Post8 HTN/Lipids

Before starting atorvastatin (LIPITOR), it is important to:
A. Document that the patient failed therapy with Niacin and one of the bile acid sequestrants (Colestipol or Cholestyramine).
B. Be sure the patient is not pregnant.
C. Teach the patient how to do home blood sugar monitoring and be sure patient has the equipment.
D. Document normal conductivity through heart with EKG.

Some antihypertensive drugs block both alpha and beta receptors. Why would this be a good thing for someone with hypertension?
A. it causes vasodilation
B. it decreases renin release
C. it increases cardiac output
D. 1, 2 onlyE. 1,2,3

The mechanism of action of this drug is dilation of arterioles by a direct effect on vascular smooth muscle.
A. clonidine (CATAPRES)
B. captopril (CAPOTEN)
C. hydralazine (APRESOLINE)
D. atropine

Hypertension results from an increase in vascular resistance, and several factors contribute to this. Which of the following would be the MOST POWERFUL way to decrease blood pressure?
A. Decrease the viscosity of the blood
B. Increase the viscosity of the blood
C. Decrease the radius of the vessel
D. Increase the radius of the vessel

All of the following are adverse effects of hydrochlorothiazide (ESIDRIX) EXCEPT
A. dizziness and faintness.
B. hypoglycemia.
C. high calcium levels.
D. paresthesia.

African Americans respond best to which class of antihypertensives?
A. ACE Inhibitor
B. Alpha-1 agonist
C. Diuretic
D. Beta blockers

The mechanism of action of furosemide (LASIX) is
A. antagonizing aldoseterone.
B. inhibiting sodium and chloride reabsorption in the loop of Henle.
C. increasing the osmolality of urine, thus increasing urinary output.
D. supressing renin release.

Hyperlipidemia drug therapy for a person with existing coronary heart disease should begin when:
A. LDL cholesterol is greater than 100.
B. HDL cholesterol is elevated.
C. The patient has lost 10% of his/her body weight.
D. Blood pressure is under control.

T.G. is a Caucasion, 32 yo, otherwise healthy male with BP 144/82 and a pulse of 72. He weighs 250 pounds and is sedentary. He does not smoke. He is not on any other medications. What is the best treatment?
A. Take 25 mg hydrochlorothiazide orally each morning. Recheck BP in one month.
B. Encourage increased physical activity and weight loss. Check BP in 3 months.
C. Take Cardizem CD (diltiazem extended release) 240 mg three times each day with lisinopril 20 mg once each day. Monitor BP daily at home.
D. Take hydralazine 50 mg twice each day. Recheck BP in one week.

R.J. is a 55 yo male with long standing hypertension who has been treated with Dyazide one capsule each day. On this clinic visit, a urine sample is positive for spilled protein. His BP is 136/82. You should:
A. Increase the Dyazide dose to 2 capsule each day.
B. Discontinue the Dyazide. After 1 week, start captopril 25 mg twice each day.
C. Add captopril 50 mg three times each day.
D. No drug changes are required. He should have a low protein diet.

Which of the following statements best describes the mechanism of action of captopril (CAPOTEN)?
A. stimulating alpha1 receptors on blood vessels
B. supressing renal excretion of sodium
C. depressing contractility of the heart
D. inhibiting angiotensin converting enzyme

P.J. is a 56 year old male who is taking an angiotensin receptor blocker for hypertension. You should teach him to
A. discontinue his medications if he develops a headache.
B. take his medication first thing in the morning to counteract the sedation.
C. purchase his new prescription 3-4 days before his old prescription runs out.
D. increase his salt intake to counteract the salt wasting associated with this drug.

Losartan (COZAAR) is an angiotensin II receptor antagonist which would be expected to have which side effect(s):
A. Hypokalemia (low potassium)
B. Pupil constriction
C. Dizziness
D. Dry mouth

Diuretics are useful in treating hypertension becasue they
A. decrease preload.B. increase vessel diameter.
C. block renin release.
D. block angiotensin converting enzyme.

A patient without other cardiac risks has triglycerides 300 mg/dl, HDLs 40 mg/dl and LDLs 150 mg/dl. Which drug (if any) should be given?
A. losartan
B. atorvastatin
C. fenofibrate
D. cholestyramine

S.Q. is a 45 yo diabetic with mild renal disease (creatinine 1.7, normal is 0.6-1.2). She is taking valsartan 320 mg each day, hydrochlorothiazide 50 mg each day, and metoprolol 50 mg twice each day. She has tolerated these drugs without significant side effects. Today her BP is 138/94. You should:
A. Reduce the valsartan dose.
B. Increase the metoprolol.
C. Add lisinopril.
D. Continue the medications as listed.