Hypertension Pharmacology I and II Flashcards Preview

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Flashcards in Hypertension Pharmacology I and II Deck (44)
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1

Define Stage I HTN

BP: 140-159/90-99

2

Define Stage II HTN

Systolic BP >160; or diastolic BP >100

3

What is essential HTN

no known secondary cause for HTN; accounts for 95% of cases

4

Causes of Secondary HTN

Renal disease, drugs (EtOH, oral contraceptives, NSAIDS, MAOIs), Endocrine (pheochromocytoma, Cushings, hyperaldosteronism, hyper/hypothyroidism), Pulmonary (Obstructive Sleep Apnea)

5

Clinical Features of Secondary HTN

Severe/resistant HTN, onset before puberty, onset before 30 with no fam history or obesity, electrolyte disturbances

6

Modifiable Risk Factors for HTN

sodium intake, obesity, EtOH intake, meds, sedentary lifestyle, stress

7

Risk factors for aggressive treatment of HTN

young age at onset, hyperlipidemia, diabetes, smoking, family history of vascular disease

8

What is end-organ disease related to?

extent of BP elevation and duration of HTN

9

What are some manifestations of end-organ disease?

stroke, CAD, LV hypertrophy, atherosclerosis, nephrosclerosis, aneurysms

10

Who is more likely to benefit from lowering BP: a 45 y/o male with obesity and BP 145/95, or a 45 y/o female smoker with obesity, diabetes, LV hypertrophy, and BP 145/95

45 y/o female-the benefit of lowering BP increases in the setting of end-organ disease

11

General MOA: Diuretics

decrease intravascular volume

12

General MOA: Angiotensin Blockers

inhibit production/action of angiotenisin II->decrease PVR

13

General MOA: Direct Vasodilators

relax smooth muscle to decrease PVR

14

General MOA: Sympathoplegic agents

decrease sympathetic tone -> decrease PVR (ex. beta blockers, alpha blockers)

15

Which drug classes have no effect on heart rate and cardiac output (5)

diuretics, ISA beta blockers, ACEI, ARB, renin inhibitors

16

Which drug classes have no effect on plasma volume (3)

ACEI, ARB, Renin inhibitors

17

Which type of diuretic is high potency and what is its MOA

Loop diuretic; competitively inhibit Na-K-Cl transporter in proximal ascending tubule

18

Which type of diuretic is medium potency and what is its MOA

Thiazides; inhibits exchange of Na-Cl in the distal ascending loop

19

Which type of diuretic is low potency and what is its MOA

Potassium sparing; inhibits Na reabsorption in the distal tubule

20

When would you use a loop diuretic

severe HTN, CHF, cirrhosis, renal insufficiency (GFR < 30-40 ml/min)

21

Side effects of loop and thiazide diuretics

hypokalemia, hypomagnesemia, impaired glucose tolerance, increased lipids, increased uric acid, erectile dysfunction, volume depletion

22

Side effects of potassium sparing drugs

gynecomastia, menstrual irregularities, hyperkalemia

23

Most famous loop diuretic

Furosemide

24

MOA of ARBs

competitive receptor binding of angiotensin II to vascular endothelium

25

Ending associated with ACEIs

-pril (ex. lisinopril)

26

Ending associated with ARBs

-sartan (ex. losartan)

27

Short acting ACEI

captopril

28

Unique side effect to ACEIs

cough

29

Contraindications to ACEIs and ARBs

renal artery stenosis, hyperkalemia, pregnancy

30

ACEIs/ARBs benefit:

chronic kidney disease and proteinuria, CHF, LV remodeling post-MI, LV hypertrophy