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Hypertension Flashcards

(47 cards)

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1
Q

Diuretics

A

Inhibit NaCl Pump in DCT
Increase Na and H2O Excretion
SE Hypokalemia
Hydrochlorothiazide HCTZ QD

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2
Q

K Sparing Diuretics

A

Block Na Channels in DCT
SE Hyperkalemia
Amiloride (Midamor) QD
Triamterne (Dyrenium) BID

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3
Q

Loop Diuretics

A

-semides
Blocks Na/Cl/K Transporter in Loop of Henle
Decrease Na Resorb = Decrease H2O Resorb
Best for Pressure & Volume Reduction w/ CHF
SE Dehydration
Furosemide (Lasix) BID
Torsemide (Demadex) QD

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4
Q

Torsemide

A

(Demadex) QD
Loop Diuretic
“Tor Som Dem Loops Today”

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5
Q

Amiloride

A

(Midamor) QD
K Spare Diuretic
Ami Mi Tri and Dye K

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6
Q

HCTZ

A

Hydrochlorothiazide QD

Diuretic “water pill”

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7
Q

First Line Antihypertensives

A

HCTZ & K Spare
Amiloride (Midamor) QD Kspare
Triamterne (Dyrenium) BID Kspare

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8
Q

Furosemide

A

(Lasix) BID
Loop D
“Fur Six Loop Dos”

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9
Q

ACEI

A 
-prills
use in mono or combo therapy
Decreases Angiotensin II conversion from Angiotensin I
Increase Bradykinin Levels= vasodilation
Decrease Sympathetic Activity
First Line Antihypertensive for Renal Disease Pt's
Renal Protective
SE Angioedema!
Lisinopril (Prinvil) QD
Enalapril (Vasotec) QD
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10
Q

Lisinopril

A

(Prinvil) QD
ACEI
“Lisin o pril, is in Prinvil everyday, A”

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11
Q

Enalapril

A

(Vasotec) QD
ACEI
“in the End of April One Day ACE broke the VASe”

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12
Q

ARBs

A

-sartans
Angiotensin II Receptor Blocker
First Line Antihypertensive for Renal Disease Pt’s
Mono or Combo therapy (but not w/ ACEI Duh!)
Renal Protective
Valsartan (Diovan) QD
Losartan (Cozaar) QD

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13
Q

Valsartan

A

(Diovan) QD
ARB
Dio’s van in the Valley of Sartan

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14
Q

Losartan

A

(Cozaar) QD
ARB
Lo Co Zaarb

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15
Q

Aldosterone Receptor Antagonist

A

Spironolactone (Aldactone) QD or BID

Aldosterone receptor Antagonist
Decreases Na Resorb thus Decreases H2O Resorb
Increases Potassium (K)

SE Binds to Androgen Receptors, < testosterone
> estradiol = Gynecomastia, Impotence, Menstrual Abnormalities. SECOND LINE OPTION

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16
Q

Aldosterone

A

Renal Cortex

Increases Na resorb Decreases K

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17
Q

Spironolactone

A

(Aldactone) QD or BID

Aldosterone Antagonist

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18
Q

Beta Blockers

A 
-lol
commonly used
Competitively Inhibits Beta 1 receptors
Decreases HR and Contractility lowering CO
Best in Patients with History of MI
NOT for Asthma or COPD patients (causes constriction)
Metoprolol (Lopressor) BID
Labetalol (Trandate) BID
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19
Q

ADH

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A

Anterior Pituitary
Increases Na and H2O
Vasoconstrictor

20
Q

Metoprolol

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A

(Lopressor) BID

Beta Blocker

21
Q

Labetalol

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A

(Trandate) BID
Beta Blocker (1&2)
Also has Selective Alpha-1 blocking
NOT for Asthma/COPD pt’s

22
Q

Alpha Blockers

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A 
-azosins
Alpha-1 Receptor Blockers
Second Line Option
uncommonly used b/c less effective
Use in Prosthatic Hypertrophy
Doxazosin (Cardua) QD
Terazosin (Hytrin) QHS
23
Q

Doxazosin

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A

(Cardua) QD
Alpha Blocker
“A Block of Dox Cards”

24
Q

Terazosin

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A

(Hytrin) QHS=bedtime
Alpha Blocker
Alpha=#1 High, Tera=Ground “Hy Ground Blocks Water”

25
Sympatholytic Agents
Alpha-2 Receptor Agonists (inhib Norepi Release) Centrally < Resistance via < Sympathetic Outflow Peripherally < R via Depleting Norepi Second Line Option Clonidine (Catapress) BID SE: Rebound HTN, Sex dysfunction,
26
CCBs
Calcium Channel Blockers reduces vasoconstriction by < intracellular Ca Dihydro= Amlodipine (Norvasc) QD & Nifedipine (Procardia) QD Nondihydro= Diltiazem (Cardiazem) BID
27
Antihypertensive Meds
``` 11 Cats: D K L Ace Arb Ald Beta Alpha Sympa CaD CaN Diuretics K Sparing Diuretics Loop Diuretics ACEI ARBs Aldosterone Antagonists Beta Blockers Alpha Blockers Sympatholytic Agents CCBs Dihydropyridines and Nondihydropyridines ```
28
Hypertension DOUBLES Risk of:
``` CAD PAD CHF Stroke Renal Failure ```
29
Clonidine
(Catapress) BID | Sympatholytic Agent
30
Amlodipine
``` (Norvasc) QD Dihydro CCB Focus: decrease SVR & arterial pressure doesn't slow AV node conduction - SE reflex tachy FL Option ```
31
Nifedipine
``` (Procardia) QD Dihydro CCB Focus: decrease SVR & arterial pressure doesn't slow AV node conduction - SE reflex tachy FL Option ```
32
Diltiazem
(Cardiazem) BID Nondihydro CCB Focus: < force of contraction, vasodilation Slows conduction through SA and AV node FL Option for A Fib and Conduction Issues b/c slows SE: Peripheral Edema
33
JNC7 Under 50yrs
ACEI & BB < 50 | ABCD
34
JNC7 Over 50yrs
Diuretic & CCB > 50 | ABCD
35
HTN Lab Workup
BUN/Cr Electrolytes (Na, Cl, K, Ca, Mg) Urinalysis (proteinuria= renal disease) Fasting: Glucose and Cholesterol (metabolic syndrome)
36
JNC 7 Targets
BP < 135-140 / 80-85 w/ CAD & DM < 130/80 Renal Disease < 120 sys w/ CHF no set #
37
JNC 8 Targets
Over 60yrs < 150/90 30-59yrs D < 90 < 30yrs < 140/90 No difference with DM or CKD
38
Resistant Hypertension
BP> 140/90 & on 3 Meds Look for secondary Cause: ETOH, Drugs, Noncompliance, Obesity
39
JNC 8 Med Recommendations
Thiazide, CCB, ACEI or ARB (never ACEI & ARB) "TAC Never Double TAAC" "No More BB Unless MI History" Blacks: CCB or Thiazide "Diabetes Don't Matter" CKD: Add ACE or ARB improve renal outcomes
40
Med for Patients with CKD
ACEI or ARB for Renal Protection
41
Med for Patients with A Fib
CCB NonDihydro Diltiazem "A Fib Zem" A-Z
42
Alpha 1
Vascular Smooth Muscle Vasoconstriction "Alpha 1 CONstricTION" A1C
43
Alpha 2
Norepi Nerves Inhibits Norepi Release "Alpha 2 Glue" Ag
44
Beta 1
Cardiac Cells Increase Rate and Contractility "Beta 1 Get it Done"
45
Beta 2
Vascular Smooth Muscle Vasodilation "Beta 2 Reverse Blue"
46
Cuff Size Too Big=
BLOW Big=Low "This cuff blows"
47
Hypertension Classifications
``` Higher Number Wins Normal _160/>_100 Stage I 140-159/90-99 Stage II 160/100 and up Isolated >140/<90 ```

Hypertension (2 decks)

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