Antihypertensive and Hypertensive Drugs

1. A 58-year-old female has undergone surgery for necrotic bowel. Despite having been treated with antibiotics, on postoperative day 5, she develops symptoms (fever, hypotension, tachycardia, declining urine output, and confusion) consistent with septic shock. What hemodynamic support would be helpful?

*A. Fluid and Dobutamine infusion

B. Dobutamine infusion

C. Atropine administration

D. Fluid administration

E. Antibiotic administration

2. In a hypertensive patient who is taking insulin to treat diabetes, which of the following drugs is to be used with extra caution and advice to the patient?

*A. Propranolol

B. Prazosin

C. Guanethidine

D. Hydralazine

E. Methyldopa

3. Drugs that block the catecholamine uptake process (e.g., cocaine, tricyclic antidepressants) are apt to block the antihypertensive action of which of the following drugs?

*A. Guanethidine

B. Propranolol

C. Prazosin

D. Hydralazine

E. Diazoxide

4. The nonselective β-adrenergic blocking agent that is also a competitive antagonist at α₁-adrenoceptors is:

*A. Labetalol

B. Nadolol

C. Pindolol

D. Acebutolol

E. Timolol

5. A 35-year-old female with a pheochromocytoma is treated with labetalol. Select the mechanism of action of labetalol.

*A. Mixed α- and β-antagonist

B. α-Adrenergic antagonist

C. β-Adrenergic agonist

D. β-Adrenergic antagonist

E. α-Adrenergic agonist

6. A 65-year-old male has a blood pressure of 170/105 mmHg. Which of the following would be effective in lowering this patient’s blood pressure?

*A. Prazosin

B. Terbutaline

C. Dobutamine

D. Proserinum

E. Scopolamine

7. A 66-year-old male with a one-year history of essential hypertension has minimal response to diet and diuretic. His blood pressure is now 160/105 mmHg. The diuretic is discontinued and propranolol is given. Select the mechanism of action that is associated with propranolol.

*A. β-Adrenergic antagonist

B. α-Adrenergic antagonist

C. M-Cholinergic agonist

D. Sodium channel antagonist

E. β-Adrenergic agonist

8. A patient you are treating in the hospital has a hypertensive emergency, with blood pressure of 210/140 mm Hg. Of the following drugs, which would be most effective intravenously?

*A. Arfonade (trimethaphan)

B. Pirilenum (pempidine)

C. Pachycarpine

D. Scopolamine

E. Atropine

9. ACE inhibitors are associated with a high incidence of which of the following adverse reactions?

*A. Proteinuria

B. Hypokalemia

C. Agranulocytosis

D. Hepatitis

E. Hirsutism

10. Significant relaxation of smooth muscle of both venules and arterioles is produced by which of the following drugs?

*A. Sodium nitroprusside

B. Minoxidil

C. Diazoxide

D. Hydralazine

E. Nifedipine

11. A 50-year-old male with a two-year history of essential hypertension well controlled on dichlothiazide is found on a recent physical examination to have a blood pressure of 160/105 mm Hg. The dichlothiazide is substituted with another agent. Two weeks later, he returs for follow-up complaining of a loss of taste. Select the drug which most likely to have caused this adverse effect.

*A. Captopril

B. Adenosine

C. Furosemide

D. Nifedipine

E. Propranolol

12. A 54-year-old female is treated for essential hypertension with an antihypertensive that controls her blood pressure. One day, she comes to the emergency department with chest pain, tachycardia, anxiety, and a blood pressure of 240/140 mm Hg. She has not taken her medication for two days. Which antihypertensive drug can account for her findings?

*A. Clonidine

B. Propranolol

C. Doxazosin

D. Minoxidil

E. Prazosin

13. A 48-year old salesman with known hypertension complains of a decreasing annual income, a loss of "drive", and a depressed outlook on life. His blood pressure is normal on medication. The antihypertensive drug most likely to be the cause of his new complaints is:

*A. Reserpine

B. Alpha methyldopa

C. Hydralazine

D. Hydrochlorothiazide

E. Guanethidine

14. Clonidine hydrochloride lowers blood pressure by reducing sympathetic tone. It is believed to act by inhibiting sympathetic outflow from the vasomotor center in the medulla. A potentially serious adverse reaction that has been reported is:

*A. Withdrawal syndrome resembling hypertensive crisis

B. Anaphylaxis

C. Irreversible nephrotoxicity

D. Ventricular fibrillation

E. Systemic lupus erythematosus

15. Diuretic drug was prescribed to the patient with hypertension in the course of complex treatment. In a few days blood pressure decreased but signs of hypokaliemia developed. What drug could cause such complications?

*A. Lasix

B. Clophelin

C. Spironolactone

D. Enalapril

E. Triamterene

16. A patient with hypertensive disease with an accompanying obstructive bronchitis receives propranolol in complextherapy. After a while, the attacks of asthma are become more frequent. What is the cause of this side effect?

*A. Blockade of ₂-adrenoceptors of bronchi

B. Blockade of ₁-adrenoceptors of bronchi

C. Stimulation of ₂-adrenoceptors of bronchi

D. Blockade of ₂-adrenoceptors of bronchi

E. Stimulation of ₁-adrenoceptors of bronchi

17. For the correction of arterial pressure in collaptoid state mesatonum has been injected to the patient. What is the mechanism of action of this drug?

*A. Stimulation of ­₁-adrenoceptors

B. Stimulation of -adrenoceptors

C. Blockade of -adrenoceptors

D. Blockade of -adrenoceptors

E. Stimulation of - and -adrenoceptrs

18. A patient suffers from hypertensive crisis. What is necessary to prescribe to the patient for the normalization of arterial pressure?

*A. Magnesium sulfate

B. Reserpinum

C. Prazosinum

D. Atropine

E. Propranolol

19. High renin level is developed in blood of 55-year-old patient with hypertensive disease. What hypotensive drug should be prescribed for the treatment of the patient?

*A. Enalaprilum

B. Clophelinum

C. Magnesium sulfate

D. Papaverine

E. Prazosinum

20. The antihypertensive agent has decreased the blood pressure during first several days of treatment owing to diminish of minute heart volume. In four weeks of using, minute heart volume restored to initial level but blood pressure had remained low. Indicate drug which is used in this case.

*A. Anaprilinum

B. Prazosin

C. Methyldopa

D. Octadine

E. Losartan

21. The 65-year-old patient received the injection of drug A. for interruption of hypertensive crisis. It is known, that drug A. has anticonvulsive and analgesic actions; and in case of peropal administration it also shows the laxative and bile-expelling actions. Identify the drug A.

*A. Magnesium sulfate

B. Sodium nitroprusside

C. Clophelinum

D. Pentaminum

E. Dibazole

22. A patient with a hypertensive crisis was admitted to the cardiological department. He was given an intravenous injection of an antihypertensive drug – alkali-earth metal salt. What drug was injected?

*A. Magnesium sulfate

B. Sodium hydrocarbonate

C. Calcium lactate

D. Benzohexonium

E. Potassium chloride