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1. Question
Reflex tachycardia, headache, and postural hypotension are adverse effects that limit the use of which of the following antihypertensive agents?
Correct
Answer & Explanation:
The answer is E
Explanation:
Hydralazine is a vasodilator that works by directly relaxing arterioles, thereby reducing peripheral vascular resistance. Its eff ectiveness as an antihypertensive agent is compromised; however, by the compensatory reactions it triggers (e.g., refl ex tachycardia) and by its other adverse eff ects (e.g., headache, postural hypotension, nausea, palpitations). Fortunately, the unwanted eff ects of hydralazine are minimized when it is used in combination with a diuretic agent and a -blocker. Hydralazine is most eff ective as a supplemental antihypertensive drug in combination with fi rst-line therapy.
Incorrect
Answer & Explanation:
The answer is E
Explanation:
Hydralazine is a vasodilator that works by directly relaxing arterioles, thereby reducing peripheral vascular resistance. Its eff ectiveness as an antihypertensive agent is compromised; however, by the compensatory reactions it triggers (e.g., refl ex tachycardia) and by its other adverse eff ects (e.g., headache, postural hypotension, nausea, palpitations). Fortunately, the unwanted eff ects of hydralazine are minimized when it is used in combination with a diuretic agent and a -blocker. Hydralazine is most eff ective as a supplemental antihypertensive drug in combination with fi rst-line therapy.
Hydralazine (Various) NAPLEX Review
Actions.
Hydralazine directly relaxes arterioles, decreasing systemic vascular resistance. It is also used intravenously or intramuscularly in managing hypertensive crisis.
Precautions and monitoring eff ects
Because hydralazine triggers compensatory reactions that counteract its antihypertensive eff ects, it is most useful when combined with a -blocker, central -agonist, or diuretic as a latter-step agent.
Refl ex tachycardia is common and should be considered before initiating therapy.
Hydralazine may induce angina, especially in patients with coronary artery disease and those not receiving a -blocker.
Drug-induced systemic lupus erythematosus (SLE) may occur.
(i) Baseline and serial complete blood counts (CBCs) with antinuclear antibody titers should be followed routinely to detect SLE. (ii) Slow acetylators of this drug have an increased incidence of SLE. Th eir risk may be reduced by administering doses of 200 mg/day.
(iii) Fatigue, malaise, low-grade fever, and joint aches may signal SLE.
Other adverse eff ects may include headache, peripheral neuropathy, nausea, vomiting, fl uid retention, and postural hypotension.