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cardiovascular system > Hypertension Therapy > Flashcards

Hypertension Therapy Flashcards

1
Q

in stage 1 hypertension what is clinical blood pressure

A

140/90 mmHg or higher

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2
Q

in stage 1 hypertension what is ABPM daytime average

A

135/85mmHg or higher

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3
Q

in stage 2 hypertension what is clinical blood pressure

A

160/100mmHg or higher

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4
Q

in stage 2 hypertension what is ABPM daytime average

A

150/95mmHg or higher

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5
Q

what is renal artery stenosis most often caused by

A

atherosclerosis or fibromuscular dysplasis

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6
Q

what is Fibromuscular dysplasia

A

a disease of the blood vessels that causes abnormal growth within the artery wall

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7
Q

why do we treat hypertension

A

reduce cerebrovascular disease by 40-50%

reduce MI by 16-30%

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8
Q

how do we treat hypertension

A

stepped approach use of low doses of several drugs

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9
Q

what age group would receive an ACE inhibitor/ARB as part of treatment for hypertension

A

under 55 years old

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10
Q

what age group would receive Calcium Channel Blocker and Thiazide –Type Diuretic

A

over 55 years old

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11
Q

what are the two Angiotensin converting enzyme inhibitors

A

Ramipril

Perindopril

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12
Q

what does ACE convert Angiotensin I to

A

active angiotensin II

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13
Q

what does Angiotensin II do to blood vessels

A

Angiotensin II is a potent vasoconstrictor

also a hypertrophic agent

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14
Q

what is the function of aldosterone

A
  1. increases Na+ re-absorption
  2. increases the release of ADH from the pituritary
  3. vasoconstrictor
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15
Q

what are contraindications that may prevent you from giving a patient ACE inhibitors

A

renal artery stenosis
renal failure
hyperkalemia

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16
Q

what drug that you know of precipitates acute renal failure

A

NSAIDs

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17
Q

what is an example of a Angiotensin II Antagonist (ARB)

A

Losartan

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18
Q

what happens to blood vessels as a result of taking Angiotensin II Antagonists

A

they block the action of angiotensin II binding to the receptors on the muscles surrounding blood vessels. As a result blood vessels dilate and blood pressure is reduced

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19
Q

are calcium channel blockers vasodilaters or vasoconstrictors

A

vasodilaters

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20
Q

what are two examples of calcium channel blockers

A

Amlodipine/Felodipine

21
Q

what type of calcium channels do CCBs block

A

L type calcium channels

22
Q

if a patient is over 55 years and in need of a antihyperintensive, what would you give them

A

a CCB

23
Q

if a women of child bearing age needed an anti hypertensive, what would you give her

A

a CCB

24
Q

what are two Thiazide type diuretics that you know of

A

Indapamide, Clortalidone

25
Q

what is commonly the first line of treatment for afro-caribbean individuals with mild-moderate hypertension

A

Thiazide-type diuretic

26
Q

what is the effect of Thiazide type diuretics

A

make kidneys pass out more water
dilate blood vessels
these two effects reduce blood pressure

27
Q

what is the function of Alpha-adrenoceptor antagonists

A

block the effect of the sympathetic nerves on blood vessels by binding to alpha-adrenoceptors located on vascular smooth muscle.

28
Q

name a alpha-adrenoceptor antagonist

A

Doxazosin

29
Q

what is the function of Centrally acting agents in the treatment of hypertension

A

lower heart rate
reduce blood pressure
they do this by preventing your brain from sending signals to your nervous system to speed up your heart rate and narrow your vessels

30
Q

what are some adverse drug reactions of Alpha-adrenoceptor antagonists

A

first dose hypotension
dizziness
dry mouth
headache

31
Q

in hypertension treatment what group of patients will centrally acting agents mainly be used as treatment

A

treatment of hypertension on pregnant women

32
Q

what is a common risk factor for preeclampsia

A

existing primary hypertension

33
Q

what is esmolol

A

cardioselective beta 1 receptor

34
Q

what is stage 1 hypertension in children defined as

A

Defined as BPs from the 95th-99th percentile plus 5mmHg.

35
Q

what is stage 2 hypertension in children defined as

A

BP above the 99th percentile plus 5mmHg

36
Q

what are the commonest causes of hypertension i newborn infants

A

Renal artery thrombosis
Renal artery stenosis
Congenital renal malformations
Coarctation

37
Q

what is coarctation

A

congenital narrowing of a short section of the aorta

38
Q

what are the commonest causes of hypertension in infants - 6 years

A

Renal parenchymal disease
Coarctation
Renal artery stenosis

39
Q

what are the commonest causes of hypertension in children 6-10 years

A

renal parenchymal disease
renal artery stenosis
primary hypertension

40
Q

what are the commomest causes of hypertension in adolescents aged 10-18

A

primary hypertension

renal parenchymal disease

41
Q

what is accelerated hypertension

A

Increase in blood pressure to levels ≥180 mm Hg systolic and ≥110 mm Hg diastolic, resulting in target organ damage

42
Q

what is the definition of hypertensive urgency

A

sever hypertension with no evidence of target organ damage

43
Q

what is a common cause a accelerated hypertension

A

non adherence to medication

44
Q

how many “what not to do!” treatment guidelines are there

A

6 * see slide 90 of hypertension therapy

45
Q

how are patents with a hypertensive emergency best managed

A

a continuous infusion of a short acting, titratable antihypertensive agent

46
Q

during a hypertensive emergency what type of drug administration should be avoided at all time

A

sublingual

intramuscular

47
Q

in accelerated hypertension what is the aim of treatment in the first hour

A

The immediate goal is to reduce DBP by 15–20% or to about 110mmHg over a period of 30–60 min

48
Q

what are treatable causes of hypertension that can be screened for

A

renal artery stenosis
cushings disease
Conns syndrome
sleep apnoea

cardiovascular system (34 decks)

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