B4.043 - Pharmacology of Drugs to treat Hypertension Flashcards
(65 cards)
What are common types of end organ damage that can be caused by hypertension
MI Stroke Renal Failure Death
what is the most common etiology of HT
Primary aka we dont know really
epidemiological evidence shows involvement of what factors in HT
genetic inheritance phycological stress environmental dietary factors
high prevalence of HT is driven by what factors
increased age of population obesity high salt intake
what are steps you need to take to be sure you’re getting an accurate measurement on BP
Pt. should avoid caffeine, exercise, smoking 30 minutes prior No talking during measurement Remove clothing covering cuff location placement Use validated device with correct cuff size Support patients arm Record BP on both arms at first visit
what is stage 1 hypertension
systolic 130-139 diastolic 80-89
what is stage 2 hypertension
systolic > 140 diastolic >90
what is elevated BP
120-129, <80
what demographic is more likely to have HT and worse HT
african americans
what drug intervention do african american patients respond to
calcium channel blockers and diuretics
what drug classes should you not start treatment of HT with
ACE inhibitors, Beta blockers they are better for add on therapy
what do diuretics do
Deplete body of sodium and reduce blood volume
what do agents that interact with angiotensin do
reduce peripheral vascular resistance
what do direct vasodilators do
relax vascular smooth muscle and dilate resistance
what do sympatholytic agents do
reduce peripheral vascular resistance, inhibit cardiac function, and increase venous pooling
what should you always start with therapy wise in hypertensive patients
lifestyle change
why can drug treatments for HT be a hard sell
the patients are usually asymptomatic so they dont feel the need to take anything
what is the most common cause of treatment failure
Non-compliance
primary agents used in treatment of HT
thiazide diuretics ACE I/ARBs CCBs
what are thiazides
inhibit NaCl reabsorption in distal convoluted tubule
what are 2 main clinical uses for thiazides
1.) At low dose to lower BP 2.) at high dose second to loop diuretics in congestive heart failure
what are some drug names of thiazides
Hydrochlorothiazide Chlorthaidone Indapamide Metolazone
what is the preferred thiazide
chlorothalidone because fo the long t1/2 and proven trial reduction of CV disease
how do thiazides treat nephrolithiasis and nephrogenic diabetes insipidus
to reduce urinary calcium concentration and to reduce polyuria and polydipsia; paradoxical effect due to plasma volume reduction
