ACE inhibitors and ARBs reduce the production of angiotensin II, leading to vasodilation, decreased response to sympathetics, and reduced preload, afterload, and mortality, and are used in heart failure to relieve dyspnea and prolong exercise tolerance, with adverse effects including dry cough, severe hypotension, and hyperkalemia.
- ACE inhibitors and ARBs also have effects on morbidity, relieving dyspnea and prolonging exercise tolerance, and mortality, decreasing the risk of death due to slowing of cardiac remodeling and disease progression.
- ACE inhibitors and ARBs are generally used in all patients with left ventricular (LV) systolic dysfunction, including those with no symptoms, and their improvement may take weeks to months.
- ACE inhibitors and ARBs have adverse effects like dry, persistent cough, severe hypotension in hypovolemic patients, acute renal failure, and hyperkalemia.
- ACE inhibitors and ARBs are generally not used in acute heart failure.
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Description
Test your knowledge of antipsychotic drugs and mood stabilizers, as well as antihypertensive drug classes and specific drugs with this informative quiz. Learn about their mechanisms of action, clinical efficacy, and potential adverse effects.
