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Hypertension > Hypertension > Flashcards

Hypertension Flashcards

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

A

Anterior Pituitary
Increases Na and H2O
Vasoconstrictor

20
Q

Metoprolol

A

(Lopressor) BID

Beta Blocker

21
Q

Labetalol

A

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

22
Q

Alpha Blockers

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

A

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

24
Q

Terazosin

A

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

25
Q

Sympatholytic Agents

A

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, <heroin withdrawl

26
Q

CCBs

A

Calcium Channel Blockers
reduces vasoconstriction by < intracellular Ca
Dihydro=
Amlodipine (Norvasc) QD & Nifedipine (Procardia) QD
Nondihydro= Diltiazem (Cardiazem) BID

27
Q

Antihypertensive Meds

A 
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
Q

Hypertension DOUBLES Risk of:

A 
CAD
PAD
CHF
Stroke
Renal Failure
29
Q

Clonidine

A

(Catapress) BID

Sympatholytic Agent

30
Q

Amlodipine

A 
(Norvasc) QD
Dihydro CCB
Focus: decrease SVR & arterial pressure
doesn't slow AV node conduction - SE reflex tachy
FL Option
31
Q

Nifedipine

A 
(Procardia) QD
Dihydro CCB
Focus: decrease SVR & arterial pressure
doesn't slow AV node conduction - SE reflex tachy
FL Option
32
Q

Diltiazem

A

(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
Q

JNC7 Under 50yrs

A

ACEI & BB < 50

ABCD

34
Q

JNC7 Over 50yrs

A

Diuretic & CCB > 50

ABCD

35
Q

HTN Lab Workup

A

BUN/Cr
Electrolytes (Na, Cl, K, Ca, Mg)
Urinalysis (proteinuria= renal disease)
Fasting: Glucose and Cholesterol (metabolic syndrome)

36
Q

JNC 7 Targets

A

BP < 135-140 / 80-85
w/ CAD & DM < 130/80
Renal Disease < 120 sys
w/ CHF no set #

37
Q

JNC 8 Targets

A

Over 60yrs < 150/90
30-59yrs D < 90
< 30yrs < 140/90
No difference with DM or CKD

38
Q

Resistant Hypertension

A

BP> 140/90 & on 3 Meds
Look for secondary Cause:
ETOH, Drugs, Noncompliance, Obesity

39
Q

JNC 8 Med Recommendations

A

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
Q

Med for Patients with CKD

A

ACEI or ARB for Renal Protection

41
Q

Med for Patients with A Fib

A

CCB NonDihydro
Diltiazem
“A Fib Zem” A-Z

42
Q

Alpha 1

A

Vascular Smooth Muscle
Vasoconstriction
“Alpha 1 CONstricTION” A1C

43
Q

Alpha 2

A

Norepi Nerves
Inhibits Norepi Release
“Alpha 2 Glue” Ag

44
Q

Beta 1

A

Cardiac Cells
Increase Rate and Contractility
“Beta 1 Get it Done”

45
Q

Beta 2

A

Vascular Smooth Muscle
Vasodilation
“Beta 2 Reverse Blue”

46
Q

Cuff Size Too Big=

A

BLOW
Big=Low
“This cuff blows”

47
Q

Hypertension Classifications

A 
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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