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NAPLEX · NAPLEX

NAPLEX Cardiovascular Pharmacotherapy

Hypertension, heart failure, and dyslipidemia drug therapy decisions and monitoring parameters tested on the NAPLEX.

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What is the mechanism of action of ACE inhibitors?
They block conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone release.
Why do ACE inhibitors commonly cause a dry cough?
They increase bradykinin levels, which normally gets broken down by ACE.
Are ACE inhibitors and ARBs safe during pregnancy?
No, they are contraindicated due to risk of fetal renal toxicity and birth defects.
What two lab values should be monitored after starting an ACE inhibitor or ARB?
Serum potassium and serum creatinine (renal function).
What is the mechanism of action of thiazide diuretics?
They inhibit the Na+/Cl- symporter in the distal convoluted tubule, increasing sodium and water excretion.
Both thiazide and loop diuretics commonly cause ____ due to increased distal sodium delivery and potassium wasting.
hypokalemia
What is the mechanism of action of loop diuretics?
They inhibit the Na+/K+/2Cl- symporter in the thick ascending limb of the loop of Henle.
Which class of diuretics carries the highest risk of ototoxicity, especially at high IV doses?
Loop diuretics, such as furosemide.
What is a common dose-dependent side effect of dihydropyridine calcium channel blockers like amlodipine?
Peripheral edema.
Why are non-dihydropyridine calcium channel blockers (verapamil, diltiazem) generally avoided in HFrEF?
They have negative inotropic effects that can worsen systolic heart failure.
Why should verapamil or diltiazem be used cautiously with beta blockers?
The combination can cause severe bradycardia or heart block from additive AV node suppression.
In which patient population are beta blockers considered a compelling indication for hypertension treatment?
Patients with a history of myocardial infarction or coronary artery disease.
What can happen if clonidine is stopped abruptly?
Rebound hypertension.
What autoimmune side effect is associated with long-term hydralazine use?
Drug-induced lupus.
Name a commonly used IV agent for treating a hypertensive emergency.
Sodium nitroprusside (or IV labetalol/nicardipine).

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