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PHRM3011 > Hypertension > Flashcards

Hypertension Flashcards

1
Q

Compare primary and secondary hypertension

A

Primary = no underlying cause. Secondary = caused by underlying health condition like kidney disease

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2
Q

Sx of hypertension?

A

Often none.

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3
Q

Optimal blood pressure?

A

120/80

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4
Q

Mild hypertension is 140/90, what is moderate?

A

160 /100

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5
Q

What is classified as severe hypertension?

A

180/110

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6
Q

Target BP for hypertensive patients?

A

140/90 or lower

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7
Q

Would you commence anti HT treatment if the patients BP was 170/100?

A

No. Usually only start if 180/110 or if isolated systolic HT

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8
Q

Name 2 substances that can increase BP and may exaggerate a BP reading

A

Caffiene and cigarettes

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9
Q

Which arm should you use to measure BP?

A

Once on each arm, then repeat on the arm with the highest measurement

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10
Q

Most accurate vs least accurate BP measuring tool?

A

Mercury is the best, then finger is the worst

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11
Q

First progression to Tx if the first line drug isn’t effective?

A

Add a second drug, then increase the dose of the first drug if needed

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12
Q

Which 2 classes of drugs can be teratogenic

A

ACEI and Sartans

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13
Q

CCBs can have what effect on a fetus?

A

Foetal hypoxia

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14
Q

Which 2 beta blockers are ok for use in pregnancy?

A

Labetolol and oxprenolol

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15
Q

2 first line anti-HTs for pregnancy?

A

Labetolol or methyldopa

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16
Q

Which beta blockers is excreted excessively in breast milk and should be avoided when breastfeeding?

A

Atenolol. The rest are ok

17
Q

Which combination is better, ACE-I + CCB or ACE-I + ARB?

A

ACE-I + CCB. Second combo is contraindicated due to risk of renal issues

18
Q

Verapamil + beta blocker combination is avoided. why?

A

Risk of heart block. Risk is less when verapamil is replaced with diltiazem

19
Q

Thiazide diuretics are not recommended in which 2 conditions?

A

GOUT (increases Uric acid levels) and diabetes (causes hyperglycaemia)

20
Q

Why can ACE-Is not be used with NSAIDs?

A

Causes a reduced GFR, leading to increased BP and kidney damage

21
Q

Which drug class can cause a cough?

A

Ace inhibitors. Due to their ability to inhibit bradykinin breakdown

22
Q

2 ADRs to watch for in ACE-Is?

A

Cough and angioedema (swelling of face and lips)

23
Q

A patient on a diuretic or recently had diarrhoea / fluid loss is more likely to experience which ADR of ACE inhibitors?

A

First dose hypotension

24
Q

Which class of CCBs do amlodipine and nifedipine belong to?

A

Dihydropyridines. Note the suffix -ipine

25
Q

Diltiazem and verapamil are more selective for the peripheral vasculature. True or false?

A

False. More selective for heart

26
Q

Name 2 non-dihydropyridines.

A

Verapamil and diltiazem

27
Q

Which class of anti-HTs can cause reflex cardiac events such as tachycardia, angina or palpitations?

A

Short acting dihydropyridines like nifedipine. Because it is more selective for vasculature and has little cardiac activity.

28
Q

B1 selective beta blockers?

A

Atenolol, metoprolol, bisoprolol

29
Q

Which receptors is propranolol most selective for?

A

B1 and B2. Not selective

30
Q

Labetolol is a non-selective beta blocker that also antagonises the A1 receptor. What effect does this cause?

A

Vasodilation

31
Q

Why aren’t beta blockers first line agents in elderly patients?

A

Because they are less protective against strokes compared to the others

32
Q

Why is label 9 needed on BBs?

A

Because your body compensates by producing more beta receptors. If you suddenly stopped, increased activity of all the receptors would cause rapid HR, angina, rebound HT, etc. Need to reduce over a few weeks

33
Q

Why is precaution needed for BBs in diabetes?

A

Can mask signs of hypoglycaemic events such as tachycardia or tremors.

34
Q

ADRs of beta blockers?

A

Bradycardia, hypotension, orthostatic hypotension, cold extremities, altered lipids, SLUDGE BBB

35
Q

Name 2 ARBs

A

Irbesartan and candesartan

36
Q

Which supplements and drugs need to be stopped before starting ARB Tx?

A

Potassium supplements and potassium sparing diuretics. Would cause hyperkalemia

37
Q

ARB ADRs?

A

Dizzy, headache, hyperkalaemia, orthostatic hypotension, first dose hypotension, etc

38
Q

If a patient‘s GFR was reduced by 25% after starting an ACE-I, would you stop Tx?

A

Generally not stopped unless decline is greater than 30%. Also need to ask about NSAID use.

PHRM3011 (17 decks)

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