NAPLEX Exam FULL PACKAGE UPDATED EXAM TESTS AND ANSWERS| 100%
CORRECT| GRADED A+|100% PASS
Beta-Blockers✔ANS-No longer recommended first line for HTN unless patient has a comorbid
condition with BB indication
Beta-1 Selective Beta-Blockers✔ANS-Atenolol (Tenormin)
Esmolol (Brevibloc): injection
Metoprolol tartrate (Lopressor): take after food
- IV:PO is 1:2.5
Metoprolol succinate (Toprol XL): take after food
BBW: do not d/c abruptly, taper over 1-2 weeks
warnings: may mask hypoglycemia, may worsen hyperglycemia/hypoglycemia in diabetes,
caution with bronchospastic diseases (beta-1 selective preferred)
bradycardia, fatigue, hypotension, dizziness, depression, impotence, exacerbate Raynaud's
Beta-1 Selective Beta-Blocker with Nitric Oxide dependent vasodilation✔ANS-Nebivolol
(Bystolic)
*same as Beta-1 blockers, except:
CI: severe liver impairment
fatigue, nausea, inc TG, dec HDL
Beta-1 and Beta-2 Blockers (Non-Selective)✔ANS-Propranolol (Inderal LA, Inderal XL): high lipid
solubility, more CNS effects
Nadolol (Corgard)
,Pindolol
Timolol
*same as beta-1 selective and non-selective, plus:
used in portal hypertension
Non-Selective Beta-Blocker and Alpha-1 Blockers✔ANS-Carvedilol (Coreg, Coreg CR): take with
food
Labetalol: drug of choice in pregnancy, dizziness
- major CYP2D6 substrate, PGP inhibitor
*same as beta-1 selective and non-selective, plus:
CI: severe hepatic impairment
Centrally-acting alpha-2 adrenergic agonists✔ANS-Clonidine (Catapres, Catapres-TTS)
- resistant htn and patients that cannot swallow
- oral
- patch (change weekly, remove prior to MRI)
- Kapvay (for ADHD)
Guanfacine ER (Intuniv)
- for ADHD
Methyldopa (tablet, injection)
- preferred in pregnancy
- DILE
- CI with MAOis
,- risk for hemolytic anemia
All:
- do not abruptly discontinue; must taper
- dry mouth, somnolence, fatigue, constipation, decreased HR
Direct Vasodilators✔ANS-Hydralazine (tablet, injection)
- DILE
- peripheral edema, headache, flushing, palpitations, reflex tachycardia, N/V
Minoxidil
- potent - administer with beta blocker and loop diuretic
- fluid retention, tachycardia, hair growth
Alpha-Blockers✔ANS-Not recommended for hypertension, but may be used in men with HTN
and BPH
Doxazosin, prazosin, terazosin
Hypertensive Crisis✔ANS-Rapidly accelerating BP: >/= 180/120 mmHg
Emergency: acute target organ damage
- treat with IV medications
- decrease BP by no more than 25% in first hour, then if stable, decrease to 160/100 in the next
2-6 hours
Urgency: no evidence of acute target organ damage
- treat with PO medications
, - decrease BP gradually over 24-48 hours
Key IV hypertension medications✔ANS-Chlorothiazide
Clevidipine
Diltiazem
Enalaprilat
Esmolol
Hydralazine
Labetalol
Metoprolol tartrate
Nicardipine
Nitroglycerin
Nitroprusside
Propranolol
Verapamil
SIADH treatment✔ANS-Non-drug:
- BMI 18.5-24.9
- waste circumference <35 inches (females), <40 inches (males)
- 30-60 mins moderate-intensity aerobic activity 5-7 days per week
Drug:
A- Antiplatelet and antianginal drugs
B- Blood pressure and beta-blockers
C- Cholesterol (statins) and cigarettes (cessation)
D- Diet and diabetes
E- Exercise and education
CORRECT| GRADED A+|100% PASS
Beta-Blockers✔ANS-No longer recommended first line for HTN unless patient has a comorbid
condition with BB indication
Beta-1 Selective Beta-Blockers✔ANS-Atenolol (Tenormin)
Esmolol (Brevibloc): injection
Metoprolol tartrate (Lopressor): take after food
- IV:PO is 1:2.5
Metoprolol succinate (Toprol XL): take after food
BBW: do not d/c abruptly, taper over 1-2 weeks
warnings: may mask hypoglycemia, may worsen hyperglycemia/hypoglycemia in diabetes,
caution with bronchospastic diseases (beta-1 selective preferred)
bradycardia, fatigue, hypotension, dizziness, depression, impotence, exacerbate Raynaud's
Beta-1 Selective Beta-Blocker with Nitric Oxide dependent vasodilation✔ANS-Nebivolol
(Bystolic)
*same as Beta-1 blockers, except:
CI: severe liver impairment
fatigue, nausea, inc TG, dec HDL
Beta-1 and Beta-2 Blockers (Non-Selective)✔ANS-Propranolol (Inderal LA, Inderal XL): high lipid
solubility, more CNS effects
Nadolol (Corgard)
,Pindolol
Timolol
*same as beta-1 selective and non-selective, plus:
used in portal hypertension
Non-Selective Beta-Blocker and Alpha-1 Blockers✔ANS-Carvedilol (Coreg, Coreg CR): take with
food
Labetalol: drug of choice in pregnancy, dizziness
- major CYP2D6 substrate, PGP inhibitor
*same as beta-1 selective and non-selective, plus:
CI: severe hepatic impairment
Centrally-acting alpha-2 adrenergic agonists✔ANS-Clonidine (Catapres, Catapres-TTS)
- resistant htn and patients that cannot swallow
- oral
- patch (change weekly, remove prior to MRI)
- Kapvay (for ADHD)
Guanfacine ER (Intuniv)
- for ADHD
Methyldopa (tablet, injection)
- preferred in pregnancy
- DILE
- CI with MAOis
,- risk for hemolytic anemia
All:
- do not abruptly discontinue; must taper
- dry mouth, somnolence, fatigue, constipation, decreased HR
Direct Vasodilators✔ANS-Hydralazine (tablet, injection)
- DILE
- peripheral edema, headache, flushing, palpitations, reflex tachycardia, N/V
Minoxidil
- potent - administer with beta blocker and loop diuretic
- fluid retention, tachycardia, hair growth
Alpha-Blockers✔ANS-Not recommended for hypertension, but may be used in men with HTN
and BPH
Doxazosin, prazosin, terazosin
Hypertensive Crisis✔ANS-Rapidly accelerating BP: >/= 180/120 mmHg
Emergency: acute target organ damage
- treat with IV medications
- decrease BP by no more than 25% in first hour, then if stable, decrease to 160/100 in the next
2-6 hours
Urgency: no evidence of acute target organ damage
- treat with PO medications
, - decrease BP gradually over 24-48 hours
Key IV hypertension medications✔ANS-Chlorothiazide
Clevidipine
Diltiazem
Enalaprilat
Esmolol
Hydralazine
Labetalol
Metoprolol tartrate
Nicardipine
Nitroglycerin
Nitroprusside
Propranolol
Verapamil
SIADH treatment✔ANS-Non-drug:
- BMI 18.5-24.9
- waste circumference <35 inches (females), <40 inches (males)
- 30-60 mins moderate-intensity aerobic activity 5-7 days per week
Drug:
A- Antiplatelet and antianginal drugs
B- Blood pressure and beta-blockers
C- Cholesterol (statins) and cigarettes (cessation)
D- Diet and diabetes
E- Exercise and education
