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Cardiovascular Disorders Flashcards

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1
Q

Which stage of hypertension is a SBP of 120-139 mmHg / DBP of 80-89 mmHg?

A

Pre-hypertension

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2
Q

Which stage of hypertension is SBP 140-159mmHg / DBP 90-99?

A

Stage 1 Hypertension

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3
Q

What stage of hypertension is SBP >160 mmHg / >100 mmHg?

A

Stage 2 Hypertension

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4
Q

What are the JNC8 blood pressure goals for uncomplicated Hypertension in >60 years and <60 years?

A

<140/90 for <60 years

<150/90 for >60 years

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5
Q

What are the JNC8 blood pressure goals for a patient with diabetes or CKD?

A

<140/90

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6
Q

What treatment does JNC8 recommend for a patient with hypertension and the compelling indication of Left Ventricular Dysfunction?

A

Diuretic with ACEi or ARB, then add a Beta Blocker

Can add on an Aldosterone Antagonist as second line

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7
Q

What treatment does JNC8 recommend for a patient with hypertension and the compelling indication of prior MI?

A

Beta blocker, then add ACEi or ARB

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8
Q

What treatment does JNC8 recommend for a patient with hypertension and the compelling indication of Coronary Artery Disease?

A

Beta blocker, then ACEi or ARB

CCB as second line

Thiazide as 3rd line

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9
Q

What treatment does JNC8 recommend for a patient with hypertension and the compelling indication of Diabetes Mellitus?

A

ACEi or ARB if Caucasian

CCB or Thiazide if African American

ACEi or ARB, CCB, Thiazide as second line

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10
Q

What treatment does JNC8 recommend for a patient with hypertension and the compelling indication of CKD?

A

ACEi or ARB

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11
Q

What treatment does JNC8 recommend for a patient with hypertension and the compelling indication of Recurrent Stroke Prevention?

A

Thiazide or Thiazide + ACEi

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12
Q

What therapy approach does JNC8 recommend for stage 1 hypertension?

A

Mono therapy using ACEi, ARB, CCB, or Thiazide

For African Americans: CCB or Thiazide

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13
Q

What therapy approach does JNC8 recommend for stage 2 hypertension?

A

Initiate a two drug combination, preferably using:

Thiazide or CCB
PLUS
ACEi or ARB

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14
Q

What class of diuretic is chlorthalidone?

A

Thiazide diuretic

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15
Q

What class of drug is Lozol?

A

Thiazide diuretics

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16
Q

What class of drug is Metolazone?

A

Thiazide diuretics

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17
Q

What is the MOA of thiazide diuretics?

A

Inhibit Na+ reabsorption in the distal convoluted tubule

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18
Q

What is the brand name of chlorthalidone?

A

Thalitone

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19
Q

What is the brand name of hydrochlorothiazide?

A

Microzide

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20
Q

What is the brand name of Metolazone?

A

Zaroxolyn

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21
Q

What is a contraindication for thiazide diuretics?

A

Sulfa allergy

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22
Q

What are the six primary side effects of thiazide diuretics?

A

Hypokalemia, hypomagnesemia, hyponatremia, hypercalcemia, hyperglycemia, hyperuricemia.

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23
Q

What are the five main monitoring parameters for Thiazide diuretics?

A

Blood pressure, electrolytes, BUN/SCr, blood glucose, uric acid

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24
Q

What is the drug interaction between thiazide diuretics and lithium?

A

Thiazides may increase the risk of lithium toxicity

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25
What is the drug interaction between thiazide diuretics and antidiabetic agents?
Thiazides may decrease the effects of antidiabetic agents
26
What is the drug interaction between thiazide diuretics and NSAIDs?
NSAIDs May decrease the antihypertensive effects of thiazides
27
What is the correlation between thiazide diuretics and creatinine clearance?
Thiazide diuretics are not effective when CrCl is less than 30 mL/min. The exception to this is Metolazone. In the case of CrCL less than 30 mL/min a loop diuretic should be used.
28
True or False Thiazide diuretics have a ceiling dose and loop diuretics do not?
True
29
What is the MOA of Loop diuretics?
Inhibit Na+ reabsorption in the ascending loop of Henle
30
What are the only three cases that loop diuretics should be used for hypertension?
CrCl <30 mL/min Severe edema Heart failure
31
What is the MOA of potassium sparing diuretics?
Inhibits Na+ reabsorption in the collecting ducts
32
What are the two potassium sparing diuretics?
Midamor (Amiloride) | Triamterene (Dyrenium)
33
What are the two contraindications for potassium sparing diuretics?
Hyperkalemia and CKD
34
What are the three main monitoring parameters for potassium sparing diuretics?
Blood pressure, K+, BUN/SCr
35
What is the risk involved with using potassium sparing diuretics K+ supplements, ACEis, ARBs, ARAs, Or NSAIDs?
Increased risk of hyperkalemia
36
True or False Potassium sparing diuretics are often used as monotherapy?
False Potassium sparing diuretics are weak antihypertensives. Therefore they are usually used with HCTZ to decrease K+ loss
37
What is the brand name for triamterene and hydrochlorothiazide?
Dyazide or Maxzide
38
What is the brand name for amiloride and HCTZ
Moduretic
39
What is the MOA of aldosterone receptor antagonists and how often are they used for hypertension?
Similar to potassium sparing diuretics but they also block the effects of aldosterone. They are not often used for hypertension
40
What is the name brand for Spironolactone and hydrochlorothiazide?
aldactazide
41
What is the MOA of beta blockers?
Decreased cardiac output it by negative inotropic (decreased contractility) and negative chronotropic (decreased HR) effects.
42
What makes a beta blocker cardioselective and why would you need one?
Finding more to B1 than B2 receptors (at low doses) making it less likely to cause bronchoconstriction. It is safer to use in patients with Asthma, COPD, PAD or DM.
43
Which beta blockers are cardioselective?
BAMBA Bisoprolol, Atenolol, Metoprolol, Betaxolol, Acebutolol
44
Which beta blockers have intrinsic sympathomimetic activity/partial B receptor agonist activity?
CAPP Carteolol, Acebutolol, Pindolol, Penbutolol
45
Which beta blockers are lipophilic and thus more likely to cause CNS side effects such as depression and fatigue?
Propranolol, metoprolol, carvedilol, labetolol, pindolol
46
What is the brand name of acebutolol?
Sectral
47
What is the brand name of betaxolol?
Kerlone
48
What is the brand name of bisoprolol?
Zebeta
49
What are the two contra indications for beta blockers?
Greater than or equal to 2nd° heart block and heart failure (with the exception of metoprolol, bisoprolol or carvedilol)
50
What is the concern with beta blockers and diabetic patients?
Beta blockers can mask hypoglycemia in patients with diabetes
51
What drug interaction exist between beta blockers and negative chronotropes (digoxin, verapamil, diltiazem, clonodine)?
Increased risk of Bradycardia
52
What is the proper way to discontinue beta blockers?
Abrupt discontinuation may cause angina, MI, or hypertensive emergency. You must taper the dose over two weeks
53
What is the brand name for carvedilol?
Coreg
54
What is the brand name for labetalol?
Trandate
55
What is the brand name for Nadolol?
Corgard
56
What is the brand name for timolol?
Blocadren
57
Which beta blockers have alpha-1 blocking properties?
Labetalol and carvedilol
58
What is the brand name for atenolol and chlorthalidone?
Tenoretic
59
What is the brand name for bisoprolol and hydrochlorthiazide?
Ziac
60
What is the brand name for a propanolol and hydrochlorthiazide?
Inderide
61
What is the brand name for metoprolol and hydrochlorthiazide?
LopressorHCT
62
What is the mechanism of action of the angiotensin converting enzyme inhibitors?
Prevent the conversion of angiotensin one to angiotensin II leading to vasodilation, decreased aldosterone production and inhibited degradation of bradykinin
63
What is the brand name of benazepril?
Lotensin
64
What is the brand name of captopril?
Capoten
65
What is the brand name of enalapril?
Vasotec
66
What is the brand name of fosinopril?
Monopril
67
What is the brand name of quinapril?
Accupril
68
What is the brand name of moexipril?
Univasc
69
What is the brand name of perindopril?
Aceon
70
What is the brand name of Ramipril?
Altace
71
What is the brand name of trandolapril?
Mavik
72
What are the five contraindications for ACE inhibitors?
Pregnancy, history of angioedema or renal failure with previous use, hyperkalemia, and bilateral renal artery stenosis
73
What are the four primary side effects of ACE inhibitors?
Hyperkalemia, renal insufficiency, dry cough, and angioedema
74
What are the three monitoring parameters for ACE inhibitors?
BP BUN/ SCr K+
75
What is the drug interaction with ACEis or ARBs and lithium?
ACEis or ARBs may increase lithium toxicity
76
Which ACEi has the shortest duration of action?
Captopril
77
What is the brand name for benazepril and amlodipine?
lotrel
78
What is the name brand for benazepril and hydrochlorthiazide?
Lotensin HCT
79
What is the brand name for captopril and hydrochlorthiazide?
Capozide
80
What is the brand name for enalapril and hydrochlorthiazide?
Vaseretic
81
What is the brand name for fosinopril and hydrochlorthiazide?
Monopril HCT
82
What is the brand name for lisinopril and HCTZ?
Zestoretic
83
What is the brand name for trandolapril and verapamil?
Tarka
84
What is the MOA of the angiotensin II receptor blockers?
Inhibit the binding of angiotensin II to the angiotensin type one receptor leading to vasodilation, decreased aldosterone production, with no effect on bradykinin
85
What is the brand name of eprosartan??
Tevetan
86
What is the brand name of Irbesartan?
Avapro
87
What is the brand name of losartan?
Cozaar
88
What is the brand name of olmesartan?
Benicar
89
What is the brand name of telmisartan?
Micardis
90
What is the brand name of valsartan?
Diovan
91
What is the brand name of candesartan and hctz?
Atacand HCT
92
What is the brand name of irbesartan and hctz?
Avalide
93
What is the brand name of losartan and hctz?
Hyzaar
94
What is the brand name of olmesartan and amlodipine?
Azor
95
What is the brand name of telmisartan and amlodipine?
Twynsta
96
What is the brand name of valsartan and amlodipine?
Exforge
97
What is the name brand for Aliskiren?
Tekturna
98
What is the MOA of renin inhibitors?
Inhibits renin and prevents the conversion of angiotensinogen to angiotensin one, which then decreases production of angiotensin II
99
What are the four contra indications for renin inhibitors?
Pregnancy, history of drug induced angioedema, hyperkalemia, and bilateral renal artery stenosis
100
What are the five primary side effects for renin inhibitors?
Headache, dizziness, diarrhea, hyperkalemia, and renal insufficiency
101
Which three drugs may increase the effects of renin inhibitors?
Atorvastatin, ketoconazole, and cyclosporine
102
What type of meals should be avoided when taking aliskiren?
High fat meals
103
What is the brand name of aliskiren and hydrochlorothiazide?
Valturna
104
What is the MOA of calcium channel blockers?
Bind to L type channels and the heart to block in word movement of calcium waiting to vascular smooth muscle relaxation (vasodilation)
105
Which calcium channel blockers have negative inotropic effects (decreased contractility)?
All of them except amlodipine and felodipine
106
How are the dihydropyridine calcium Channel blockers different?
They are more selective to vasculature and are more potent vasodilators. They also have no effect on cardiac conduction
107
Which calcium channel blocker's are non-dihydropyridines and what makes them different?
Diltiazem and verapamil. They cause less peripheral vasodilation and have negative chronotropic properties. (Decreased heart rate)
108
What is the brand name for felodipine?
Plendil
109
What is the brand name of israpidine?
DynaCirc CR
110
What is the brand name for nicardipine?
Cardene
111
What is the brand name for nifedipine?
adalat or procardia XL
112
What is the brand name for nisoldipine?
Sular
113
What are the six primary side effects of DHP calcium channel blockers?
Reflex tachycardia, headache, Flushing, peripheral edema, gingival hyperplasia, heart failure exacerbation (except for amlodipine and felodipine which do not cause negative inotropy/decreased contractility)
114
What are the three key monitoring parameters for calcium channel blocker's
Blood pressure, heart rate, signs of heart failure
115
What is the effect of CYP3A4 inducers and inhibitors on DHP calcium channel blockers?
CYP3A4 inducers may decrease CCB effects Inhibitors my increase effects
116
True or false you should not use grapefruit juice when taking any calcium channel blocker?
True
117
What is the brand name for diltiazem?
cardizem or Taztia
118
What is the brand name for verapamil?
calan
119
What are the two contra indications for non-DHP calcium channel blocker's?
Greater than or equal to 2nd° heart block and systolic heart failure
120
What are the five primary side effects of non-DHP calcium channel blockers?
Bradycardia or heart block, constipation, peripheral edema, gingival hyperplasia, and Heart failure exacerbation

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