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CV PHAR 152 > HTN > Flashcards

HTN Flashcards

(67 cards)

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1
Q

What would happen if the cells in the SA node slowed down their frequency of depolarization over time?

A

they would have sick sinus

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2
Q

What are Sx of sick sinus?

A

dizziness
fatigue
low HR (42)
common in elderly

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3
Q

What is a treatment for sick sinus

A

pacemaker

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4
Q

more Ca entry =

A

stronger contraction
(inotropy/contractility)

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5
Q

faster Ca entry =

A

faster contraction
(chronotropy/HR)

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6
Q

Parts of ECG to look at

A

ST elevation
QT prolongation
QRS
QT prolongation

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7
Q

What is OBPM

A

in the office
attended for BP reading

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8
Q

What is AOBP

A

office automated (unattended)

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9
Q

What is ABPM?

A

Ambulatory BP monitoring

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10
Q

What is HBPM?

A

home BP monitoring

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11
Q

What to consider when taking BP?

A

conditions
timing
duration

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12
Q

Primary HTN

A

chronically increased BP results from multiple factors, no single factor predominates
also commonly associated with the metabolic syndrome

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13
Q

Secondary HTN

A

HTN is caused by significant dysfunction of a single system

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14
Q

Treatment resistance

A

usually defined as lack of BP control despite a combination of 3 HTN medications, one of which being a diuretic

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15
Q

What is masked HTN?

A

home will be high
office will be normal

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16
Q

What is white coat HTN?

A

office will be high
home will be normal

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17
Q

CV Risk Factors Non-Modifiable

A

Age > 55 years
Male
Family History of Premature CV

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18
Q

CV Risk Factors Modifiable

A

sedentary lifestyle
poor dietary habits
abdominal obesity
Dysglycemia
smoking
dyslipidemia
stress hypertension

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19
Q

HTN urgency

A

Situations where BP should be reduced within hours
BP ≥180 / ≥130 AND
papilledema or other target organ changes

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20
Q

HTN Emergency

A

Situations that require immediate BP reduction
E.g. hypertensive encephalopathy, intracranial bleed, unstable angina/MI, acute heart failure

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21
Q

Jugular venous pressure (JVP)

A

indirect assessment of right atrial pressure

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22
Q

Edema

A

swelling or accumulation of fluid in a tissue

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23
Q

How does BP increase from NSAIDs

A

inhibition of renal Pg production
lowers renal perfusion

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24
Q

How does BP increase from steroids

A

mineralocorticoid effects

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25
How does BP increase from hormonal contraceptives
triggers angiotensinogen production from liver
26
How does BP increase from decongestants
SNS activity
27
How does BP increase from alcohol
in excess only. Impairs ADH + other mechanisms likely important
28
Goal for HTN low risk
140/90
29
Threshold for HTN low risk
160/100
30
Goal for HTN moderate
140/90
31
Threshold for HTN moderate
140/90
32
Threshold for Diabetes mellitus
130/80
33
Goal for diabetes mellitus
130/80
34
Goal for high HTN
120
35
Threshold for high HTN
130
36
First line for uncomplicated
TZD ACEI ARB long acting CCB BB >60 years old
37
How long until it should see full effect?
1 month
38
How much will each med lower BP?
10/5
39
What treatment resistance HTN?
3 antiHTN drugs used in combo one of the drugs is diuretic non adherence is ruled out
40
Isolated Systolic HTN
stuff arteries do not accommodate systolic pressure creates a high "pulse pressure" (SBP-DBP)
41
What to use isolated systolic HTN?
TZD ARB long acting DHP CCB
42
What is each of the diuretics best for?
TZD - best for BP reduction Loop - best for fluid excretion K sparring - K+ supplement
43
What is a common consequence of diuretic therapy?
hypokalemia
44
What is low K interpretation?
<3 --> always undesirable 3-3.5 -> usually treated 3.5-4 --> action may be taken
45
Alternatives for Low K
- general measures switch to another diuretic discontinue diuretic if K seriously low add K sparring drugs add K supplement
46
Hyperkalemia
increase K is also potential cause of serious harm
47
Patient factors associated with hyperkalemia
CrCl <60ml/min Baseline K>4.5 mmol/L
48
First line for Diabetes and HTN
ACEi or ARBs without renal - ACEi, DHP CCB or TZD
49
CKD with diabetes
ACEi or ARBs
50
CKD
ACEi adding diuretics
51
HTN Pregnancy
labetalol methyldopa clonidine hydralazine
52
Pre-eclampsia
high BP with proteinuria after 20 weeks
53
Gestational HTN
high BP without proteinuria after 20 weeks
54
Chronic HTN and pregnancy
HTN was present before pregnancy began
55
What are the 3 main vasodilators classes?
Alpha blockers DHP calcium channel blockers smooth muscle relaxants
56
When combining HTN drugs list them in the two categories?
TZD or DHP CCB BB ARB ACEi
57
When should ACEi and ARBs be used in CKD
they should be used near the end they work better the worst the pt is
58
What does the HOPE trial show?
Showed that ACEi has cardio protection
59
What is first line for Vasodilators in uncomplicated HTN
DHP CCB
60
ACEi in HTN and CV disease
Most pt at high risk for CV events are put onto ACEi even if their BP is normal
61
What does accomplish trial show?
showed the ACEi have cough fluid retention is dangerous
62
What does SPRINT trial show?
BP meds help lower the risk for life threatening events
63
What does RENAAL trial show?
ARB can help protect the kidney works better on worst CKD at baseline
64
What does IDNT trial show?
ARB can help protect the kidney works better on worst CKD at baseline
65
What to monitor for ACEi or ARBs?
Kidney function -> renal harm is possible from the drugs lowering glomerulus pressure can be bad for the kidney too
66
What should happen to monitor for renal safety for ACEi and ARBs?
obtain SCr and K within 1-2 wks should not be less than 20-25% changes BP and edema should get better not worst
67
What should be monitored for all BP drugs?
Dizziness/headache/hypotension orthostatic hypotension Erectile Dysfunction

CV PHAR 152 (4 decks)

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