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Fall > HTN > Flashcards

HTN Flashcards

1
Q

Stage 1 HTN reading

A

130-139/ 80-89

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2
Q

What is the pathophysiology of HTN

A

An increase in after load affects stroke volume which in turn raises the blood pressure

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3
Q

digoxin and nifedipine (procardia xl) together interacts how together

A

Nifedipine affects the absorption of digoxin and can increase the risk of digoxin toxicity.

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4
Q

Decrease sympathetic impulses from the CNS to the heart and arterioles, causing vasodilation. Is the mechanism of action of what drugs

A

Alpha, agonists

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5
Q

Drugs whose mechanism of action
Inhibit sympathetic activation in arterioles, causing vasodilation are called what

A

Alpha, blockers

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6
Q

Drugs with a mechanism of action that
Act on the smooth muscle of arterioles, causing vasodilation are called what

A

Direct vasodilators

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7
Q

Drugs with a mechanism of action that
Decreaso the heart rate and myocardial contractility.
reducing cardiac output are called what?

A

Beta blockers

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8
Q

Drugs with a mechanism of action that
Block calcium ion channeis in artorial
smooth muscie
causing
vasodilation are called what?

A

Calcium channel blockers

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9
Q

Drugs with a mechanism of action that
Prevents angiotensin
Il from reaching its receptors, causing vasodilation are called what

A

Angiotensin receptor blockers

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10
Q

Drugs with a mechanism of action that
Block formation of angiotensin Il, causing vasodilation, and block aldosterone secretion, decreasing fluid volume. Are called what?

A

ACE inhibitors

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11
Q

Drugs that increase urine output and decrease fluid volume are called what

A

Diuretics.

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12
Q

Elevated blood pressure level

A

120-129/ less than 80

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13
Q

Htn stage 2 levels

A

140 and above/ 90 and above

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14
Q

First line drugs for hypertension

A

ACE inhibitors
Angiotensin receptor blockers (arbs)
Calcium channel blockers
Thiazide diuretics

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15
Q

Second line drugs for hypertension

A

Alpha 1- adrenergic blocker
Aloha2- adrenergic agonists
Beta-adrenergic blockers
Centrally acting alpha and beta blockers
Direct-acting vasodilators
Direct renin inhibitors
Peripherally acting adrenergic neuron blockers

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16
Q

What herbal hypertension remedy should be discontinued if patient is taking an anticoagulant drug.

A

Grape seed extract
Increased risk of bleeding

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17
Q

Common adverse effect of ACE inhibitors that is usually minor

A

Persistent cough
From accumulation of bradykinin.

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18
Q

Most serious adverse effect of ACE inhibitors that usually would develop within hours or days after beginning treatment with drug. (Although late onset has been reported months or years after therapy starts)

A

Angioedema
Swelling around the lips, eyes, throat and other body regions.

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19
Q

Concurrent use of ACE inhibitor, ARB, or renin inhibitor is or is not recommended for HTN patients

A

Not. It can be harmful and low effectiveness

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20
Q

Losartan (cozaar)
Is what type of drug
- pregnancy category?

A

Angiotensin 2 receptor blocker (ARB)
- pregnancy category D (do not use)

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21
Q

Nifedipine (adalat cc, procardia xl) is what class do drug
- what special administration alert needs to be considered with this drug

A

Calcium channel blocker
- do not administer immediate release formulations if an impending MI is suspected or within 2 weeks following a confirmed MI.

22
Q

What drug drug interaction needs to be monitored if a patient is taking nifedipine

A

Digoxin toxicity

23
Q

Beta blockers should be used with caution in what kind of patients and why?

A

Asthma or HF because it slows heart rate and causes brochoconstriction

24
Q

Alpha1 adrenergic blockers main side effects

A

Orthostatic hypotension, dizziness, nausea, nervousness and fatigue.

25
Q

Doxazosin is what kind of drug

A

Alpha 1- adrenergic blocker

26
Q

To prevent the adverse effect of reflex tachycardia when administering a direct vasodilator, what can be done?

A

Concurrent administration of a beta adrenergic blocker like propranolol

27
Q

Hydralazine is what class of drug
And has what contraindications

A

Direct acting vasodilator.
Contraindications for:
Patients with angina, or rheumatic mitral valve heart disease.
Patients with lupus as it worsens symptoms

28
Q

What is the BP level of a hypertensive emergency

A

Greater than 180/ greater than 120

29
Q

What are the 3 primary factors controlling blood pressure

A

Cardiac output, peripheral resistance, and blood volume

30
Q

Heart failure can be caused or accelerated by what conditions

A

Coronary artery disease
Mitral stenosis
Myocardial infarction
Chronic htn
Diabetes mellitus
Dyslipidemia
Thyroid disorders

31
Q

What is an inotropic effect?

A

A change in contractility of the heart

32
Q

Drugs that increase contractility are called what
Examples?

A

Positive inotropic agents
Epinephrine, norepinephrine, thyroid hormone, dopamine.

33
Q

Drugs that decrease contractility are called what?
Examples

A

Negative inotropic agents
Quinidine, beta adrenergic atangonists (propranolol)

34
Q

A patient is at high risk for developing HF but without structural heart disease or symptoms. What stage is this and how to treat

A

Stage A
Lifestyle modifications
Comorbidities treated. (Diabetes, htn, dislipidemia)

35
Q

A patient has structural evidence of heart disease (such as previous MI or valvular disease) but no symptoms. What stage is this and how to treat.

A

Stage B
Continued lifestyle modifications and treat comorbidities. Treat with ACE or ARB. Added beta blockers for patients with prior HF symptoms or MI hx.

36
Q

Patient has structural evidence of heart disease with symptoms of fatigue, fluid retention or Dyspnea. What stage and how to treat.

A

Stage C
Lifestyle mods
ACE or ARBs
Add a beta blocker to control symptoms or isosorbide, dinitrate with hydralazine, digoxin, aldosterone antagonists.
Diuretics if fluid retention is evident.

37
Q

Patient has structural evidence of heart disease with symptoms at rest or during minimal exertion despite optimal medical therapy. What stage. How to treat.

A

Stage D,
Continue lifestyle mods
Tx may include ivabradine, IV diuretics, dopamine, dobutamine, I’v nitroglycerins, nitroprusside, nesiritide, or phosphodiesterase inhibitors.

38
Q

What drug
Decreases cardiac workload by slowing the heart rate (B1) and decreasing blood pressure (a1)
(Example: carvedilol)

A

Adrenergic blockers

39
Q

What drugs
Increase cardiac output by increasing the force of myocardial contraction
(Example: digoxin)

A

Cardiac glycosides

40
Q

What drugs Increase cardiac output by increasing the force of myocardial contraction
(Example: milrinone)

A

Phosphodliesterase inhibitors

41
Q

What drugs Increase cardiac output by lowering blood pressure and decreasing blood volume
(Example: lisinopril)

A

ACE inhibitors and angiotensin receptor blockers.

42
Q

What drugs Decrease cardiac workload by dilating vessels and reducing preload (Example: isosorbide dinitrate with hydralazine)

A

Vasodilators

43
Q

What drugs Increase cardiac output by reducing fluid volume and decreasing blood pressure
(Example: furosemide)

A

Diuretics.

44
Q

All patients with HF and those at high risk for HF should receive what drug

A

ACE inhibitor

45
Q

Lisinopril (prinivil, zestril) is what class of drug
Black box warning?

A

Ace inhibitor
Fetal injury or death. Pregnancy contraindication

46
Q

A patient prescribed Lisinopril is discussing how they plan on using salt substitutes to help with their HF. What patient education do you need to address

A

Lisinopril can cause hyperkalemia which is a serious electrolyte imbalance and salt substitutes are generally potassium based, so they should be avoided while taking this med.

47
Q

What is the one potassium sparing diuretic that is useful in the treatment of heart failure

A

Spironolactone

48
Q

What 3 beta blockers are approved for treatment of HF

A

Bisoprolol (Zebeta)
Carvedilol (coreg)
Metoprolol extended release (toprol xl)

49
Q

How are beta blockers administered for HF
And why do we not start give too fast or too much

A

Low initial doses
1/10-1/20 of target dose. Then doubled every 2-4 weeks until optimal dose is reached.

They can worsen HF if too fast or too much

50
Q

What does Ivabradine (corlanor) do

A

It slows ion currents across the sa node which slows heart rate, reducing myocardial oxygen demand.

51
Q

What class of drug is Metoprolol
What black box warning

A

Beta-1 adrenergic blocker
Abrupt withdrawal may exacerbate angina or cause mi.

Fall (13 decks)

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