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Zorluk: OrtaCardiovascular System

Match the following antihypertensive medications with their characteristic mechanism of adverse effect or specific clinical contraindication.

  • AmlodipinePreferential arteriolar vasodilation leading to dose-dependent peripheral edema
  • ChlorthalidoneIncreased renal reabsorption of calcium and uric acid, potentially precipitating gout
  • LisinoprilDecreased efferent arteriolar resistance; contraindicated in bilateral renal artery stenosis
  • MetoprololNegative inotropy and chronotropy; can mask adrenergic warning symptoms of hypoglycemia
  • SpironolactoneCompetitive antagonism of androgen receptors, potentially causing gynecomastia and impotence

Cevap

Amlodipine matches with preferential arteriolar vasodilation causing edema. Chlorthalidone matches with increased calcium and uric acid reabsorption. Lisinopril matches with decreased efferent arteriolar resistance. Metoprolol matches with masking adrenergic symptoms of hypoglycemia. Spironolactone matches with competitive antagonism of androgen receptors.
Understanding the unique adverse effects and contraindications of antihypertensive agents is essential for safe prescribing in internal medicine. Each medication class possesses specific pathophysiologic mechanisms for its side effects: dihydropyridine CCBs cause precapillary vasodilation (edema); thiazides alter distal tubule transport (hyperuricemia/hypercalcemia); ACE inhibitors eliminate angiotensin II-driven efferent tone (renal failure in bilateral stenosis); beta-blockers blunt sympathetic responses (hypoglycemia masking); and non-selective aldosterone antagonists bind sex hormone receptors (gynecomastia).

Adım Adım Çözüm

1
Evaluate Amlodipine (Calcium Channel Blocker)
Matches with preferential arteriolar vasodilation
Dihydropyridines act primarily on vascular smooth muscle, selectively dilating arterioles and increasing capillary hydrostatic pressure, which drives fluid extravasation into the interstitium.
2
Evaluate Chlorthalidone (Thiazide diuretic)
Matches with increased reabsorption of calcium and uric acid
Thiazides uniquely cause hypercalcemia and hyperuricemia compared to loop diuretics, making them a risk factor for gout flares.
3
Evaluate Lisinopril (ACE inhibitor)
Matches with decreased efferent arteriolar resistance
ACE inhibitors prevent the formation of Angiotensin II. Because Angiotensin II normally constricts the efferent arteriole to maintain GFR in low-flow states, blocking it is contraindicated in bilateral renal artery stenosis.
4
Evaluate Metoprolol (Beta-blocker)
Matches with masking hypoglycemia symptoms
Beta-blockers blunt the sympathetically mediated physiologic responses to hypoglycemia, such as tachycardia, making it harder for patients to recognize dangerously low blood sugar levels.
5
Evaluate Spironolactone (Aldosterone antagonist)
Matches with competitive antagonism of androgen receptors
Its non-selective steroid hormone receptor binding causes anti-androgenic side effects, a distinguishing feature from more selective agents like eplerenone.

Anahtar Kavram

Pharmacologic mechanisms and high-yield adverse effect profiles of major antihypertensive drug classes.
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Cardiovascular System

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