10-17 outline questions

Question 1

first and second line for HTN

Answer 1

lifestyle changes, thiazides

Question 2

degree of diuresis for mild, medium profound

Answer 2

mild: k sparing
medium: thiazides
large: loop diuretics

Question 3

labs for loops

Answer 3

Crcl, CMP, BP

Question 4

ADR’s for loops

Answer 4

deafness, hypokalemia, urination, take at night.

Question 5

what allergy prevents you from taking a loop

Answer 5

sulfa allergy

Question 6

what drug shouldnt you be taking alongside loops

Answer 6

NSAIDS or ACE inhibitors

Question 7

what drug blocks sympathetic release of renin

Answer 7

beta blockers

Question 8

what drug blocks conversion of angiotensinogen to angiotensin 1?

Answer 8

Direct renin inhibitor (aliskiren)

Question 9

What drug blocks conversion of AT1 to AT2?

Answer 9

ACE’s

Question 10

What drug blocks conversion of AT2 to target cells?

Answer 10

ARB’s

Question 11

what labs do you check for ACE’s

Answer 11

BP, NA/K, Crcl, GFR (if RAS, but usually renoprotective)

Question 12

like loop’s, what should you be careful about with ACE inhibitors?

Answer 12

Sulfa allergy and taking NSAIDS

Question 13

what comobidity is good to add a BB for HTN?

Answer 13

Any heart disease patients

Question 14

What comorbidity do we avoid BB’s in HTN?

Answer 14

Diabetics and Asthma patients

Question 15

what would be the best BB if you had to give one to a diabetic

Answer 15

Carvedilol (beta 1 selective)

increases insulin sensetivity

Question 16

what BP goal do we set for Diabetics with HTN?

Answer 16

130/80 (to prevent nephropathy and renal failure)

Question 17

Whats the best med for DM HTN?

Answer 17

An ACE or an ARB (do not withdrawl quickly)

arbs have no dry cough

Question 18

a newly diagnosed diabetic comes to you with slight albuminuria and increased CrCl levels. You check his BP and diagnose him with HTN, what drug do you give?

Answer 18

ACE or ARB

renoprotective

Question 19

What situation would we give Minoxidil?

Answer 19

Moderate/Severe HTN

Question 20

What happens if you use minoxidil alone?

Answer 20

reflex tachycardia, fluid retention, angina

Question 21

what unusual S/E does minoxidil have?

Answer 21

Hypertrichosis

Question 22

what drug is given for pregger HTNers

Answer 22

Methyldopa

Question 23

Methyldopa doesnt harm the fetus but can show what positive lab result?

Answer 23

Coombs anemia

Question 24

What drug is given for eclamptic hypertension?

Answer 24

Hydralazine

Question 25

What 4 drugs treat severe HTN crisis?

Answer 25

Fenoldopam, Nicardipine, Lebatolol, Nitroprusside

Question 26

What 1 drug treats a moderate HTN crisis?

Answer 26

Clonidine

Question 27

What is the BP reduction protocol for HTN crisis?

Answer 27

25% in 1 hour | then to 160/100 over 2-6 hours

Question 28

what does aldactone (spironolactone) do?

Answer 28

It is a k+ sparing diuretic that promotes sodium excretion.

Question 29

What are the uses for aldactone?

Answer 29

hyperaldosteronism, hypokalemia, polycystic ovary disease, hirsutism, severe heart failure.

Question 30

what do you tell people about discontinuing clonidine?

Answer 30

does it slowly to prevent reflex tachycardia. a rebound in sympathetic outflow

Question 31

first line tx's for stable angina

Answer 31

asprin, BB or a CCB

Question 32

first line tx's for unstable angina

Answer 32

asprin, ONLY BB's

Question 33

first line tx's for variant (atypical) angina

Answer 33

CCB's ONLY!!!!

Question 34

why dont we give BB's to unstable angina patients?

Answer 34

we could cause reflex tachycardia

Question 35

how do nitrates work?

Answer 35

release of NO, venous pooling, increase coronary flow, dilates collateral vessels, reduces intraventricular pressure. Drops BP

Question 36

In cardiac modeling, what happens when the renin-aldosterone pathway is activated?

Answer 36

arterial vasoconstriction and fluid retention, ejection fraction and CO lowered

Question 37

In cardiac modeing, what happens when the sympathetic NS is activated?

Answer 37

ventricular walls thin and become fibrotic

Question 38

In cardiac modeling, what 2 molecules initiates and mediate local inflammation and vasoregulation?

Answer 38

Cytokines like TNF-alpha and Endothelin

Question 39

What do all the these harmful neurohumeral responses to ischemia lead to in the heart?

Answer 39

Hypertrophy, apoptosis, collagen, fibrosis

Question 40

what labs do you check for digoxin treatment?

Answer 40

Digoxin level, K, Ca2+.