Pharmacology Exam2-Greenspan

Which of the following drugs increases the plasma levels of endogenous BNP and also blocks angiotensin receptors? a) Furosemide b) Losartan c) Nesiritide d) Sacubitril e) Spironolactone

Sacbitril

orthostatic hypotension may be caused or exacerbated by

alpha 1 blockers such as prazosin

A 73-year old man with a history of a recent change in his treatment for moderately severe hypertension is brought to the emergency department because of a fall at home. Which of the following drug groups is most likely to cause postural hypotension and thus an increased risk of falls? a) ACE inhibitors b) Alpha1 selective receptor blockers c) Arteriolar dilators d) beta1 selective receptor blockers e) calcium channel blockers

alpha1 selective receptor blockers

How is venous pooling normally prevented?

by alpha receptor activation in vascular smooth muscle

T/F: ACE inhibitors and ARBs have NOT been shown to be teratogenic in fetuses.

false

A 45-year-old man is brought to the emergency department with mental obtundation. He is found to have a blood pressure of 220/160 and retinal hemorrhages. Which one of the following is used in severe hypertensive emergencies, is short-acting, acts on a G-protein-coupled receptor, and must be given by intravenous infusion? A) Aliskiren B) Captopril C) Fenoldopam D) Hydralazine E) Losartan F) Metoprolol G) Nitroprusside H) Prazosin I) Propranolol

fenoldopam

A significant number of patients started on ACE inhibitor therapy for hypertension are intolerant and must be switched to a different class of drug. What is the most common manifestation of this intolerance? a) angioedema b) glaucoma c) headache d) incessant cough e) ventricular arrhythmias

incessant cough

A 57-year-old woman presents to her primary care physician with a complaint of severe chest pain when she walks uphill in cold weather. The pain disappears when she rests. She has a 40-pack-year history of smoking but her plasma lipids are within the normal range. After evaluation and discussion of treatment options, a decision is made to treat her with nitroglycerin. Which of the following is a common direct or reflex effect of nitroglycerin? a) decreased heart rate b) decreased venous capacitance c) increased afterload d) increased cardiac force e) increased diastolic myocardial fiber tension

increased cardiac force

A 32 year old woman with hypertension wishes to become pregnant. Her physician informs her that she will have to switch to another antihypertensive drug. Which of the following drugs is absolutely contraindicated in pregnancy? a) atenolol b) losartan c) methyldopa d) nifedipine e) propranolol

losartan

Why is verapamil better in prophylaxis than nitrites, sublingual nitrates, and esmolol?

nitrites and sublingual nitrates have short duration of action (few minutes to 30 min). esmolol must be given IV and also has short duration of action.

T/F: ACE inhibitors are very commonly used in hypertensive diabetic patients due to the proven benefits in reducing diabetic renal damage

true

T/F: Furosemide has no significant effect on peptide metabolism and does not block AT1 receptors

true

T/F: Losartan blocks AT1 receptors but has no effect on peptide metabolism

true

T/F: Nesiritide is a synthetic BNP and does not block AT1 receptors

true

T/F: Nitroglycerin increases heart rate and venous capacitance and decreases after load and diastolic fiber tension

true

T/F: Spironolactone blocks the aldosterone receptor in the kidney

true

T/F: calcium channel blockers and beta blockers are generally effective in reducing the number of attacks of angina of effort

true

What causes drug-induced postural hypotension?

venous pooling or excessive diuresis and inadequate blood volume

A 57-year-old woman presents to her primary care physician with a complaint of severe chest pain when she walks uphill in cold weather. The pain disappears when she rests. She has a 40-pack-year history of smoking but her plasma lipids are within the normal range. After evaluation and discussion of treatment options, a decision is made to treat her with nitroglycerin. One year later, the patient returns complaining that her nitroglycerin works well when she takes it for an acute attack but that she is now having more frequent attacks and would like something to prevent them. Useful drugs for the prophylaxis of angina of effort include... a) amyl nitrite b) esmolol c) sublingual isosorbide dinitrate d) sublingual nitroglycerin e) verapamil

verapamil