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PHRM 844 > Hypertension > Flashcards

Hypertension Flashcards

1
Q

normal BP followup time

A

1 year

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2
Q

elevated BP followup time and tx

A

3-6 months, non pharm

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3
Q

stage 1 tx and followup

A

ASC >10% or comorbid = nonpharm + 1 agent - 1 month
ASCVD <10% = nonpharm - 3-6 months

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4
Q

stage 2 tx and followup

A

nonpharm and 2+ agents - 1 month

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5
Q

HTN pts at goal followup time?

A

3-6 months

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6
Q

tx initiation BP for ASCVD >10% or CVD

A

130/80

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7
Q

tx initiation for diabetes

A

130/80

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8
Q

tx initiation for secondary stroke

A

140/90

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9
Q

SPRINT trial pts and outcome

A

no diabtetes/stroke
tighter BP goal decreased CV events 25%

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10
Q

ACCORD trial pts and outcome

A

diabetes and CVD
no death benefit with tighter goal
decrease stroke risk 41%

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11
Q

stable ischemic heart disease agents

A

ACE/ARB or beta blocker
if angina: dihydropyridine CCB

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12
Q

heart failure reduced ejection fraction agent

A

avoid non-DHP CCBS

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13
Q

heart failure preserved ejection fraction agent

A

ACE/ARB, diuretic, beta blocker

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14
Q

CKD agent

A

ACE/ARB if albuminuria >300

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15
Q

renal transplant agent

A

DHP CCB

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16
Q

secondary stroke prevention agent

A

ACE/ARB and/or thiazide only if BP >140/90

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17
Q

diabetes agents

A

any first line
ACE/ARB if proteinuria

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18
Q

atrial fib agents

A

ARB

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19
Q

black patients without CKD or HF agents

A

thiazide or CCB

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20
Q

pregnancy agents

A

methyldopa
nifedipine
labetalol

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21
Q

thiazide diuretics drugs

A

HCTZ, chlorthalidone, indapamide, metalozone

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22
Q

thiazides are more effective for pts with a CrCl > what

A

> 30 mL/min

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23
Q

hydrochlorothiazide max dose and dosing

A

25 mg daily

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24
Q

chlorthalidone max dose and dosing

A

100 mg daily

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25
Q

thiazide diuretics effect on potassium

A

hypokalemia

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26
Q

thiazide diuretics adverse effects

A

hypokalemia, hypomagnesemia, hypercalcemia, hyperuricemia, hyperglycemia, sexual dysfunction, increase in triglycerides/cholesterol

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27
Q

thiazide diuretics contraindications

A

sulfa allergy, anuria

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28
Q

loop diuretics drugs

A

furosemide, torsemide, bumetanide, ethacrynic acid

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29
Q

loop diuretics more effective with CrCl < what

A

30

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30
Q

furosemide max dose and dosing

A

80 mg once or twice daily

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31
Q

loop diuretics effect on potassium

A

hypokalemia

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32
Q

loop diuretics adverse effects

A

hypokalemia, hypomagnesmia, hypoclacemia, hyperuricemia, ototoxicity

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33
Q

loop diuretics contraindications

A

sulfa allergy

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34
Q

aldosterone antagonists drugs

A

spironolactone, eplerenone

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35
Q

ALLHAT trial

A

thiazide should be first line

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36
Q

PATHWAY 2 trial

A

spironolactone with resistant HTN

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37
Q

do not initiate spironolactone with what potassium level?

A

greater than 5

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38
Q

spironolactone max dose and dosing

A

100 mg and daily/BID

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39
Q

consider holding dose if potassium ____

A

> 5.5

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40
Q

spironolactone adverse effects

A

hyperkalemia, hyponatremia, gynecomastia

41
Q

contraindications to aldosterone antagonists

A

use with potassium-sparing diuretics

42
Q

potassium sparing diuretics drugs

A

triamterene, amiloride

43
Q

potassium sparing diuretics use

A

concominant with thiazides

44
Q

potassium sparing diuretics caution

A

GOUT, if uncontrolled its bad cause hyperuricemia

45
Q

ACE inhibitors side effects

A

cough, angioedema, hyperkalemia, acute renal failure

46
Q

ACE inhibitors contraindications

A

angioedema on ACE
concominant use of alirisken
pregnancy/breastfeeding

47
Q

ARB adverse effects

A

angioedema, hyperkalemia, acute renal failure

48
Q

ARB contraindications

A

angioedema on ARB
concominant use with alirisken
pregnancy/breastfeeding

49
Q

consider holding ACE/ARB if potassium ____

A

greater than 5.5

50
Q

alirisken

A

no cough
dont use with ACE/ARB

51
Q

alirisken adverse effects

A

hyperkalemia, diarrhea, dizziness, orthostatic hypotension

52
Q

dihydropyridine calcium channel blockers

A

amlodipine, nifedipine

53
Q

DHP uses

A

Reynauds syndrome, elderly with isolated systolic

54
Q

amlodipine max dose

A

10 mg

55
Q

nifedipine max dose

A

120 mg

56
Q

lisinopril max dose

A

40 mg

57
Q

DHP adverse effects

A

reflex tachycardia, peripheral edema

58
Q

DHP interactions

A

grapefruit, CYP3A4

59
Q

non DHP uses

A

afib, angina who cant do beta blocker

60
Q

non DHP does what to heart rate

A

decreases

61
Q

non DHP drugs

A

diltiazem and verapamil

62
Q

non DHP adverse effects

A

bradycardia, AV block, constipation (verapamil esp)

63
Q

non DHP drug interactions

A

concominant use of beta blockers
grapefruit juice
CYP 3A4

64
Q

labs required for CCB monitoring

A

none

65
Q

peripheral edema is ___

A

dose dependent

66
Q

what release is preferred in CCBs

A

extended release

67
Q

CCB drug for heart failure

A

amlodipine

68
Q

beta blockers use

A

HF or CAD

69
Q

avoid abrupt cessation of what drugs?

A

beta blockers and alpha 2 agonists

70
Q

metoprolol tartrate max dose and frequency

A

450 mg BID

71
Q

metoprolol succinate max dose and frequency

A

400 mg daily

72
Q

cardioselective beta blockers

A

metoprolol, atenolol, bisoprolol, bextaxolol, nebivolol

73
Q

non selective beta blockers

A

propranolol

74
Q

avoid which drugs in asthma / COPD?

A

non selective beta blockers (propranolol)

75
Q

ISA beta blockers

A

acebutolol, penbutolol, pindolol

76
Q

avoid what drugs in heart failure

A

ISA beta blockers

77
Q

mixed alpha/beta beta blockers

A

carvedilol, labetalol

78
Q

carvedilol max dose and frequency

A

50 mg BID

79
Q

beta blockers adverse effects

A

masked hypoglycemia, bradycardia, exercise intolerance, depression, fatigue

80
Q

beta blocker contrainidcations

A

heart block, decompensated HF, post-MI, severe bradycardia

81
Q

direct arterial vasodilators

A

minoxidil and hydralazine

82
Q

minoxidil and hydralazine special conditions use

A

severe CKD / hemodialysis

83
Q

minoxidil and hydralazine must have concominant therapy with what

A

beta blocker and diuretic

84
Q

frequncy of hydralazine

A

2-4 times daily

85
Q

frequency of minoxidil

A

1-3 times daily

86
Q

hydralazine/minoxidil side effects

A

tachycardia, chest pain
lupus like sydrome/rash with hydralazine
hair growth with minoxidil

87
Q

minoxidil boxed warning

A

pericarditis, pericardial effusion

88
Q

alpha 1 blockers drugs

A

prazosin, doxazosin, terazosin

89
Q

alpha blockers use

A

HTN with BPH

90
Q

central alpha 2 agonist drugs

A

clonidine, methyldopa, guanfacine

91
Q

alpha 2 agonist side effects

A

CNS depression, dizzy, reflex tachycardia

92
Q

must wean off of which med?

A

clonidine, wean off beta blocker first then 3-4 days to quit clonidine

93
Q

monitoring paramaters for ACE/ARB

A

BUN/Scr, potassium

94
Q

monitoring parameters for CCBs

A

heart rate

95
Q

monitoring parameters for aldosterone antagonists

A

BUN/SCr, potassium

96
Q

monitoring parameters for other diuretics

A

BUN/Scr, electrolytes, uric acid

97
Q

beta blockers monitoring parameters

A

HR

98
Q

steps of resistant HTN

A
  1. 3 drug regimen (ace/arb, ccb, diuretic) max dose
  2. chlorthalidone
  3. spironolactone
  4. beta blocker if HR >70, clonidine if <70
  5. hydralazine
  6. minoxidil
99
Q
A

PHRM 844 (16 decks)

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