lecture 8 Flashcards
(54 cards)
major modifiable risk factor for CV disease is ?
hypertension
HYPER TENSION increases the risk of CV diseases as?
(myocardial infarction,
heart failure)and stroke
Sustained arterial hypertension damages blood vessels of which organs ?
brain, kidney, heart.
Secondary hypertension percentage and examples ?
5-10%
- Renal artery stenosis
- Pheochromocytoma
- Drugs
how Glucocorticoids may lead to hypertension ?
they have the ability to cause sodium and water retention
this will increase the blood volume that will increase BP
Drug- Induced hypertension
• Oral contraceptives. • NSAIDs. • Sympathomimetic OTC cold medication • excessive doses of caffeine. • Glucocorticoids • Liquorice عرق سوس
curable / non :
essential HTN
non-essential HTN
non curable
may be curable by either surgery or remove the drug -stop it
stroke time depends on
Heart Rate
Contractility
Filling Pressure- preload
main drugs that reduces HTN
beta &alpha blockers RAAS CCD (Ca) diuretics direct VD
If primary HTN , initiate lifestyle changes how ?
smoking cessation, weight loss, diet,
stress reduction , less alcohol
Diuretics adv [3]
safe
inexpensive
effective in preventing stroke, myocardial infarction, and heart failure.
Type of diuretics:
name -efficacy-example-act on
1) Loop Diuretics (high efficacy ): furosemide (Lasix)- loop of henle
2) Thiazides Diuretics ( moderate efficacy): Hydrochlorothiazide-DCT
3) Potassium-sparing Diuretics (low efficacy) : spironolactone-collecting duct
the diuretic drug that it is use in initial therapy or hypertension is ?
thiazides diuretics
Indicated in mild to moderate HT
just thiazides
in severe HTN combination drug of ?
sympathoplegic , Angiotensin antagonist & vasodilator drugs
respond to thiazide diuretics reduce the blood pressure within about
4–6 weeks
case of using loop Diuretics
when fluid overload in the body such as pulmonary
edema→ the cause it heart failure
Favorable indication for thiazide:
❑ HTN with osteoporosis.
❑ HTN with recurrent renal stones.
Thiazides are sometimes useful in the prevention of calcium-containing kidney stones
Favorable indication for loop:
Fluid overload: heart failure ,renal disease -pulmonary edema
Hypokalemia needs to be avoided
how ?
combining a thiazide with inhibitors of the RAS or with a K+-sparing diuretic
Hypokalemia (cause by loop and thiazide) increases the risk of
drug-induced ventricular tachycardia
the risk for ischemic ventricular fibrillation
the leading cause of sudden cardiac death
major contributor to cardiovascular mortality in treated hypertensive patients.
S.E of loop diuretics :[3]
Hypocalcaemia. (inhibit Ca2+ reabsorption)
Hypokalemia.
Ototoxicity: transient and occur with rapid IV infusion
case of using loop Diuretics
when fluid overload in the body such as pulmonary edema→ the cause it heart failure
______diuretics are commonly used in HTN
thiazide
