Phar 370 Final Exam UPDATED ACTUAL
QUESTIONS AND CORRECT ANSWERS
Describe the main goal of antihypertensives (drugs to treat hypertension) - CORRECT
ANSWER - decrease blood pressure
An individual is diagnosed with hypertension when their blood pressure is chronically elevated above
what value - CORRECT ANSWER 140/90 mmhg
Name the classes (+ their subtypes) of antihypertensive agents (4) - CORRECT ANSWER 1.
Diuretics (drugs that alter sodium and water balance): loop diuretics, thiazide diuretics, potassium-
sparing diuretics
2. Drugs that decrease the sympathetic NS activity: B1 blockers, alpha blockers, centrally-acting
drugs
3. Vasodilators
4. Drugs that modify the renin-angiotensin system (RAS): ACE inhibitors, arbs
Describe the MOA, clinical use, and key adverse effects of loop diuretics - CORRECT
ANSWER - acts within thick ascending limb of loop of Henle, where 25% of sodium
reabsorption takes place
- function to decrease reabsorption of sodium
- most effective diuretics bc of large reabsorptive capacity of thick ascending limb of loop of Henle
- rare adverse effect: ototoxicity (lack of hearing)
Describe the MOA, clinical use, and key adverse effects of thiazide diuretics - CORRECT
ANSWER - acts on distal convoluted tubule
- decreases sodium reabsorption, increasing volume of water in urine
- gentle diuresis = safe to use with elderly
- hyperglycemia, hyperlipidemia
Describe describe the MOA, clinical use, and key adverse effects of potassium-sparing diuretics -
CORRECT ANSWER - function by increasing excretion of sodium and water, and decreasing
excretion of potassium
,- weak diuretics
Describe describe the MOA, clinical use, and key adverse effects of beta-1 blockers - CORRECT
ANSWER - decrease activity of symp NS by producing a selective blockade of beta receptors
in heart and other organs, reducing cardiac output
- less effective than diuretics in elderly and african americans
- adverse effects: bronchospasm, don't use in people with asthma
Describe describe the MOA, clinical use, and key adverse effects of alpha blockers - CORRECT
ANSWER - bind to and block alpha receptors in peripheral arterioles and capacitance vessels
- reduces vasoconstriction caused by norepinephrine = decrease in peripheral resistance
- limited use due to adverse effects: orthostatic hypotension, headaches, dizziness
Describe describe the MOA, clinical use, and key adverse effects of centrally-acting drugs -
CORRECT ANSWER - act on CNS
- decrease sympathetic NS outflow to blood vessels, resulting in reduced resistance of blood vessels =
decreased blood pressure
- limited use due to adverse effects: orthostatic hypotension, headaches, dizziness
Describe describe the MOA, clinical use, and key adverse effects of vasodilators - CORRECT
ANSWER - dilate the blood vessels
- reduce blood pressure
Describe describe the MOA, clinical use, and key adverse effects of ACE inhibitors - CORRECT
ANSWER - acts on RAS to inhibit conversion of angiotensin I to the hypertensive agent
angiotensin II
- less constriction of blood vessels
- can be used for patients with asthma
- does not cause alterations in carbohydrate metabolism or plasma concentration of lipids = can be
used by diabetics
- adverse effects: dry cough, shouldn't be used in pregnant women
, Describe describe the MOA, clinical use, and key adverse effects of angiotensin receptor blocking
drugs (arbs) - CORRECT ANSWER - block angiotensin II receptor and prevent its
vasoconstrictive effect
- more effective than ACE inhibitors
Name the 3 classes of drugs that treat angina - CORRECT ANSWER 1. Organic nitrates
(nitroglycerin)
2. Beta blockers
3. Calcium channel antagonists
Describe describe the MOA, clinical use, 3 therapeutic uses, and key adverse effects of nitroglycerin
(GTN) - CORRECT ANSWER - GTN enters blood vessels and moves into smooth muscle cells
and is converted to NO
- NO activates the enzyme guanylyl cyclase which leads to blood vessel relaxation
- relaxation of large capacitance veins = decreased cardiac output and blood pressure
- dilation of large coronary arteries = oxygen supplied to areas of the heart that are deficient
- used sublingually: rapid absorption, no tolerance develops
- used transdermally: used to control acute episodes, but is of limited value in prevention of angina
episodes, tolerance develops after several hours
- therapeutic uses: termination of individual attack, prevention of individual attack, chronic
prophylaxis
- adverse effects: headaches, hypotension, tachycardia
Describe describe the MOA, clinical use, and key adverse effects of beta blockers for angina -
CORRECT ANSWER - decreases activation of sympathetic NS, angina is precipitated by
factors that increase sympathetic NS activity (stress and exercise)
- used for long term prophylaxis of typical angina
- avoided in variant angina
Describe describe the MOA, clinical use, and key adverse effects of calcium channel blocking drugs
for angina - CORRECT ANSWER - decrease extracellular calcium reaching vascular smooth
muscle cells
- block calcium channels in cardiac muscle, reducing oxygen demand for heart
- relaxes arterioles and decreases workload on heart
QUESTIONS AND CORRECT ANSWERS
Describe the main goal of antihypertensives (drugs to treat hypertension) - CORRECT
ANSWER - decrease blood pressure
An individual is diagnosed with hypertension when their blood pressure is chronically elevated above
what value - CORRECT ANSWER 140/90 mmhg
Name the classes (+ their subtypes) of antihypertensive agents (4) - CORRECT ANSWER 1.
Diuretics (drugs that alter sodium and water balance): loop diuretics, thiazide diuretics, potassium-
sparing diuretics
2. Drugs that decrease the sympathetic NS activity: B1 blockers, alpha blockers, centrally-acting
drugs
3. Vasodilators
4. Drugs that modify the renin-angiotensin system (RAS): ACE inhibitors, arbs
Describe the MOA, clinical use, and key adverse effects of loop diuretics - CORRECT
ANSWER - acts within thick ascending limb of loop of Henle, where 25% of sodium
reabsorption takes place
- function to decrease reabsorption of sodium
- most effective diuretics bc of large reabsorptive capacity of thick ascending limb of loop of Henle
- rare adverse effect: ototoxicity (lack of hearing)
Describe the MOA, clinical use, and key adverse effects of thiazide diuretics - CORRECT
ANSWER - acts on distal convoluted tubule
- decreases sodium reabsorption, increasing volume of water in urine
- gentle diuresis = safe to use with elderly
- hyperglycemia, hyperlipidemia
Describe describe the MOA, clinical use, and key adverse effects of potassium-sparing diuretics -
CORRECT ANSWER - function by increasing excretion of sodium and water, and decreasing
excretion of potassium
,- weak diuretics
Describe describe the MOA, clinical use, and key adverse effects of beta-1 blockers - CORRECT
ANSWER - decrease activity of symp NS by producing a selective blockade of beta receptors
in heart and other organs, reducing cardiac output
- less effective than diuretics in elderly and african americans
- adverse effects: bronchospasm, don't use in people with asthma
Describe describe the MOA, clinical use, and key adverse effects of alpha blockers - CORRECT
ANSWER - bind to and block alpha receptors in peripheral arterioles and capacitance vessels
- reduces vasoconstriction caused by norepinephrine = decrease in peripheral resistance
- limited use due to adverse effects: orthostatic hypotension, headaches, dizziness
Describe describe the MOA, clinical use, and key adverse effects of centrally-acting drugs -
CORRECT ANSWER - act on CNS
- decrease sympathetic NS outflow to blood vessels, resulting in reduced resistance of blood vessels =
decreased blood pressure
- limited use due to adverse effects: orthostatic hypotension, headaches, dizziness
Describe describe the MOA, clinical use, and key adverse effects of vasodilators - CORRECT
ANSWER - dilate the blood vessels
- reduce blood pressure
Describe describe the MOA, clinical use, and key adverse effects of ACE inhibitors - CORRECT
ANSWER - acts on RAS to inhibit conversion of angiotensin I to the hypertensive agent
angiotensin II
- less constriction of blood vessels
- can be used for patients with asthma
- does not cause alterations in carbohydrate metabolism or plasma concentration of lipids = can be
used by diabetics
- adverse effects: dry cough, shouldn't be used in pregnant women
, Describe describe the MOA, clinical use, and key adverse effects of angiotensin receptor blocking
drugs (arbs) - CORRECT ANSWER - block angiotensin II receptor and prevent its
vasoconstrictive effect
- more effective than ACE inhibitors
Name the 3 classes of drugs that treat angina - CORRECT ANSWER 1. Organic nitrates
(nitroglycerin)
2. Beta blockers
3. Calcium channel antagonists
Describe describe the MOA, clinical use, 3 therapeutic uses, and key adverse effects of nitroglycerin
(GTN) - CORRECT ANSWER - GTN enters blood vessels and moves into smooth muscle cells
and is converted to NO
- NO activates the enzyme guanylyl cyclase which leads to blood vessel relaxation
- relaxation of large capacitance veins = decreased cardiac output and blood pressure
- dilation of large coronary arteries = oxygen supplied to areas of the heart that are deficient
- used sublingually: rapid absorption, no tolerance develops
- used transdermally: used to control acute episodes, but is of limited value in prevention of angina
episodes, tolerance develops after several hours
- therapeutic uses: termination of individual attack, prevention of individual attack, chronic
prophylaxis
- adverse effects: headaches, hypotension, tachycardia
Describe describe the MOA, clinical use, and key adverse effects of beta blockers for angina -
CORRECT ANSWER - decreases activation of sympathetic NS, angina is precipitated by
factors that increase sympathetic NS activity (stress and exercise)
- used for long term prophylaxis of typical angina
- avoided in variant angina
Describe describe the MOA, clinical use, and key adverse effects of calcium channel blocking drugs
for angina - CORRECT ANSWER - decrease extracellular calcium reaching vascular smooth
muscle cells
- block calcium channels in cardiac muscle, reducing oxygen demand for heart
- relaxes arterioles and decreases workload on heart
