Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NAPLEX review 2024 RXPrep Book > Cardiovascular Conditions: Hypertension > Flashcards

Cardiovascular Conditions: Hypertension Flashcards

1
Q

Primary vs secondary HTN?

A

Primary = cause unknown, combo of risk factors
Secondary = can be caused by renal or adrenal disease, sleep apnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Stages of HTN

A

Normal = SBP < 120, DBP < 80
Elevated = SBP 120-129, DBP < 80

Stage 1: SBP 130 - 139, DBP 80-89
Stage 2: SBP > 140, DBP > 90

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Proven lifestyle interventions

A

Weight loss
Heart Healthy Diet = DASH
Sodium intake < 1,500mg
Exercise
Stop smoking
Limit alcohol smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

ACC/AHA treatment principles

A

Lifestyle modifications
QD regimen preferred
4 drug classes preferred (ACE, ARB,DHP CCBs, Thiazide diuretics)

most req combo, dont add second until max dose of 1st. Dont use ACE/ARBs together

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which HTNsion drugs have boxed warnings in pregnancy

A

ACE
ARB
PSCK9i

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

First line txm for HTN in pregnancy

A

labetalol
nifedipine ER
Metyhldopa less effective but an optionW

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When to start txm for HTN?

A

Start stage 2
Stage 1 + CVD, ASCVD > 10%, dont drop BP after 6 month of life changes

Goal = <130/80

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where do thiazide diuretics work?

A

Inhibit sodium reabsorption in DCT< inc excretion of sodium, Cl, H20, potassium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Thiazide CI

A

cross hypersensitivity with sulfonamide-derived drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Thiazide side effects

A

dec K/Mg/Na
Inc Ca/UA/LDL/TG/BG
Photo sensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Thiazides are not effective when

A

CrCl < 30 mL/minT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Thiazide notes

A

take during day to avoid nocturia
Chlorothiazide only one you can get IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Dont use thiazides in combo with drugs that inc sodium/water retention such as…

A

NSAID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Two types of CCB

A

DHP
Non-DHP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

DHP CCBs

A

Nifedipine
Amlodipine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Non-DHP CCBs

A

diltiazem
Verapamil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

DHP CCB warnings

A

Hypotension
** Nifedipine IR: dont use for chronic HTN or acute BP reduction in non-pre adults **

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

DHP CCB side effects

A

Peripheral edema
Headache
flushing
palpitations
reflex tachycardia
gingival hyperplasia (more w/ non DHP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Safest CCB to use in HFrEF?

A

Amlodipine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which DHP is drug of choice in pregnancy

A

Nifedipine ER

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Clevidipine CI

A

allergy to soybeans, products or eggs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Clevidipine warnings

A

Hypotension
reflex achy
infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Clevidipine side effects

A

Hypertriglyceridemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

DHP CCB work by

A

inhibit Ca ions form entering vascular smooth muscle and myocardial cells, causing peripheral arterial vasodilation (dec SVR/BP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Non-DHP CCB work by

A

inhibit Ca ions from entering vascular smooth muscle and myocardial cells (more selective for myocardium than DHP)

decrease in BP due to negative inotropic and chronotropic effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Non-DHP CCBs CI

A

AV block or sick sinus syndrome
acute MI and pulmonary congestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Non-DHP CCBs warnings

A

May worsen HF symptoms
bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Non-DHP CCBs side effects

A

Edema
constipation (more w/ verapamil)
gingival hyperplasia

29
Q

All CCBs should not be used with….

A

grapefruit juice

30
Q

Pts on diltiazem and verapamil who are taking statins should….

A

lower doses of simvastatin or lovastatin

31
Q

Angioedema is more common with…

A

ACEi than ARBs or aliskiren
black patients higher risk

if pts develops it with any RAASi, other RAASi should be avoided

32
Q

ACEi mechanism of action

A

block conversion of angiotensin I to angiotensin II, leading to dec vasoconstriction and aldosterone secretion

33
Q

ACEi side effects

A

dry cough**
hyperkalemia (inc potassium)
inc SCr

34
Q

ACEi boxed warnings

A

D/c if pregnancy detected

35
Q

ACEi CI

A

Dont use w/ history of angioedema
Dont use within 36hrs of entresto
dont use w/ aliskiren in diabetes

36
Q

ACEi warnings

A

angioedema
hyperkalemia
renal impairment

37
Q

ARBs mechanism of action

A

Block Angiotensin II form binding to receptor

38
Q

ARBs safety/side effects

A

Less cough
Less angioedema
No washout period required w/ Entresto

39
Q

ACEi/ARBs effect in lithium?

A

Can decrease lithium renal clearance and inc risk of lithium toxicity

40
Q

Potassium-sparing diuretics

A

Triamterene and amiloride

41
Q

Potassium-sparing diuretics used often in….

A

combo with HCTZ to counteract mild potassium lossess

42
Q

Preferred add-on drugs in resistant HTN are

A

aldosterone receptor antagonists

spironolactone & eplerenone

43
Q

Spironolactone vs eplerenone

A

Spironolactone = non-selective
Eplerenone = selective, doesnt exhibit endocrine side effects

44
Q

Boxed warnings for Amiloride and triamterene

A

K > 5.5

45
Q

Spironolactone SE and CI

A

CI: dont sue in hyperkalemia, severe renal impairment or Addison’s disease

SE: Gyno, breast tenderness, impotence

46
Q

Beta-1 Selective Blockers : AMEBBA

A

Atenolol
Metoprolol tartrate/succinate
Esmolol
Bisoprolol
Betaxolol
Acebutolol

47
Q

Beta blockers boxed warnings

A

Down stop abruptly, taper slowly over 1-2 weeks

48
Q

Beta blocker warnings

A

caution pts with diabetes, can mask hypoglycemia
caution in COPD/asthma
caution Reynaud’s

49
Q

Beta blocker side effects

A

Bradycardia
Fatigue
hypotension
dizziness
depression
impotence

50
Q

Metoprolol notes

A

tartrate IV:PO ratio 1:2.5

should be taken with food, but other ones dont need to

51
Q

Nebivolol CI

A

severe liver impairment Child-Pugh B or C

52
Q

Beta blockers used in portal hypertension?

A

Non-selective

Propranolol, nadolol, pindolol, timolol

53
Q

All forms of carvedilol should be taken with….

A

food, to dec rate of absorption and risk of orthostatic hypertension

54
Q

Which beta blocker is drug of choice in pregnancy?

A

Labetolol

55
Q

Clondine is usually used for….

A

resistant hypertension

56
Q

Methyldopa CI

A

concurrent use with MAOi and acute liver disease

57
Q

Clonidine warning

A

Dont d/c abrupt y, can cause rebound hypertension and should taper

58
Q

Clondine side effects

A

dry mouth
somnolence
fatigue
dizziness
constipation
dec HR
Hypotension
impotence

** remove patch before MRI**

59
Q

Methyldopa Side effects

A

DILE
edema or weight gain
inc prolactin lvls

** can use in pregnancy **

60
Q

Direct vasodilators mechanism of action

A

Hydralazine
Minoxidil

61
Q

Hydralazine warnings & SE

A

warnings: DILE

SE: peripheral edema
Headache
flushing
palpitations
reflex tachy

62
Q

Minoxidil Boxed warning, CI, SE

A

Boxed warning: potent antihypertensive, with with Beta-blocker n loop diuretic

CI: Pheochromocytoma

SE: Fluid retention, tachycardia, hair growth

63
Q

Alpha blockers not recommended for HTN but may be used in men with….

A

HTN and benign prosaic hyperplasia

64
Q

Alpha blockers

A

Doxazosin
prazosin
terazosin

65
Q

Hypertensive crisis

A

BP > 180/120

2 types, emergency or urgency

66
Q

Hypertensive emergency

A

patient has acute target organ damage that may be life threatening

Treat with IV meds, decrease BP by no more than 25% in 1st hour

67
Q

Hypertensive urgency

A

no evidence of acute target organ damage

Use short acting oral med, gradually decrease BP over 24-48hrs

68
Q
A

NAPLEX review 2024 RXPrep Book (67 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions