Hypertension Flashcards
(61 cards)
Which htn drug to choose initially if black
thiazide or CCB
when to start 2 1st line drugs
in stage 2 when avg SBP and SBP 150/90
which drugs should be used in pregnancy and when to start?
BP goal: if 160/105
may use labetalol and nifedipine ER 1st line or methyldopa
where do thiazide diuretics work?
distal convoluted tubule
What is in Zestoritic, Hyzaar, benicar, diovan?
ace/arb + hydrochlorothiazide
what is in lotrel, exforge
ace or arb + ccb
what is in tenoretic, ziac
betablocker + diuretic
what is in maxzide, dyazide
k sparing + hydrochlorothiazide
BP categories:
- Normal: 120/80
- Elevated: 120-130/80
- Stage 1: 130-139 OR 80/89
- Stage 2: greater than 140/90
When to start tx
If stage 2 (>140/90) or if stage 1 (130-140/80-89) with clinical CVD/10% 10 year ascvd risk
when to check BP
every 4 weeks
thiazide diuretic MOA
inhibit NA/cl cotransporter thus preventing its reabsorption into the blood and resulting in excretion of Na, Cl, H20, MG and K
Retains CA, UA,
All diuretics retain: LDL, TG, BG
Thiazide monitoring
renal function because not effective when CrCL <30
Norvasc
Amlodipine
Cardene
Nicardipine IV
Adalat CC, Procardia XL
Nifedipine ER
MOA of DHP CCB
blocks ca channels on peripheral smooth muscle to cause “vasodilation”
DHP CCB names end in
“pine”
DHP CCB side effects
- Vasodilator class s/e: peripheral edema, headache, flushing, palpitations, reflex tachy
- gingival hyperplasia
Non-DHP CCB MOA
inhibit ca entry into cardiac smooth muscle (but are more selective for myocardium) to decrease HR and contractility
big warning for non-dhp ccp
avoid in HF due to negative ionotropic and chronotropic effect that suppresses CO and ability of heart to pump even more
Which are non-DHP CCB
Diltiazem (Cardizem, Tiazac), Verapamil (Calan SR)
All CCB are substrates of what
CYP3a4
ace inhibitors end in
-pril
