For each antihypertensive agent listed below, select the set of undesirable side effects with which it is most commonly associated with hydralazine
- cough, hyperkalemia, angioedema
- positive Coombs test, hemolytic anemia, hepatitis
- hypokalemia, hyperuricemia, hyperglycemia
- peripheral edema, flushing, and constipation
- increased angina, tachycardia, systemic lupus erythematosus (SLE)
Answer(s): E
Explanation:
All of the drugs used to treat hypertension can cause adverse reactions, ranging from trivial to life threatening. Thiazide diuretics are associated with hypokalemia, causing arrhythmias; hyperuricemia causing gout; and hyperglycemia due to insulin resistance. The vasodilator hydralazine can cause tachycardia with increased angina and a lupuslike syndrome. As many as 10% of patients on angiotensin- converting enzyme (ACE) inhibitors develop an annoying dry cough. Because they block aldosterone, they can lead to hyperkalemia. ACE inhibitors cause 1025% of all cases of angioedema. Peripheral edema is the most commonly reported side effect of calcium channel blockers, especially amlodipine and nifedipine.
Constipation, flushing, and dizziness are also frequently reported. Coombs'-positive hemolytic anemia and hepatitis are idiosyncratic reactions to the central adrenergic-stimulant methyldopa.