Deck 21: Antihypertensive Drugs

Question 1

Presynaptic adrenergic inhibitors such as reserpine (Serpalan,others)and guanethidine (Ismelin)decrease activity at peripheral arterioles by impairing the release of:

A)epinephrine.
B)norepinephrine.
C)acetylcholine.
D)dopamine.
E)5-hydroxytryptamine (serotonin).

Answer 1

norepinephrine.

Question 2

Beta blockers are cardioselective if they bind preferentially to:

A)beta-1 receptors.
B)beta-2 receptors.
C)beta-3 receptors.
D)all of the above
E)A and B

Answer 2

beta-1 receptors.

Question 3

Calcium channel blockers can help reduce high blood pressure by:

A)stimulating the sinoatrial node in the heart.
B)stimulating the atrioventricular node in the heart.
C)inhibiting the vasomotor control center in the brainstem.
D)inhibiting vascular smooth muscle contraction.
E)increasing renal sodium and water excretion.

Answer 3

inhibiting vascular smooth muscle contraction.

Question 4

Angiotensin converting enzyme (ACE)inhibitors can help _____ blood pressure by _____ the formation of angiotensin II.

A)increase;increasing
B)increase;decreasing
C)decrease;increasing
D)decrease;decreasing
E)none of the above

Question 5

Sympatholytic drugs such prazosin (Minipress)and doxazosin (Cardura)can directly decrease vascular resistance by:

A)stimulating alpha-1 receptors on the arteriole.
B)blocking alpha-1 receptors on the arteriole.
C)stimulating alpha-2 receptors on the arteriole.
D)blocking alpha-2 receptors on the arteriole.
E)stimulating beta-1 receptors on the arteriole.

Question 6

According to the "stepped-care" approach to treating hypertension,the simultaneous use of a diuretic,beta blocker,and converting enzyme inhibitor would occur in:

A)step 1.
B)step 2.
C)step 3.
D)step 4.
E)none of the above;several drugs are not used simultaneously to control hypertension.

Question 7

Nonselective beta blockers may produce bronchoconstriction in patients with asthma and similar respiratory disorders because nonselective beta blockers:

A)stimulate beta-1 receptors on the lungs.
B)block beta-1 receptors on the lungs.
C)stimulate beta-2 receptors on the lungs.
D)block beta-2 receptors on the lungs.
E)stimulate alpha-1 receptors on the lungs.

Question 8

Beta blockers are named because they block the effects of _______ on the heart.

A)epinephrine
B)norepinephrine
C)acetylcholine
D)all of the above
E)A and B

Question 9

Systemic heat (e.g. ,Hubbard tank)should be avoided in patients taking ______ drugs because the combination of these two interventions will cause excessive hypotension.

A)vasodilator
B)alpha-2 antagonist
C)beta-1 agonist
D)beta-2 agonist
E)all of the above

Question 10

Diuretics ______ the excretion of water by _______ sodium reabsorption at the kidneys.

A)increase;inhibiting
B)decrease;inhibiting
C)increase;stimulating
D)decrease;stimulating
E)none of the above;diuretics do not affect water and sodium excretion

Question 11

A sudden severe,life-threatening increase in blood pressure (autonomic crisis)should be treated with:

A)diuretics.
B)alpha-1 agonists.
C)alpha-2 antagonists.
D)beta-agonists.
E)ganglionic blockers.

Question 12

Abnormally high activity in the renin-angiotensin system should be controlled pharmacologically because increased production of ____ causes ____.

A)angiotensin I;cardiac arrhythmias
B)angiotensin II;vascular smooth muscle hypertrophy
C)angiotensin I;angina pectoris
D)angiotensin II;cardiac arrhythmias
E)angiotensin I;vascular smooth muscle atrophy

Question 13

Alpha blockers may cause a sudden fall in blood pressure,which results in a compensatory increase in heart rate.This increased heart rate is known as _______,and can be treated by administering ______ along with the alpha blocker.

A)reflex tachycardia;a diuretic
B)orthostatic hypotension;a diuretic
C)reflex tachycardia;a beta blocker
D)orthostatic hypotension;a beta blocker
E)reflex tachycardia;a beta-1 receptor agonist

Question 14

Certain beta blockers such as pindolol (Visken)and acebutolol (Sectral)are valuable because they block the effects of excessive endogenous catecholamines while producing a normal background level of sympathetic stimulation to the heart.These beta blockers are said to have:

A)nonselective sympatholytic activity.
B)intrinsic sympatholytic activity.
C)intrinsic sympathomimetic activity.
D)extrinsic sympatholytic activity.
E)selective sympatholytic activity.

Question 15

Nitric oxide can be used to reduce vascular resistance and to decrease arterial pressure in specific hypertensive syndromes because nitric oxide:

A)inhibits (blocks)beta-1 receptors on the heart.
B)inhibits (blocks)beta-2 receptors on the heart.
C)inhibits (blocks)alpha-1 receptors on arteriole smooth muscle.
D)directly inhibits the contraction of vascular smooth muscle.
E)none of the above;nitric oxide is not useful in reducing arterial pressure.

Question 16

Centrally acting sympatholytic drugs decrease blood pressure by affecting sympathetic discharge from:

A)the sympathetic chain ganglia.
B)the spinal cord.
C)the brainstem.
D)the cerebellum.
E)the hypothalamus.

Question 17

Patients who overdose on diuretics:

A)may become hyponatremic.
B)may become hypokalemic.
C)may lose too much fluid from the vascular system.
D)all of the above
E)none of the above

Question 18

When standing up suddenly,patients taking antihypertensive medications may be more susceptible to a sudden ____ in blood pressure,known commonly as _____.

A)decrease;orthostatic hypotension
B)increase;orthostatic hypotension
C)decrease;orthostatic hypertension
D)increase;orthostatic hypertension
E)decrease;malignant hypertension

Question 19

An abnormally high amount of activity in the renin-angiotensin system can be controlled by drugs that directly:

A)block angiotensin II receptors on cardiovascular tissues.
B)inhibit the production of angiotensin II.
C)inhibit the production of angiotensin I.
D)all of the above
E)A and B