Hypertension Flashcards

1
Q

Which htn drug to choose initially if black

A

thiazide or CCB

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2
Q

when to start 2 1st line drugs

A

in stage 2 when avg SBP and SBP 150/90

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3
Q

which drugs should be used in pregnancy and when to start?

A

BP goal: if 160/105

may use labetalol and nifedipine ER 1st line or methyldopa

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4
Q

where do thiazide diuretics work?

A

distal convoluted tubule

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5
Q

What is in Zestoritic, Hyzaar, benicar, diovan?

A

ace/arb + hydrochlorothiazide

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6
Q

what is in lotrel, exforge

A

ace or arb + ccb

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7
Q

what is in tenoretic, ziac

A

betablocker + diuretic

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8
Q

what is in maxzide, dyazide

A

k sparing + hydrochlorothiazide

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9
Q

BP categories:

A
  • Normal: 120/80
  • Elevated: 120-130/80
  • Stage 1: 130-139 OR 80/89
  • Stage 2: greater than 140/90
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10
Q

When to start tx

A

If stage 2 (>140/90) or if stage 1 (130-140/80-89) with clinical CVD/10% 10 year ascvd risk

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11
Q

when to check BP

A

every 4 weeks

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12
Q

thiazide diuretic MOA

A

inhibit NA/cl cotransporter thus preventing its reabsorption into the blood and resulting in excretion of Na, Cl, H20, MG and K

Retains CA, UA,

All diuretics retain: LDL, TG, BG

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13
Q

Thiazide monitoring

A

renal function because not effective when CrCL <30

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14
Q

Norvasc

A

Amlodipine

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15
Q

Cardene

A

Nicardipine IV

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16
Q

Adalat CC, Procardia XL

A

Nifedipine ER

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17
Q

MOA of DHP CCB

A

blocks ca channels on peripheral smooth muscle to cause “vasodilation”

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18
Q

DHP CCB names end in

A

“pine”

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19
Q

DHP CCB side effects

A
  • Vasodilator class s/e: peripheral edema, headache, flushing, palpitations, reflex tachy
  • gingival hyperplasia
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20
Q

Non-DHP CCB MOA

A

inhibit ca entry into cardiac smooth muscle (but are more selective for myocardium) to decrease HR and contractility

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21
Q

big warning for non-dhp ccp

A

avoid in HF due to negative ionotropic and chronotropic effect that suppresses CO and ability of heart to pump even more

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22
Q

Which are non-DHP CCB

A

Diltiazem (Cardizem, Tiazac), Verapamil (Calan SR)

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23
Q

All CCB are substrates of what

A

CYP3a4

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24
Q

ace inhibitors end in

A

-pril

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25
Q

ace inhibitor MOA

A

prevent conversion of angiotensin 1 to 2 which downstream prevents aldosterone secretion and vasoconstriction

26
Q

lotensin

A

benazepril

27
Q

vasotec

A

enalapril (enalaprilat is Vasotec IV)

28
Q

Prinivil, zestril

A

lisinopril

29
Q

Accupril

A

quinapril

30
Q

altace

A

Ramipril

31
Q

ace/arb boxed warning and contraindications

A

BW: teratogenic

Contraindications: angioedema

Avoid use in bilateral renal artery stenosis

  • ace only: not for use within 36 hours of entresto
32
Q

side effects of ace/arb

A

cough, hyperkalemia, increased scr, hypotension

arb has less s/e

33
Q

entresto components

A

valsartan and sacubitril which is a nephralysin inhibitor

34
Q

what is contraindicated with the use of an ace or arb in diabetic patients

A

aliksiren

35
Q

Avapro

A

Irbesartan

36
Q

Losartan

A

Cozaar

37
Q

Benicar

A

Olmesartan

38
Q

Valsartan

A

Diovan

39
Q

Aldactone

A

Spironolactone

40
Q

Dyazide, Mazide

A

Triamterine + HCTz

41
Q

Tenormin

A

Atenolol

42
Q

Brevibloc

A

Esmolol

43
Q

Lopressor

A

Metoprolol tartrate

44
Q

Toprol XL

A

Metoprolol succinate Er

45
Q

Beta blockers preferred in HF

A

Metoprolol succinate, bisoprolol, carvedilol

46
Q

Atenolol, esmolol, metoprolol

A

b1 selective bb

47
Q

Bystolic

A

Nebivolol (b1 selective with NO dependant vasodilation)

48
Q

Inderal

A

Propanolol

49
Q

Corgard

A

Nadolol

50
Q

Non-selective B1/B2 blockers

A

propanolol and nadolol

51
Q

Coreg

A

Carvedilol

52
Q

Non-selective beta blockers

A

Carvedilol and labetalol

53
Q

What are BB 1st line for?

A

Post-MI, Stable ischemic heart disease, heart failure

54
Q

Acebutol

A

Beta blocker with intrinsic sympathomimetic activity

55
Q

Catapres

A

Clonidine

56
Q

Intuniv

A

Guanfacine ER

57
Q

pneumonic for B1 selective beta blockers

A

AMEBBA

58
Q

clonidine patch application

A

weekly, remove before MRI

59
Q

effect of alpha 2 agonism on norepinephrine

A

decreases release

60
Q

what are the dile drugs in this chapter?

A

methyldopa (alpha 2 agonist), hydralazine (direct vasodilators)

also isoniazid and minocycline from previous chapter

61
Q

methyldopa warnings

A

requires coombs test (hemolytic anemoa), DILE, do not use with MAO inhibitors