HTN/Lipid

Question 1

BP Treatment Goals

Answer 1

< 140/90 for all

< 150/90 for older than 60

Question 2

Pregnancy BP Med of choice

Answer 2

Labetalol

ACEi in pregnancy can cause fetal death

Question 3

What BP meds increase lithium toxicity?

Answer 3

ACEi or ARBs, decrease lithium clearance

Question 4

Which ACEi can be IV?

Answer 4

Enalapril (Vasotec)

Question 5

Tekturna generic

Answer 5

Aliskiren

Question 6

ACEi SE

Answer 6

cough, hyperkalemia, HA

angioedema (more in black pts)

Question 7

True or False: All ARBs are oral tabs

Answer 7

True

-sartan’s

Question 8

Which ARB must stay in original container?

Answer 8

Edarbi (Azilsartan)

Question 9

Which CYP do CCBs affect?

Answer 9

CYP3A4

DHP more potent like amlodipine, nifedipine

Question 10

Which CCB appears in stool?

Answer 10

Procardia XL (Nifedipine ER)

Question 11

Contraindication for IV Diltiazem?

Answer 11

avoid IV beta blockers within a few hours

Question 12

Verapamil many brand names

Answer 12

Calan SR
Covera ER
Verelan ER
(the IR version is TID)

Question 13

main SE from Verapamil

Answer 13

constipation, gingival hyperplasia

Question 14

Types of Diuretics

Answer 14

Loop(more potent. use for HF and edema)-Bumetanide, Furosemide, Torsemide.

Thiazide type use for BP-HCTZ, chlorthalidone, indapamide, metolazone

K+ sparing-Amiloride or Triamterene (avoid w/ ACEi, aliskiren, too much K+)

Question 15

What class of meds interacts with a sulfa allergy?

Answer 15

Thiazide diuretics

Question 16

Thiazide/HCTZ SE

Answer 16

take in AM
hypokalemia, photosensitive (need sunscreen), hyperuricemia
could cause glaucoma?
avoid with lithium and steroids
avoid NSAIDs

Question 17

Which thiazide is ok if CrCl < 30 ml/min?

Answer 17

Metolazone (Zaroxolyn)

Question 18

What BP meds cause gynecomastia?

Answer 18

Aldosterone Antags: Spironolactone, Eplerenone

Question 19

What BP med is on BEERs criteria?

Answer 19

Eplerenone and Spironolactone due to hyperkalemia

Question 20

K+ sparing diuretics (give w/ HCTZ if potassium too low)

Answer 20

Amiloride or Triamterene

Question 21

What class of BP meds can cause ototoxicity?

Answer 21

Loop diuretics (Furosemide, Torsemide, Bumetanide)

Question 22

Furosemide dosing

Answer 22

IV to PO ratio 1:2

ok in CrCl < 30

Question 23

Tenormin generic

Answer 23

Atenolol

renal excretion

Question 24

Zebeta generic

Answer 24

Bisoprolol

Question 25

What Beta blockers are IV?

Answer 25

Esmolol(Brevibloc) | Metoprolol

Question 26

Lopressor generic

Answer 26

Metoprolol (Toprol = brand for XL) Take w/ food. can mask hypoglycemia

Question 27

Bystolic generic

Answer 27

Nebivolol | * contraindication severe liver impairment

Question 28

Sectral generic

Answer 28

Acebutolol

Question 29

Inderal generic

Answer 29

Propranolol

Question 30

Cholesterol normal levels

Answer 30

LDL < 100 HDL > 60 TC < 200 TG < 150

Question 31

Adding Gemfibrozil to Statin therapy is not recommended due to what?

Answer 31

Myopathy No statins in pregnancy

Question 32

Vytorin generic

Answer 32

Simvastatin + Ezetimibe (Zetia)

Question 33

Crestor generic

Answer 33

Rosuvastatin

Question 34

Livalo generic

Answer 34

Pitavastatin

Question 35

Pravachol generic

Answer 35

Pravastatin

Question 36

Lescol generic

Answer 36

Fluvastatin

Question 37

Which statin is not hepatically metabolized?

Answer 37

Pravastatin | *all others are CYP3A4

Question 38

Lipitor generic

Answer 38

Atorvastatin | *no renal adjustment

Question 39

CYP3A4 inhibitors | increase myopathy risk bc statin metabolism is reduced when taken together

Answer 39

``` Ketoconazole, Itraconazole Clarithromycin Nefazodone Fluoxetine, grapefruit juice Cyclosporine Amiodarone ```

Question 40

How does Zetia affect Warfarin?

Answer 40

Increases INR (bleed risk)

Question 41

Welchol generic

Answer 41

Colesevelam (tab) - bile acid seq. | safe in pregnancy

Question 42

Cholestyramine

Answer 42

bile acid seq. (liquid) | 2nd line for LDL lowering

Question 43

Lopid generic

Answer 43

Gemfibrozil | also risk of myopathy. need to renal dose

Question 44

Tricor/Trilipix

Answer 44

Fenofibrate | can increase INR

Question 45

What Niacin is off market?

Answer 45

Simcor-Niacin + Simvastatin Advicor-Niacin + Lovastatin no longer recommended with statins*

Question 46

Mevacor generic

Answer 46

Lovastatin

Question 47

How to reduce Niacin SE?

Answer 47

Flushing. also pruritus | can pre-treat with ASA or NSAIDs

Question 48

What do omega-3 fatty acids treat?

Answer 48

TGs* (no effect on LDL) | Lovaza or Vascepa(Icosapent)