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Flashcards in HTN4 Deck (24):
1

what is the first line option for HTN in CKD?

ACE-I's

2

what effect do ACE-I's have on peripheral vascular resistance?

decrease peripheral vascular resistance and increases vasodialation

3

what effect does angiotensin II have?

potent vasoconstrictor

4

what major effect do ACE-I's have on CHF

decrease risk of death

5

what are 4 evidence based benefits of ACE-I's

1. decrease morbidity and mortality in CHF
2. decrease CKD progression
3. decreases CV events in high risk pts
4. protect kidneys in diabetic pts

6

what is the most common adverse effect of ACE-I's?

dry cough (20%)

7

what is the most severe adverse effect of ACE-I's often seen in the ER?

angioedema (swelling of face)

8

what are some contraindications with ACE-I's

1. pregnancy
2. angioedema
3. bilateral renal artery stenosis
4. unilateral stenosis

9

what are some adverse effects of ACE-I's

1. angioedema
2. dry cough
3. acute renal failure
4. hyperkalemia
5. sexual disfunction
6. rash
7 neutropenia

10

what should be monitored with pt's on ACE-I's

1. renal function (BUN and SCr)
2. K levels
3. BP

11

If a patient has a high potassium level and is on an ACE-I, especially with acute renal failure, what should be done?

withhold ACE-I for a while until K levels normalize

12

what is ACE-I's affect on AKI and CKD

ACE-I's may cause AKI, but protects kidney in CKD.
d/c ACEI's with AKI until acute symptoms are gone

13

what artery condition is contraindicated with ACE-I's

renal artery stenosis (bilateral or unilateral)

14

what are the only non-prodrug ACEI's?

lisinopril and captopril

15

what is the MOAof ARBs?
what are its effects on vasculature?

inhibit angiotensin II type 1 receptor

increase vasodilation and decrease PVR

16

ARB's have the same adverse effects, monitoring and contraindications as what

ACE-I's

17

what type of CCB is most advantageous in HTN

dihydropyridines

18

name the dihydropyridine CCBs

1. nifedipine
2. amlodipine
3. felodipine
4. nicardipine
5. isradipine

19

what is the MOA of CCBs

inhibit L-type calcium channels to prevent calcium influx to cardiac and smooth muscle cells

20

nondihydropyrimines act in what area that dihydropyridines do not?

act in nodal tissue, effecting heart conductance

21

dihydropyridines effect what system the most?
how?

periphery
vasodilation

22

what are some adverse effects of dihydropyridines

peripheral edema
flushing
headache
reflex tachycardia

23

what effect do dihydropyridines have on FOC?
HR?

no effect on force of contraction
no effect, to very little on dihydropyridines

24

what are some contraindications of dihydropyridines?

1. lower extremity edema
2. angina
3. MI
4. HF