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Flashcards in Gupas Info Deck (24)
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1

JNC 8 BP classification

Normal = <120 and <80

Prehypertenson = 120-139 / 80-89

Stage 1 = 140-159 / 90-99

Stage 2 = >160 / > 100

2

ACC/AHA BP classifications

Normal = <120 / <80

Elevated = 120-129 / <80

Stage 1 = 130-139 / 80-89

Stage 2 = >140 / >90

3

JNC-8 goals of therapy

Age <60 = <140/90 **limited data for pt 18-29

Age > 60 = <150/90 ** Can try to get 140/90 but watch for AE that effect QOL, treatment doesnt need to be adjusted

Diabetes and CKD =. <140/90 **regardless of age

4

ACC/AHA goals fo therapy

Known CVD or 10-year ASCVD event risk > 10% = 130/80
*** CVD = CHD, CHF, stroke; ASCVD is using Pooled Cohort equation

Diabetes, CKD, all other patients = <130/80

5

JNC-8 Therapy recommendations

Normal (<120/<80) = N/A

Pre (120-139/80-89) = Non-pharm treatment

Stage 1 (140-159/90-99) = non-phram and 1-drug

Stage 2 (>160/>100) = Non-pharm and 2 drugs

6

ACC/AHA therapy recommendations

Normal (<120/<80) = Promote healthily lifestyle

Elevated (120-129/<80) = non-pharm therapy

stage 1 (130-139/80-89) = If estimated 10 year CVD < 10% , initiate non-pharm; if clinical CVD or 10 year risk >10% then non-pharm and 1 drug

Stage 2 (>140/>90) = non-pharm and 1-2 BP-lowering meds

7

Therapy recommendations for Non-black, black, CKD and diabetes

Non-black - any first line (ACEI/ARB, thiazides and CCB)

Black- Start with CCB or thiazides

CKD - ACEI/ARB (regardless of race)

Diabetes - With albuminuria= ACEI/ARB (regardless of race)
Without Albuminuria= any first line DEPENDING on race

*****Albuminuria = >300mg/day or >300mg/g albumin-to-creation ratio

8

Lisinopril dosing got HTN

Zestril/Prinivil

Max effective dose is 40mg/day

9

Losartan max effective dose for HTN

Cozaar

100mg/day

10

Valsartan max daily dose for HTN

Diovan

Max effective is 320mg/day

11

Chlorthalidone max effective dose of HTN

Hygroton

25mg/day is max for HTN

12

Hydrochlorothiazide max dose for HTN

HydroDiuril/Mircozide

Max dose is 25-50mg/day

13

Spironolactone max dose for HTN

Aldactone

25-50mg/day for HTN

14

Amlodipine max daily dose for HTN

10mg/day

Norvasc

15

B1 selective beta blockers

AMEBBA
Atenolol
Metoprolol
Esmolol
Bisoprolol
Betaxolol
Acebutolol

With Nitric oxide
Nebivolol

16

Non-cardioselevtive beta blockers

Propranolol
Time lol
Nadolol
Pindolol (with ISA)

17

Beta blockers with a1 blocker

Carvedilol
Labetalol

18

Summery of ACEI, ARB, RI side effects

HyperK

Inc SrCr

C/I in prego

Angioadema / cough (ACEI)

Spartans, tekterna, prils

19

Summery of Thiazdies and loops side effects

HYPOK

HYPONa

HYPERuricemia (uric acid)

Photosensitive (HCTZ)

Thiazides = HCTZ, chlorthaladone, metaxlone, indapamide

Loops = furosemide, butinemide, ethacrynic acid, torsemide

20

Summery of K-sparring side effects

HYPERK

Gyneomastia (spironolactone)

ENaC = amiloride, triemtamine

ARAs = spironolactone and eplerenone

21

Summery of effects for DHP CCBs

No effect on HR

Peripheral edema

Headache

3A4 Substrates

-dipines

22

Summery of effects of beta blockers

Bradycardia

Dizziness

Fatigue

4 contraindications (2-3rd degree AV block, Severe bradycardia, decompensated heart failure, cardiogenic shock)

Don’t DC abruptly (must tapper 1-2 weeks for inc risk of CV, stroke, MI, reflexive tachycardia)

23

Summery of a1 blockers and a2 agonists

Orthostatic hypotension

Dizzy

Fatigue/drowsiness

Headache

Don’t DC abruptly (a2 only)

a1 = -zosins

A2= clonidine, methylodpa (good for prego), guanfacine

24

Summery of direct arterial vasodilators

Reflex tachycardia

Edema

DILE (lupus thing with hydralazine only)

EKG changes and hypertrichosis (hair growth all over (minoxidil only)