Take the quiz: Do you know your antihypertensive agents?


Identify the antihypertensive agent:

1. Rapid acting systemic and coronary artery vasodilator with minimal effects on cardiac conductivity or inotropy. Well studied in pregnancy. Caution in patients with left ventricular failure, liver cirrhosis

Answer

Nicardipine


2. Predominantly dilates the venous system. Useful in patients with cardiac ischemia, pulmonary edema, or congestive heart failure. Caution in patients with right ventricular failure

Answer

Nitroglycerin


3. Drug of choice in eclampsia, pre-eclampsia, and aortic dissection. Contraindicated in patients with congestive heart failure and heart block  

Answer

Labetalol


4. Decreases peripheral vascular resistance and increases collateral coronary blood flow in an uncontrolled and unpredictable manner and may result in serious complications. Drug of choice during pregnancy

Answer

Nifedipine


5. Direct arterial vasodilator that increases cardiac output and heart rate (Reflex response). Patient may develop lupus like syndrome. Not to be used as first line in the ED

Answer

Hydralyzine


6. Arterial vasodilator that delays atrioventricular conduction and has a negative inotropic effect


Answer

Verapamil


7. Rapid onset of effect after oral administration (30 mins) with little change in cardiac output or reflex tachycardia. Adverse effect may include cough, angioedema. Toxic during first trimester


Answer

Captopril


8. Only for patients with subarachnoid hemorrhage. Not to be given IV only PO or NG tube  


Answer

Nimodipine


9. The only parenteral angiotensin-converting enzyme inhibitor. May cause azotemia in older patients after MI


Answer

Enalapril


10. Oral or transdermal decreases peripheral vascular resistance. May cause sedation and bradycardia  


Answer

Clonidine


11. Used in patients who are volume overloaded but not in patients who are hypertensive and  volume depleted


Answer

Diuretics


12. Drug of choice  for pheochromocytoma, MAOI crisis, and cocaine overdose


Answer

Phentolamine



Reference:
1.  Richard S. Irwin, James M. Rippe. Manual of Intensive Care Medicine; 4th ed
2. Marx: Rosen’s Emergency Medicine, 7th ed (Chapter 82- Hypertension: Richard O. Gray)

Image 1 source: http://www.dancinggiraffe.com/feature/20121005/over-counter-painkillers-are-we-paying-premium-packaging

 Image 2 source: http://www.minnpost.com/second-opinion/2011/08/minnesotas-children-too-often-receive-ineffective-or-harmful-antipsychotic-me