Pharmacy - Antihypertensives

1. Increased blood pressure causes damage to the brain, heart and kidneys

True

False

2. Patients taking Verapamil (Calan) should be aware of its increased side effect profile and its negative inotropic effects

True

False

3. Moexipril (Univasc), Perindopril (Aceon), Quinapril (Accupril) and Trandolapril (Mavik) belong to which class of drugs

Peripheral Acting Sympatholytics

Direct Vasodilators

Angiotension II Receptor Blockers

ACE Inhibitors

Selective Renin Inhibitors

4. Amlodipine (Norvasc), Nicardipine (Cardene), Nisoldipine (Sular) and Clevidipine (Cleviprex) are in which class of drugs?

Non-Selective Beta Blockers

Peripherally acting sympatholytics

Dihydropyridines Calcium Channel Blockers

Selective Beta-1 Blockers

ACE inhibitors

5. Candesartan (Atacand), Losartan (Cozaar), Olmesartan (Benicar) and Valsartan (Diovan) belong to which class of drugs?

Selective Renin Inhibitors

Angiontension-II Receptor Blockers

Dihydropyridine Calcium Channel Blockers

Non-Selective Beta Blockers

ACE Inhibitors

6. Direct Vasodilators are reserved for urgent to emergent HTN

True

False

7. ACE Inhibitors are the Drugs of choice for patients with both HTN and CHF

True

False

8. Increasing dosage of Hydrochlorothiazide is the best method to help patients with increased need for Blood pressure control

True

False

Thiazides have ceiling effect and the BP lowering effects are usually not dose related

Explanation

Thiazides have ceiling effect and the BP lowering effects are usually not dose related

9. Guanafacine(Tenex), Clonidine (Catapres), Guanabenz (Wytensin), Methyldopa (Aldomet) belong to which class of drugs?

Peripheral acting sympatholytics

Direct vasodilators

Cardiac glycosides

Central acting sympatholytics

10. Which of the following drugs is a Selective Renin Inhibitor?

Hydralazine (Apresoline)

Aliskiren (Tekturna)

Benaprezil (Lotensin)

Losartan (Cozaar)

11. Before administering Doxazosin (Cardura) it is necessary to rule out Prostate Cancer for your differential diagnosis.

True

False

12. According to the Frank-Starling Law, as preload increases the stroke volume decreases

True

False

13. Acebutolol (Sectral), Betaxolol (Kerlone) and Nebivolol (Bystolic) are which class of drug?

Non Selective Beta Blockers

Selective Beta-1 Blockers

Angiotension II Receptor Blockers

ACE Inhibitors

14. Non-dyhydropyridine Calcium Channel Blockers include which of the following drugs?

Diltiazem (Cardizem) and Clevidipine (Cleviprex)

Verapamil (Calan) and Diltiazem (Cardizem)

Isradypine (Dynacirc) and Verapamil (Calan)

All of the above

15. Which of the following drugs inhibit Calcium influx into vascular smooth muscle and cardiac myocites

Nisoldipine (Sular)

Hydralazine (Apresoline)

Aliskiren (tekturna)

Nitroprusside (Nitropress)

16. Which of the following is true about vasodilators

Nitroprusside(nitropress) may cause cyanide poisoning

Have been used to treat Baldness

Should not be used for prolonged therapy

All of the above

17. 20 y/o female presents with HTN. has no past history of gout or diabetes and is currently on no other drugs. Family history reveals HTN in mother before 65 and father before 55. All labs are normal, pregnancy test is positive. Physical exam is unremarkable. Pt. has no known allergies and is a non smoker. Which of the following drugs would be the recommended treatment?

Hydrochlorothiazide 12.5-50 mg qd

Doxazosin (Cardura) 4-8mg/d max 8mg/d

Atenolol(Tenormin) 50mg qd, max 100mg/day

Methyldopa (Aldomet) 250-500mg bid

Valsartan (Diovan) 80-160mg qd 320 max

18. Angiotension II receptor Blockers prohibit the conversion of Angiotension-1 to Angiotension-2

True

False

they only block aangiotension-II receptors

Explanation

they only block aangiotension-II receptors

19. Which of the following drugs should not be prescribed to pregnant women?

Enalapril (Vasotec)

Valsartan (Diovan)

Aliskiren (Tekturna)

All of the Above

A & B

20. Which of the following is not true about Hydralazine (Apresoline)

Available PO IV IM

Dosage is 10mg qid X 2-4 days

May cause lupus or angina

Is first line for CHF pts with HTN

21. Which of the following has a high side effect profile and ceiling effect

Thiazides

Sympatholytics

Calcium Channel Blockers

None of the above

22. Which of the following drugs may cause orthodstatic hypotension on the first dose?

Hydrochlorothiazide

Prazosin (Minpress)

Amlodipine (Norvasc)

Atenolol (Tenormin)

23. Amlodipine (Norvasc) is indicated for Unstable angina.

True

False

Norvasc is contraindicated for unstable angina but indicated for stable angina

Explanation

Norvasc is contraindicated for unstable angina but indicated for stable angina

24. A patient presents with HTN and BPH. Is currently on no other medications and has no known allergies. No past history of gout or diabetes and all labs are normal. which of the following drugs will be the most useful in treatment of this patient?

Hydrochlorothiazide

Doxazosin (cardura)

Esmolol (Becibloc)

Carvedilol (Coreg)

cardura has both HTN and BPH therapeutic effects

Explanation

cardura has both HTN and BPH therapeutic effects

25. Which of the following prescriptions would be appropriate HTN dosing for Diltiazem (Cardizem)

120-240mg qd max 360mg qd

12.5-50mg qd

4-8mg qd max 8mg qd

1mg qd titrate up to 16mg

26. Which of the following statistics about HTN is true?

10% of HTN patients have essential hypertension

Hypertension presents with severe acute symptoms

African Americans and middle aged males are most likely to be affected

A & C

90% have essential (unknown cause), 10% have identifiable cause

Explanation

90% have essential (unknown cause), 10% have identifiable cause

27. Baroreflexes and the Renin-Angiotension-Aldosterone System function in the short-term control of blood pressure

True

False

28. Which of the following drugs have renal protective effects in patients with diabetes and slows progression of LVH post MI?

Aliskiren (Tekturna)

Nitroprusside (Nitropress)

Benaprezil (Lotensin)

A & B

ACE inhibitors have these effects

Explanation

ACE inhibitors have these effects

29. Pt presents with HTN and PMH of AV Block and Sick Sinus Syndrome. Which of the following drugs are contraindicated?

Hydrochlorothiazide

Diltiazem (Cadizem)

Amlodipine (Norvasc)

Enalapril (Vasotec)

Atenolol (Tenormin) is also contraindicated for AV block and Sinus bradycardia

Explanation

Atenolol (Tenormin) is also contraindicated for AV block and Sinus bradycardia

30. A patient may experience rebound HTN if they abruptly stop using which of the following drugs?

Terazosin (Hytrin)

Methyldopa (Aldomet)

Enalapril (vasotec)

Fosinopril (Monopril)

31. Preload is....?

The force against which the heart must pump blood out

Pressure from blood returning to ventricles prior to contraction

Increase in volume within the vascular system in response to pressure increase

Volume of blood pumped out by each ventricle in one contraction

None of the above

A= afterload
B= preload
C= compliance
D= stroke volume

Explanation

A= afterload
B= preload
C= compliance
D= stroke volume

32. Which of the following HTN medications would be indicated post MI

Diltiazem (Cardizem)

Atenolol (Tenormin)

Analapril (Vasotec)

B & C

33. Which of the following would not be a risk factor for developing Cardiovascular Disease

Hypertension

Diabetes Mellitus

Family History of CVD in Men over 55 and women over 65

Cigarette smoking

Being a male over 55 or a female over 65

34. 35 y/o african american female presents with HTN. Past medical history shows hepatic disease and anemia but no history of gout or diabetes. Has two children and no FH of premature HTN. You recommend them Oral Fe supplements and order liver function tests. Which of the following methods is best to treat their HTN?

Methyldopa (Aldomet) 250-500 mg bid

Doxazosin (cardura) 1mg/ day but can titrate up to 16mg/day

Diltiazem (Cardizem) 120-240 mg/day, 360mg/day max

Atenolol (Tenormin) 50mg qd max 100mg qd

methyldopa is contraindicated in active hepatic disease and has drug inter Rx with oral Fe+
Cardura is contraindicated in impaired liver function
Diltiazem a CCB is a better choice for African Americans

Explanation

methyldopa is contraindicated in active hepatic disease and has drug inter Rx with oral Fe+
Cardura is contraindicated in impaired liver function
Diltiazem a CCB is a better choice for African Americans

35. A patient taking Verapamil (Calan), Cimetadine (Tagamet) or Sildenafil (Viagra) should take precautions when taking which of the following medications?

Hydralazine (Apresoline)

Doxazosin (Cardura)

Valsartan (Diovan)

Trandolapril (Mavik)

36. 28 y/o female presents with HTN and CHF. ROS reveals essential tremor and performance anxiety but no history of respiratory problems or depression. The patient is a newlywed and is currently taking Hydochlorothiazide and Methyldopa(Aldomet). Which of the following drugs may be a better choice.

Nadolol (Corgard)

Enalapril (Vasotec)

Valsartan (Diovan)

Sildenafil (Viagra)

Corgard covers all problems.
Vasotec and Diovan are contraindicated in pregnancy and the patient may want to have children.

Explanation

Corgard covers all problems.
Vasotec and Diovan are contraindicated in pregnancy and the patient may want to have children.

37. 35 y/o male HTN patient presents for follow up. PE reveals gynecomastia and peripheral edema. Which drug is the patient most likely to have been taking?

Diltiazam (Cardizem)

Amlodipine (Norvasc)

Minoxidil (Viagra)

Ramipril (Altace)

38. A 35 y/o female presents with HTN, no H/O diabetes or gout. Has one child delivered by c-section and is currently on Birth control and Dofetilide. All labs were normal and Physical exam was unremarkable. Patient has no allergies. Which of the following medications are contraindicated?

Methyldopa (Aldomet)

Hydrochlorothiazide

Doxazosin (Cardura)

Minoxidil (Rogaine)

39. Which of the following effects are not consistent with an increase in Angiotension-II levels?

Decreased secretion of ADH

Increased thirst

Decreased fluid loss

Increased Aldosterone

A & C

40. A newly wed 25 y/o male presents with HTN. Which of the following drugs may prevent him from being able to have children?

Methyldopa (Aldomet)

Atenolol (Tenormin)

Minoxidil(Rogaine)

All of the above

A & B

Atenolol causes impotence

Explanation

Atenolol causes impotence

41. Which of the following presentations is not consistent with a diagnosis of pheochromocytoma?

Severe HTN

Hypertensive retinopathy

Hypogylcemia /hypocalcemia

Weightloss

42. Which of the following describes Hydrochlorothiazide?

Decreases preload by decreasing Na+ and H20 loss

Causes hyperglycemia and hyperuricemia

Usual dosage of 4-8mg/day , max 8mg/day

All of the above

B & C

promotes Na+ and H2O loss by inhibiting Na+ and Cl- reabsorption
usual dose is 12.5- 50mg qd

Explanation

promotes Na+ and H2O loss by inhibiting Na+ and Cl- reabsorption
usual dose is 12.5- 50mg qd

43. 40 y/o male presents with HTN and chonic headaches. convenient tx would include which of the following?

Nifedipine (Procardia)

Penbutolol (Levatol)

Acebutolol (Sectral)

Any of the above

Methyldopa (Aldomet)

44. Which of the following are least likely to cause HTN

Sleep apnea

Renovascular disease

Coarctation of the aorta

Congestive heart failure

Pheochromocytoma

congestive heart failure is a result of HTN not a cause

Explanation

congestive heart failure is a result of HTN not a cause

45. A patient has recently developed HTN. Which of the following treatments are most appropriate at this stage of Tx?

Diuretics: Hydrochlorothiazide 12.5-50mg/d

Restrict sodium intake to 20-24g per day

Maintain BMI of 18.5-24.9 with DASH diet

ACE Inhibitor + Diuretic Combination treatment

All of the above

46. Which of the following is Diltiazem (Cardizem) least likely to have a significant interaction with?

Tagamet

Propanolol (Inderal)

Digitalis

Doxazosin (Cardura)

47. Which of the following is true about Valsartan (Diovan)

HTN DOSE: 80-160mg qd PO max 320

Often paired with potassium sparing diuretics

Adverse effects include neutrophilia and viral infections

All of the above

A & C

48. Which of the following drugs have an adverse effect of orthostatic hypotension or hypotentinsion?

Doxazosin (Cardura)

Methyldopa (Aldomet)

Atenolol (Tenormin)

All of the above

A & C

Pharmacy - Antihypertensives

1. Increased blood pressure causes damage to the brain, heart and kidneys

2.

What first name or nickname would you like us to use?

2. Patients taking Verapamil (Calan) should be aware of its increased side effect profile and its negative inotropic effects

3. Moexipril (Univasc), Perindopril (Aceon), Quinapril (Accupril) and Trandolapril (Mavik) belong to which class of drugs

4. Amlodipine (Norvasc), Nicardipine (Cardene), Nisoldipine (Sular) and Clevidipine (Cleviprex) are in which class of drugs?

5. Candesartan (Atacand), Losartan (Cozaar), Olmesartan (Benicar) and Valsartan (Diovan) belong to which class of drugs?

6. Direct Vasodilators are reserved for urgent to emergent HTN

7. ACE Inhibitors are the Drugs of choice for patients with both HTN and CHF

8. Increasing dosage of Hydrochlorothiazide is the best method to help patients with increased need for Blood pressure control

9. Guanafacine(Tenex), Clonidine (Catapres), Guanabenz (Wytensin), Methyldopa (Aldomet) belong to which class of drugs?

10. Which of the following drugs is a Selective Renin Inhibitor?

11. Before administering Doxazosin (Cardura) it is necessary to rule out Prostate Cancer for your differential diagnosis.

12. According to the Frank-Starling Law, as preload increases the stroke volume decreases

13. Acebutolol (Sectral), Betaxolol (Kerlone) and Nebivolol (Bystolic) are which class of drug?

14. Non-dyhydropyridine Calcium Channel Blockers include which of the following drugs?

15. Which of the following drugs inhibit Calcium influx into vascular smooth muscle and cardiac myocites

16. Which of the following is true about vasodilators

18. Angiotension II receptor Blockers prohibit the conversion of Angiotension-1 to Angiotension-2

19. Which of the following drugs should not be prescribed to pregnant women?

20. Which of the following is not true about Hydralazine (Apresoline)

21. Which of the following has a high side effect profile and ceiling effect

22. Which of the following drugs may cause orthodstatic hypotension on the first dose?

23. Amlodipine (Norvasc) is indicated for Unstable angina.

24. A patient presents with HTN and BPH. Is currently on no other medications and has no known allergies. No past history of gout or diabetes and all labs are normal. which of the following drugs will be the most useful in treatment of this patient?

25. Which of the following prescriptions would be appropriate HTN dosing for Diltiazem (Cardizem)

26. Which of the following statistics about HTN is true?

27. Baroreflexes and the Renin-Angiotension-Aldosterone System function in the short-term control of blood pressure

28. Which of the following drugs have renal protective effects in patients with diabetes and slows progression of LVH post MI?

29. Pt presents with HTN and PMH of AV Block and Sick Sinus Syndrome. Which of the following drugs are contraindicated?

30. A patient may experience rebound HTN if they abruptly stop using which of the following drugs?

31. Preload is....?

32. Which of the following HTN medications would be indicated post MI

33. Which of the following would not be a risk factor for developing Cardiovascular Disease

35. A patient taking Verapamil (Calan), Cimetadine (Tagamet) or Sildenafil (Viagra) should take precautions when taking which of the following medications?

36. 28 y/o female presents with HTN and CHF. ROS reveals essential tremor and performance anxiety but no history of respiratory problems or depression. The patient is a newlywed and is currently taking Hydochlorothiazide and Methyldopa(Aldomet). Which of the following drugs may be a better choice.

37. 35 y/o male HTN patient presents for follow up. PE reveals gynecomastia and peripheral edema. Which drug is the patient most likely to have been taking?

38. A 35 y/o female presents with HTN, no H/O diabetes or gout. Has one child delivered by c-section and is currently on Birth control and Dofetilide. All labs were normal and Physical exam was unremarkable. Patient has no allergies. Which of the following medications are contraindicated?

39. Which of the following effects are not consistent with an increase in Angiotension-II levels?

40. A newly wed 25 y/o male presents with HTN. Which of the following drugs may prevent him from being able to have children?

41. Which of the following presentations is not consistent with a diagnosis of pheochromocytoma?

42. Which of the following describes Hydrochlorothiazide?

43. 40 y/o male presents with HTN and chonic headaches. convenient tx would include which of the following?

44. Which of the following are least likely to cause HTN

45. A patient has recently developed HTN. Which of the following treatments are most appropriate at this stage of Tx?

46. Which of the following is Diltiazem (Cardizem) least likely to have a significant interaction with?

47. Which of the following is true about Valsartan (Diovan)

48. Which of the following drugs have an adverse effect of orthostatic hypotension or hypotentinsion?