CMN 572 TESTS III COMPETENCY REVIEW
2026 MOCK TEST COMPLETE KEY INSIGHTS
◉ Reserpine, guanethidine and guanadrel to lower BP.
Answer: Causes depression, sedation, nasal stuffiness, sleep
disturbances, peptic ulcers
Granathidine and guanadrel - diarrhea, hypotension, fluid retention
◉ Hydralazine and Minoxidil.
Answer: Arterial vasodilators - reflex tachy - HA, palpitation and
fluid retention
Combine it with diuretic or BBs
Hydralazine can cause lupus like syndrome
◉ Hypertensive meds and cancer.
Answer: ACEi and lung cancer
CCBs and breast cancer ????
◉ Initial tx for HTN:.
Answer: ACEi, ARBs or CCBs
Thiazides: older pts
Blacks: THIAZIDES
,Calcium channel blockers and diuretics are more effective in older or
black persons, in whom renin levels are generally lower.
In diabetic patients, three or four drugs are usually required to
reduce systolic blood pressure to less than 140 mm Hg
◉ The mnemonic ABCD.
Answer: These four classes can be divided into two categories: AB
and CD. AB refers to drugs that block the RAAS (ACE/ARB and beta-
blockers). CD refers to those that work in other pathways (calcium
channel blockers and diuretics)
In light of unwanted metabolic effects, calcium channel blockers
might be preferable to thiazides in the younger hypertensive patient
requiring a second antihypertensive drug following initiation of
therapy with an ACE inhibitor or ARB
◉ Stage 1 HTN management.
Answer: In patients with mild or stage 1 hypertension (less than
160/90 mm Hg) in whom pharmacotherapy is indicated, treatment
should start with a single agent or two-drug combination at a low
dose. Follow-up visits should usually be at 4- to 6-week intervals to
,allow for full medication effects to be established (especially with
diuretics) before further titration or adjustment.
If, after titration to usual doses, the patient has shown a discernible
but incomplete response and a good tolerance of the initial drug,
another medication should be added.
As a rule of thumb, a blood pressure reduction of 10 mm Hg can be
expected for each antihypertensive agent added to the regimen and
titrated to the optimum dose.
◉ Stage 2 HTN management.
Answer: In those with more severe hypertension (stage 2), or with
comorbidities (such as diabetes) that are likely to render them
resistant to treatment, initiation with combination therapy is
advised and more frequent follow-up is indicated.
◉ Step 1 HTN mgmt.
Answer: ACEi or ARB or CCB or Thiazide diuretic
◉ Step 2 HTN mgmt.
Answer: ACEi/ARB PLUS CCB or thiazide
◉ Step 3 HTN mgmt.
, Answer: ACEi/ARB plus CCB plus thiazide
◉ Step 4 HTN mgmt.
Answer: ACEi/ARB plus CCB plus thiazide plus SPIRONOLACTONE
ALLOW 2 WEEKS TO REACH FULL EFFECT OF EACH DRUG
BBs can be used in any stage for HF or angina
thiazides better for blacks and older pts
add a CCB rathan than diuretic for younger pts to avoid metabolic
syndrome
Watch for hyperkalemia with spironolactone and ACE/ARBs
◉ First line HTN med agent for blacks.
Answer: CCB or diuretic
◉ Second line agent for blacks.
Answer: ARB or ACEi or BBs
◉ Resistant HTN line agent for blacks.
Answer: Aldosterone receptor blocker
◉ First line agent for all but blacks <55yo.
Answer: ACEi or ARB or CCB or diuretic
2026 MOCK TEST COMPLETE KEY INSIGHTS
◉ Reserpine, guanethidine and guanadrel to lower BP.
Answer: Causes depression, sedation, nasal stuffiness, sleep
disturbances, peptic ulcers
Granathidine and guanadrel - diarrhea, hypotension, fluid retention
◉ Hydralazine and Minoxidil.
Answer: Arterial vasodilators - reflex tachy - HA, palpitation and
fluid retention
Combine it with diuretic or BBs
Hydralazine can cause lupus like syndrome
◉ Hypertensive meds and cancer.
Answer: ACEi and lung cancer
CCBs and breast cancer ????
◉ Initial tx for HTN:.
Answer: ACEi, ARBs or CCBs
Thiazides: older pts
Blacks: THIAZIDES
,Calcium channel blockers and diuretics are more effective in older or
black persons, in whom renin levels are generally lower.
In diabetic patients, three or four drugs are usually required to
reduce systolic blood pressure to less than 140 mm Hg
◉ The mnemonic ABCD.
Answer: These four classes can be divided into two categories: AB
and CD. AB refers to drugs that block the RAAS (ACE/ARB and beta-
blockers). CD refers to those that work in other pathways (calcium
channel blockers and diuretics)
In light of unwanted metabolic effects, calcium channel blockers
might be preferable to thiazides in the younger hypertensive patient
requiring a second antihypertensive drug following initiation of
therapy with an ACE inhibitor or ARB
◉ Stage 1 HTN management.
Answer: In patients with mild or stage 1 hypertension (less than
160/90 mm Hg) in whom pharmacotherapy is indicated, treatment
should start with a single agent or two-drug combination at a low
dose. Follow-up visits should usually be at 4- to 6-week intervals to
,allow for full medication effects to be established (especially with
diuretics) before further titration or adjustment.
If, after titration to usual doses, the patient has shown a discernible
but incomplete response and a good tolerance of the initial drug,
another medication should be added.
As a rule of thumb, a blood pressure reduction of 10 mm Hg can be
expected for each antihypertensive agent added to the regimen and
titrated to the optimum dose.
◉ Stage 2 HTN management.
Answer: In those with more severe hypertension (stage 2), or with
comorbidities (such as diabetes) that are likely to render them
resistant to treatment, initiation with combination therapy is
advised and more frequent follow-up is indicated.
◉ Step 1 HTN mgmt.
Answer: ACEi or ARB or CCB or Thiazide diuretic
◉ Step 2 HTN mgmt.
Answer: ACEi/ARB PLUS CCB or thiazide
◉ Step 3 HTN mgmt.
, Answer: ACEi/ARB plus CCB plus thiazide
◉ Step 4 HTN mgmt.
Answer: ACEi/ARB plus CCB plus thiazide plus SPIRONOLACTONE
ALLOW 2 WEEKS TO REACH FULL EFFECT OF EACH DRUG
BBs can be used in any stage for HF or angina
thiazides better for blacks and older pts
add a CCB rathan than diuretic for younger pts to avoid metabolic
syndrome
Watch for hyperkalemia with spironolactone and ACE/ARBs
◉ First line HTN med agent for blacks.
Answer: CCB or diuretic
◉ Second line agent for blacks.
Answer: ARB or ACEi or BBs
◉ Resistant HTN line agent for blacks.
Answer: Aldosterone receptor blocker
◉ First line agent for all but blacks <55yo.
Answer: ACEi or ARB or CCB or diuretic
