EXAM QUESTIONS & ANSWERS
LATEST VERSION
Hypertension - correct answer ✔✔Underlying vascular dysfunction that leads to end organ
damage
Brain, heart, eyes, kidneys
Thiazide diuretics are preferred agent for ___ - correct answer ✔✔Stage 1 HTN; preferred initial
therapy for African Americans
Mechanism of action: Diuretics - correct answer ✔✔Decrease blood volume, venous pressure,
and preload
Mechanism of action: Thiazide diuretics - correct answer ✔✔Block Na-Cl channel in kidneys
Decreased Na > decreased Na-K+ pump = increased urine output
Thiazide diuretics considerations - correct answer ✔✔Monitor K+ and other electrolytes
Contain sulfa
Can be used in osteoporosis-decreases Ca+ loss in bones
Medications: Thiazide diuretics - correct answer ✔✔HCTZ
Hygotron (chlorthalidone)
Lozol (indapamide)
,Side effects: Thiazide diuretics - correct answer ✔✔Hyperglycemia, hyperuricemia,
hyperlipidemia
Hypokalemia, hyponatremia, hypomagensemia
Contraindications: Thiazide diuretics - correct answer ✔✔Sulfa sensitivity/allergy
Thiazide sensitivity/allergy
4 factors that influence drug selection - correct answer ✔✔1. Special populations
(pregnant/nursing/older adult)
2. Hepatic/renal function
3. Drug interactions
4. Allergies
Mechanism of action: ACEIs and ARBs - correct answer ✔✔Block conversion of angiotensin I to
II
Results in vasoconstriction
Drug of choice for DM/CKD due to renal protection
Side effects: ACEIs and ARBs - correct answer ✔✔Dry cough-10% with ACEIs, less with ARBs
Hyperkalemia
Angioedema (rare)
Contraindications: ACEIs and ARBs - correct answer ✔✔Moderate-severe kidney disease
(monitor GFR)
Renal artery stenosis
Acute renal failure
Pregnancy category C/1st and D/2nd trimester (fetal kidney malformation + hypotension)
, HTN medications to avoid in African-Americans - correct answer ✔✔ACEIs and ARBs
Mechanism of action: Calcium channel blockers - correct answer ✔✔Vasodilation by blocking
voltage-gated Ca++ channels in cardiac smooth muscle and blood vessels
Inotropic effect: heart is depressed
Chronotropic effect: heart is slowed down
Side effects: Calcium channel blockers - correct answer ✔✔Due to vasodilation:
Headache
Ankle edema
Heart block/bradycardia due to depressed cardiac muscle and av node
Contraindications: Calcium channel blockers - correct answer ✔✔Due to inotropic/chronotropic
effects:
2nd and 3rd degree heart block
bradycardia
CHF
Medications: Calcium channel blockers - correct answer ✔✔"Pine"
Nifedipine (Procardia XL)
Amlodipine (Norvasc)
Felodipine (Plendil)
Preferred HTN medication for African Americans - correct answer ✔✔Calcium channel blockers
Order HTN medications are typically prescribed - correct answer ✔✔Thiazide diuretics