NURS 1141 - EXAM 2 QUESTIONS
WITH COMPLETE ANSWERS
ACE Inhibitors for hypertension ANSW✅✅Inhibits ACE, decreasing angiotensin 2 (vasoconstrictor)
-prils
Useful when used with diuretics, less effective in AAs
Slows diabetic neuropathy
Good for s/p heart failure
*DO NOT USE WITH ARBs or renin inhibitors
*Chronic cough (bradykinin)
*Can cause fetal/neonatal harm
ARB agents for hypertension
(angiotensin 2 receptor blockers) ANSW✅✅Block angiotensin 2 receptor sites, preventing
vasoconstriction
No effect on renal function, cholesterol, sugar
-artans
Starts effect @1 week, full effect at 3-6 weeks
Can add HCTZ for effect
*Neonatal/fetal harm
*hyperkalemia
Enhance - diuretics, phenothiazines, alcohol, beta blockers
Can cause small increase in K+, don't add K+ or K+ diuretics
Issues with spironolactone/eplerenone
Eplerenone ANSW✅✅Aldosterone receptor antagonist
Uses - htn, heart failure
Also causes aldosterone secretion - leads to Na retention in renal cortex
Dose: 50mg qd, possibly bid
SE - gynecomastia, vaginal bleeding, hyperK, increased uric acid, triglyceride, cholesterol
, *Watch for increased BUN/creatinine
*Only use if clearance > 50mL/min
Interactions with trimethoprim (enhances), lithium (lith tox), grapefruit juice (decrease metabolism),
St. Johns wort (increases elimination of eplerenone
amlodipine (norvasc), diltiazem (cardizem), felodipine, isradipine, nicardipine (cardene), nifedipine
(procardia), nisoldipine (sular), verapamil ANSW✅✅Calcium Channel Blockers
Inhibit calcium movement across cell membrane
SE Hypotension/syncope
Typical toxic interactions
Grapefruit juice
Digoxin - CCB may increase serum dig
Doxazosin (Cardura) ANSW✅✅Alpha 1 adrenergic blocker
Blocks a1 receptors - vasodilation, reducing PVR
No effect on heart rate, MVO2, or uric acid
Helps with cholesterol
Dose - 1mg qd, (am/pm), maint - 2,8, 16mg qd
**Hypotension within 2-6 hours, watch standing BP
Prazosin (Minipress) ANSW✅✅Alpha 1 adrenergic blocker
Blocks a1 receptors - vasodilation, reducing PVR
No effect on heart rate, MVO2, or uric acid
Helps with cholesterol
Dose - 1mg tid (first dose at bedtime), maint - 6-15mg/day divided into 3 doses (max 40/day)
Terazosin ANSW✅✅Alpha 1 adrenergic blocker
Blocks a1 receptors - vasodilation, reducing PVR
No effect on heart rate, MVO2, or uric acid
Helps with cholesterol
Dose - 1mg at bed, maint - 1-5mg qd, max 20mg/day
WITH COMPLETE ANSWERS
ACE Inhibitors for hypertension ANSW✅✅Inhibits ACE, decreasing angiotensin 2 (vasoconstrictor)
-prils
Useful when used with diuretics, less effective in AAs
Slows diabetic neuropathy
Good for s/p heart failure
*DO NOT USE WITH ARBs or renin inhibitors
*Chronic cough (bradykinin)
*Can cause fetal/neonatal harm
ARB agents for hypertension
(angiotensin 2 receptor blockers) ANSW✅✅Block angiotensin 2 receptor sites, preventing
vasoconstriction
No effect on renal function, cholesterol, sugar
-artans
Starts effect @1 week, full effect at 3-6 weeks
Can add HCTZ for effect
*Neonatal/fetal harm
*hyperkalemia
Enhance - diuretics, phenothiazines, alcohol, beta blockers
Can cause small increase in K+, don't add K+ or K+ diuretics
Issues with spironolactone/eplerenone
Eplerenone ANSW✅✅Aldosterone receptor antagonist
Uses - htn, heart failure
Also causes aldosterone secretion - leads to Na retention in renal cortex
Dose: 50mg qd, possibly bid
SE - gynecomastia, vaginal bleeding, hyperK, increased uric acid, triglyceride, cholesterol
, *Watch for increased BUN/creatinine
*Only use if clearance > 50mL/min
Interactions with trimethoprim (enhances), lithium (lith tox), grapefruit juice (decrease metabolism),
St. Johns wort (increases elimination of eplerenone
amlodipine (norvasc), diltiazem (cardizem), felodipine, isradipine, nicardipine (cardene), nifedipine
(procardia), nisoldipine (sular), verapamil ANSW✅✅Calcium Channel Blockers
Inhibit calcium movement across cell membrane
SE Hypotension/syncope
Typical toxic interactions
Grapefruit juice
Digoxin - CCB may increase serum dig
Doxazosin (Cardura) ANSW✅✅Alpha 1 adrenergic blocker
Blocks a1 receptors - vasodilation, reducing PVR
No effect on heart rate, MVO2, or uric acid
Helps with cholesterol
Dose - 1mg qd, (am/pm), maint - 2,8, 16mg qd
**Hypotension within 2-6 hours, watch standing BP
Prazosin (Minipress) ANSW✅✅Alpha 1 adrenergic blocker
Blocks a1 receptors - vasodilation, reducing PVR
No effect on heart rate, MVO2, or uric acid
Helps with cholesterol
Dose - 1mg tid (first dose at bedtime), maint - 6-15mg/day divided into 3 doses (max 40/day)
Terazosin ANSW✅✅Alpha 1 adrenergic blocker
Blocks a1 receptors - vasodilation, reducing PVR
No effect on heart rate, MVO2, or uric acid
Helps with cholesterol
Dose - 1mg at bed, maint - 1-5mg qd, max 20mg/day
