Therapeutics HTN 3

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Author:
kyleannkelsey
ID:
263622
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Therapeutics HTN 3
Updated:
2014-02-24 00:58:26
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Therapeutics HTN
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Therapeutics HTN 3
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Therapeutics HTN 3
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  1. What should you monitor in patients on BBs?
    • BP
    • Heart rate
    • Adverse effects
    • Comorbidities
  2. What is the MOA of alpha-blockers?
    Block postsynaptic alpa-receptors, causing vasodilation
  3. Name the alpha-blockers for HTN:
    Prazosin, Terazosin and Doxazosin (-azosin)
  4. What group are alpha-blockers particularly useful in when treating HTN?
    BPH (treats both at the same time)
  5. What are the Central alpha 2-agonists used for HTN?
    • Methyldopa
    • Clonidine
    • Guanfacine
    • Guanabenz
  6. What is the MOA of Central alpha 2-agonists?
    • STIMULATE alpha- 2 receptors in CNS
    • Inhibiting sympathetic outflow to Heart, kidneys, and periphery
    • Decreases HR, CO and TPR
  7. What are Central alpha 2-agonists mainly used for?
    Resistant Hypertension
  8. What antihypertensive drugs are likely to cause rebound HTN, so require tapering when coming off them?
    Central alpha 2-agonists and BBs
  9. Most of the side effects of Central alpha 2-agonists are due to what issue?
    Anticholinergic properties (Orthostatic hypotension, Sedation, Dizziness, Xerostomia, Fatigue)
  10. How should you discontinue a BB or Central alpha 2-agonists (no angina present)?
    Over 4-5 days
  11. How should you discontinue a BB when angina is present?
    Over 1-2 weeks
  12. How should you discontinue a Central alpha 2-agonists and a BB and why?
    • Taper BB first
    • Taper AA second
    • (Vasoconstriction properties of the chatecholemines are unopposed if you do it the opposite way around)
  13. Central alpha 2-agonists require what monitoring?
    BP and Side effects
  14. Which alpha 2 –agonist is most useful for menopause?
    Clonidine
  15. Which alpha 2 –agonist is most useful for smoking cessation?
    Clonidine
  16. Which alpha 2 –agonist is most useful for ADHD tics?
    Clonidine and Guanfacine
  17. Which alpha 2 –agonist is most useful for Pregnancy?
    Methyldopa (being replaced by Labetolol)
  18. Are alpha 2-agonists a good choice for elderly?
    No
  19. What is the MOA of direct vasodilators?
    Direct relaxation of arteriolar smooth muscle, activate baroreceptors
  20. What HTN related indication are Direct vasodilators most used for?
    Resistant HTN
  21. Which drugs are direct vasodilators?
    Hydralazine, Minoxidil
  22. Which is more potent: Minoxidil or Hydralazine?
    Minoxidil
  23. What are the major side effects of direct vasodilators?
    Reflex tachycardia, H20/Na retention, edema and Hypertrychosis
  24. Hydralazine should be given with what diuretic?
    Thaizides
  25. Minoxidil should be given with what diuretic?
    Loops
  26. Why would you give a direct vasodilator with a BB?
    Reduce rebound tachycardia
  27. What is the MOA of adrenergic antagonists for HTN?
    Decrease NE stores in periphery leading to decreased sympathetic tone
  28. What are the adrenergic antagonists used for HTN?
    Reserpine
  29. What dose do you need to keep Reserpine under to minimize depression?
    0.25mg/day
  30. HTN drugs to caution in Diabetes Mellitus
    B -blocker, high-dose thiazides
  31. HTN drugs to recommend in Diabetes Mellitus
    ACEI/ARBs, thiazides, CCB
  32. HTN drugs to caution in Asthma/COPD
    Nonselective B-blocker
  33. HTN drugs to caution in PVD
    Nonselective B-blocker
  34. HTN drugs CI in CHF
    Nondihydropyridine CCB, clonidine
  35. HTN drugs to recommend in CHF
    ACE-I, diuretics, B-blocker (bisoprolol, carvedilol, metoprolol succinate), aldosterone antagonists, ARB
  36. HTN drugs to caution in IHD
    Hydralazine, minoxidil
  37. HTN drugs to recommend in IHD
    B-blocker, ACE-I/ARB
  38. HTN drugs to caution in Gout/Hyperuricemia
    Diuretics

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