Pharmacy - Antihypertensives
In the study of drugs, the term “antihypertensive” refers to a class of drug which are used to treat high blood pressure, which is also known as hypertension. What can you tell us about these kinds of narcotics?
- 1.
Which of the following statistics about HTN is true?
- A.
10% of HTN patients have essential hypertension
- B.
Hypertension presents with severe acute symptoms
- C.
African Americans and middle aged males are most likely to be affected
- D.
A & C
Correct Answer
C. African Americans and middle aged males are most likely to be affectedExplanation
90% have essential (unknown cause), 10% have identifiable causeRate this question:
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- 2.
Increased blood pressure causes damage to the brain, heart and kidneys
- A.
True
- B.
False
Correct Answer
A. True -
- 3.
Which of the following would not be a risk factor for developing Cardiovascular Disease
- A.
Hypertension
- B.
Diabetes Mellitus
- C.
Family History of CVD in Men over 55 and women over 65
- D.
Cigarette smoking
- E.
Being a male over 55 or a female over 65
Correct Answer
C. Family History of CVD in Men over 55 and women over 65 -
- 4.
A patient has recently developed HTN. Which of the following treatments are most appropriate at this stage of Tx?
- A.
Diuretics: Hydrochlorothiazide 12.5-50mg/d
- B.
Restrict sodium intake to 20-24g per day
- C.
Maintain BMI of 18.5-24.9 with DASH diet
- D.
ACE Inhibitor + Diuretic Combination treatment
- E.
All of the above
Correct Answer
C. Maintain BMI of 18.5-24.9 with DASH diet -
- 5.
Which of the following are least likely to cause HTN
- A.
Sleep apnea
- B.
Renovascular disease
- C.
Coarctation of the aorta
- D.
Congestive heart failure
- E.
Pheochromocytoma
Correct Answer
D. Congestive heart failureExplanation
congestive heart failure is a result of HTN not a causeRate this question:
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- 6.
Preload is....?
- A.
The force against which the heart must pump blood out
- B.
Pressure from blood returning to ventricles prior to contraction
- C.
Increase in volume within the vascular system in response to pressure increase
- D.
Volume of blood pumped out by each ventricle in one contraction
- E.
None of the above
Correct Answer
B. Pressure from blood returning to ventricles prior to contractionExplanation
A= afterload
B= preload
C= compliance
D= stroke volumeRate this question:
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- 7.
According to the Frank-Starling Law, as preload increases the stroke volume decreases
- A.
True
- B.
False
Correct Answer
B. False -
- 8.
Baroreflexes and the Renin-Angiotension-Aldosterone System function in the short-term control of blood pressure
- A.
True
- B.
False
Correct Answer
B. False -
- 9.
Which of the following effects are not consistent with an increase in Angiotension-II levels?
- A.
Decreased secretion of ADH
- B.
Increased thirst
- C.
Decreased fluid loss
- D.
Increased Aldosterone
- E.
A & C
Correct Answer
A. Decreased secretion of ADH -
- 10.
Which of the following has a high side effect profile and ceiling effect
- A.
Thiazides
- B.
Sympatholytics
- C.
Calcium Channel Blockers
- D.
None of the above
Correct Answer
A. Thiazides -
- 11.
Increasing dosage of Hydrochlorothiazide is the best method to help patients with increased need for Blood pressure control
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Thiazides have ceiling effect and the BP lowering effects are usually not dose relatedRate this question:
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- 12.
Which of the following describes Hydrochlorothiazide?
- A.
Decreases preload by decreasing Na+ and H20 loss
- B.
Causes hyperglycemia and hyperuricemia
- C.
Usual dosage of 4-8mg/day , max 8mg/day
- D.
All of the above
- E.
B & C
Correct Answer
B. Causes hyperglycemia and hyperuricemiaExplanation
promotes Na+ and H2O loss by inhibiting Na+ and Cl- reabsorption
usual dose is 12.5- 50mg qdRate this question:
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- 13.
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?
- A.
Methyldopa (Aldomet)
- B.
Hydrochlorothiazide
- C.
Doxazosin (Cardura)
- D.
Minoxidil (Rogaine)
Correct Answer
B. Hydrochlorothiazide -
- 14.
Guanafacine(Tenex), Clonidine (Catapres), Guanabenz (Wytensin), Methyldopa (Aldomet) belong to which class of drugs?
- A.
Peripheral acting sympatholytics
- B.
Direct vasodilators
- C.
Cardiac glycosides
- D.
Central acting sympatholytics
Correct Answer
D. Central acting sympatholytics -
- 15.
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?
- A.
Hydrochlorothiazide 12.5-50 mg qd
- B.
Doxazosin (Cardura) 4-8mg/d max 8mg/d
- C.
Atenolol(Tenormin) 50mg qd, max 100mg/day
- D.
Methyldopa (Aldomet) 250-500mg bid
- E.
Valsartan (Diovan) 80-160mg qd 320 max
Correct Answer
D. Methyldopa (Aldomet) 250-500mg bid -
- 16.
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?
- A.
Methyldopa (Aldomet) 250-500 mg bid
- B.
Doxazosin (cardura) 1mg/ day but can titrate up to 16mg/day
- C.
Diltiazem (Cardizem) 120-240 mg/day, 360mg/day max
- D.
Atenolol (Tenormin) 50mg qd max 100mg qd
Correct Answer
C. Diltiazem (Cardizem) 120-240 mg/day, 360mg/day maxExplanation
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 AmericansRate this question:
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- 17.
Which of the following drugs may cause orthodstatic hypotension on the first dose?
- A.
Hydrochlorothiazide
- B.
Prazosin (Minpress)
- C.
Amlodipine (Norvasc)
- D.
Atenolol (Tenormin)
Correct Answer
B. Prazosin (Minpress) -
- 18.
A patient may experience rebound HTN if they abruptly stop using which of the following drugs?
- A.
Terazosin (Hytrin)
- B.
Methyldopa (Aldomet)
- C.
Enalapril (vasotec)
- D.
Fosinopril (Monopril)
Correct Answer
B. Methyldopa (Aldomet) -
- 19.
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?
- A.
Hydrochlorothiazide
- B.
Doxazosin (cardura)
- C.
Esmolol (Becibloc)
- D.
Carvedilol (Coreg)
Correct Answer
B. Doxazosin (cardura)Explanation
cardura has both HTN and BPH therapeutic effectsRate this question:
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- 20.
Which of the following drugs have an adverse effect of orthostatic hypotension or hypotentinsion?
- A.
Doxazosin (Cardura)
- B.
Methyldopa (Aldomet)
- C.
Atenolol (Tenormin)
- D.
All of the above
- E.
A & C
Correct Answer
D. All of the above -
- 21.
Before administering Doxazosin (Cardura) it is necessary to rule out Prostate Cancer for your differential diagnosis.
- A.
True
- B.
False
Correct Answer
A. True -
- 22.
A patient taking Verapamil (Calan), Cimetadine (Tagamet) or Sildenafil (Viagra) should take precautions when taking which of the following medications?
- A.
Hydralazine (Apresoline)
- B.
Doxazosin (Cardura)
- C.
Valsartan (Diovan)
- D.
Trandolapril (Mavik)
Correct Answer
B. Doxazosin (Cardura) -
- 23.
Non-dyhydropyridine Calcium Channel Blockers include which of the following drugs?
- A.
Diltiazem (Cardizem) and Clevidipine (Cleviprex)
- B.
Verapamil (Calan) and Diltiazem (Cardizem)
- C.
Isradypine (Dynacirc) and Verapamil (Calan)
- D.
All of the above
Correct Answer
B. Verapamil (Calan) and Diltiazem (Cardizem) -
- 24.
40 y/o male presents with HTN and chonic headaches. convenient tx would include which of the following?
- A.
Nifedipine (Procardia)
- B.
Penbutolol (Levatol)
- C.
Acebutolol (Sectral)
- D.
Any of the above
- E.
Methyldopa (Aldomet)
Correct Answer
D. Any of the above -
- 25.
Amlodipine (Norvasc), Nicardipine (Cardene), Nisoldipine (Sular) and Clevidipine (Cleviprex) are in which class of drugs?
- A.
Non-Selective Beta Blockers
- B.
Peripherally acting sympatholytics
- C.
Dihydropyridines Calcium Channel Blockers
- D.
Selective Beta-1 Blockers
- E.
ACE inhibitors
Correct Answer
C. Dihydropyridines Calcium Channel Blockers -
- 26.
Which of the following drugs inhibit Calcium influx into vascular smooth muscle and cardiac myocites
- A.
Nisoldipine (Sular)
- B.
Hydralazine (Apresoline)
- C.
Aliskiren (tekturna)
- D.
Nitroprusside (Nitropress)
Correct Answer
A. Nisoldipine (Sular) -
- 27.
Patients taking Verapamil (Calan) should be aware of its increased side effect profile and its negative inotropic effects
- A.
True
- B.
False
Correct Answer
A. True -
- 28.
Which of the following prescriptions would be appropriate HTN dosing for Diltiazem (Cardizem)
- A.
120-240mg qd max 360mg qd
- B.
12.5-50mg qd
- C.
4-8mg qd max 8mg qd
- D.
1mg qd titrate up to 16mg
Correct Answer
A. 120-240mg qd max 360mg qd -
- 29.
Which of the following is Diltiazem (Cardizem) least likely to have a significant interaction with?
- A.
Tagamet
- B.
Propanolol (Inderal)
- C.
Digitalis
- D.
Doxazosin (Cardura)
Correct Answer
D. Doxazosin (Cardura) -
- 30.
Pt presents with HTN and PMH of AV Block and Sick Sinus Syndrome. Which of the following drugs are contraindicated?
- A.
Hydrochlorothiazide
- B.
Diltiazem (Cadizem)
- C.
Amlodipine (Norvasc)
- D.
Enalapril (Vasotec)
Correct Answer
B. Diltiazem (Cadizem)Explanation
Atenolol (Tenormin) is also contraindicated for AV block and Sinus bradycardiaRate this question:
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- 31.
Amlodipine (Norvasc) is indicated for Unstable angina.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Norvasc is contraindicated for unstable angina but indicated for stable anginaRate this question:
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- 32.
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?
- A.
Diltiazam (Cardizem)
- B.
Amlodipine (Norvasc)
- C.
Minoxidil (Viagra)
- D.
Ramipril (Altace)
Correct Answer
B. Amlodipine (Norvasc) -
- 33.
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.
- A.
Nadolol (Corgard)
- B.
Enalapril (Vasotec)
- C.
Valsartan (Diovan)
- D.
Sildenafil (Viagra)
Correct Answer
A. Nadolol (Corgard)Explanation
Corgard covers all problems.
Vasotec and Diovan are contraindicated in pregnancy and the patient may want to have children.Rate this question:
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- 34.
Acebutolol (Sectral), Betaxolol (Kerlone) and Nebivolol (Bystolic) are which class of drug?
- A.
Non Selective Beta Blockers
- B.
Selective Beta-1 Blockers
- C.
Angiotension II Receptor Blockers
- D.
ACE Inhibitors
Correct Answer
B. Selective Beta-1 Blockers -
- 35.
Which of the following HTN medications would be indicated post MI
- A.
Diltiazem (Cardizem)
- B.
Atenolol (Tenormin)
- C.
Analapril (Vasotec)
- D.
B & C
Correct Answer
D. B & C -
- 36.
A newly wed 25 y/o male presents with HTN. Which of the following drugs may prevent him from being able to have children?
- A.
Methyldopa (Aldomet)
- B.
Atenolol (Tenormin)
- C.
Minoxidil(Rogaine)
- D.
All of the above
- E.
A & B
Correct Answer
B. Atenolol (Tenormin)Explanation
Atenolol causes impotenceRate this question:
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- 37.
Which of the following drugs have renal protective effects in patients with diabetes and slows progression of LVH post MI?
- A.
Aliskiren (Tekturna)
- B.
Nitroprusside (Nitropress)
- C.
Benaprezil (Lotensin)
- D.
A & B
Correct Answer
C. Benaprezil (Lotensin)Explanation
ACE inhibitors have these effectsRate this question:
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- 38.
ACE Inhibitors are the Drugs of choice for patients with both HTN and CHF
- A.
True
- B.
False
Correct Answer
A. True -
- 39.
Moexipril (Univasc), Perindopril (Aceon), Quinapril (Accupril) and Trandolapril (Mavik) belong to which class of drugs
- A.
Peripheral Acting Sympatholytics
- B.
Direct Vasodilators
- C.
Angiotension II Receptor Blockers
- D.
ACE Inhibitors
- E.
Selective Renin Inhibitors
Correct Answer
D. ACE Inhibitors -
- 40.
Which of the following drugs should not be prescribed to pregnant women?
- A.
Enalapril (Vasotec)
- B.
Valsartan (Diovan)
- C.
Aliskiren (Tekturna)
- D.
All of the Above
- E.
A & B
Correct Answer
D. All of the Above -
- 41.
Angiotension II receptor Blockers prohibit the conversion of Angiotension-1 to Angiotension-2
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
they only block aangiotension-II receptorsRate this question:
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- 42.
Candesartan (Atacand), Losartan (Cozaar), Olmesartan (Benicar) and Valsartan (Diovan) belong to which class of drugs?
- A.
Selective Renin Inhibitors
- B.
Angiontension-II Receptor Blockers
- C.
Dihydropyridine Calcium Channel Blockers
- D.
Non-Selective Beta Blockers
- E.
ACE Inhibitors
Correct Answer
B. Angiontension-II Receptor Blockers -
- 43.
Which of the following is true about Valsartan (Diovan)
- A.
HTN DOSE: 80-160mg qd PO max 320
- B.
Often paired with potassium sparing diuretics
- C.
Adverse effects include neutrophilia and viral infections
- D.
All of the above
- E.
A & C
Correct Answer
A. HTN DOSE: 80-160mg qd PO max 320 -
- 44.
Which of the following drugs is a Selective Renin Inhibitor?
- A.
Hydralazine (Apresoline)
- B.
Aliskiren (Tekturna)
- C.
Benaprezil (Lotensin)
- D.
Losartan (Cozaar)
Correct Answer
B. Aliskiren (Tekturna) -
- 45.
Direct Vasodilators are reserved for urgent to emergent HTN
- A.
True
- B.
False
Correct Answer
A. True -
- 46.
Which of the following is true about vasodilators
- A.
Nitroprusside(nitropress) may cause cyanide poisoning
- B.
Have been used to treat Baldness
- C.
Should not be used for prolonged therapy
- D.
All of the above
Correct Answer
D. All of the above -
- 47.
Which of the following is not true about Hydralazine (Apresoline)
- A.
Available PO IV IM
- B.
Dosage is 10mg qid X 2-4 days
- C.
May cause lupus or angina
- D.
Is first line for CHF pts with HTN
Correct Answer
D. Is first line for CHF pts with HTN -
- 48.
Which of the following presentations is not consistent with a diagnosis of pheochromocytoma?
- A.
Severe HTN
- B.
Hypertensive retinopathy
- C.
Hypogylcemia /hypocalcemia
- D.
Weightloss
Correct Answer
C. Hypogylcemia /hypocalcemia -
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