PHRD6085 Pharmacotherapy Lecture 5 - Hypertension Overview (Part 2)

Card Set Information

Author:
daynuhmay
ID:
281604
Filename:
PHRD6085 Pharmacotherapy Lecture 5 - Hypertension Overview (Part 2)
Updated:
2014-08-29 04:19:38
Tags:
Hypertension
Folders:

Description:
Hypertension
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user daynuhmay on FreezingBlue Flashcards. What would you like to do?


  1. list some thiazide/thiazide-type diuretics
    • chlorthalidone
    • hydrochlorothiazide
    • indapamide
    • metolazone
  2. list some loop diuretics
    • furosemide
    • torsemide
    • bumetanide
  3. list some potassium sparing diuretics
    • amiloride
    • amiloride/HCTZ
    • triamterene
    • triamterene/HCTZ
  4. list possible SEs of diuretics (4)
    • electrolyte depletion
    • hypokalemia (K sparing, esp in CKD)
    • dehydration & orthostatic hypotension
    • exacerbation of gout (thiazides)
  5. diuretic DI
    may inc [lithium]
  6. diuretic contraindications (4)
    • gout (esp thiazides)
    • hypotension
    • dehydration
    • hyponatremia
  7. which is more potent: HCTZ or chlorthalidone?
    chlorthalidone
  8. list some ACE inhibitors
    • lisinopril
    • benazepril
    • ramipril
    • quinapril
    • captopril
    • enalapril
    • fosinopril
    • moexipril
    • trandolapril
  9. list possible SEs of ACEi's (4)
    • dry cough (20-30% of pts)
    • hyPERkalemia
    • renal failure (in pts w/ bilateral renal artery stenosis)
    • angioedema (rare)
  10. ACEi DI
    may increase [lithium]
  11. ACEi contraindications
    • pregnancy
    • bilateral artery stenosis
    • hx of angioedema
  12. how ACEi's affect SCr
    can increase SCr due to dilation of efferent arteriole in kidney
  13. list some Angiotensin II Receptor Blockers (ARBs)
    • losartan
    • valsartan
    • azilsartan
    • candesartan
    • eprosartan
    • irbesartan
    • telmisartan
    • olmesartan
  14. which antihypertensive drug class has the fewest side effects?
    ARBs
  15. list some ARB SE's (2)
    • hyPERkalemia
    • potential renal failure in pts w/ bilateral renal artery stenosis
  16. ARB DI
    may increase [lithium]
  17. ARB contraindications (2)
    • pregnancy
    • bilateral renal artery stenosis
  18. clinical difference between ARB & ACEi
    ARBs don't affect bradykinin -> no dry cough SE
  19. list some dihydropyridine calcium channel blockers
    • amlodipine
    • felodipine
    • isradipine
    • nicardipine
    • nifedipine
    • nisoldipine
  20. list some dihydropyridine CCB SE's
    • headache
    • peripheral edema
    • flushing
    • reflex tachycardia
    • worsen GERD
  21. dihydropyridine CCB CI
    HFrEF (except amlodipine & felodipine)
  22. list some non-dihydropyridine CCBs
    • diltiazem
    • verapamil
  23. list some non-dihydropyridine CCB SEs (5)
    • dec HR & possible heart block
    • constipation (worse w/ verapamil)
    • peripheral edema
    • worsen GERD
  24. non-dihydropyridine CCB DIs (3)
    • can inhibit drugs that use CYP450 3A4
    • inc [cyclosporine]
    • inc risk of heart block w/ BBs or digoxin
  25. list some cardioselective BBs (4)
    • atenolol
    • metoprolol
    • betaxolol
    • bisoprodol
  26. list some nonselective BBs (3)
    • nadolol
    • propranolol
    • timolol
  27. list some BBs w/ intrinsic sympathomimetic activity (4)
    • acebutolol
    • carteolol
    • penbutolol
    • pindolol
  28. list some mixed - and -blockers (2)
    • carvedilol
    • labetalol
  29. list some conditions in which BBs are indicated (4)
    • HFrEF
    • post-MI
    • CAD
    • diabetes
  30. list some SEs of BBs (4)
    • exercise intolerance/fatigue
    • dec HR, possible heart block
    • CNS SEs
    • ED
    • can mask diabetic hypoglycemia sx
  31. BB DIs
    • cocaine inc angina
    • verapamil, diltiazem, digoxin inc risk of heart block
  32. BB CIs
    • 2nd/3rd degree heart block
    • acute left ventricular dysfunction
    • asthma
  33. which type of BB is generally preferred over others?
    cardioselective
  34. issue w/ d/c BBs
    • rebound HTN
    • must taper off over 3-7 days
  35. list some aldosterone antagonists (3)
    • spironolactone
    • spironolactone/HCTZ
    • eplerenone
  36. when is an aldosterone antagonist indicated?
    HFrEF
  37. aldosterone antagonist SEs (4)
    • hyPERkalemia (esp in CKD)
    • dehydration, orthostatic hypotension
    • hyPOnatremia
    • gynecomastia (only w/ spironolactone)
  38. aldosterone antagonist CIs (3)
    • hyPOtension
    • dehydration
    • hyPERkalemia
  39. when to consider initial tx w/ 2 drugs
    • if far from BP goal (eg stage 2 HTN)
    • compelling indications for multiple drug classes
    • NEVER in very elderly (>80yo)
  40. general things to monitor for (4)
    • drug efficacy
    • drug toxicity
    • adherence
    • disease progression, presence of HTN-assoc'd complications
  41. parameters to monitor when taking diuretics (6)
    • BP
    • BUN/SCr
    • serum K
    • Mg
    • Na
    • uric acid (thiazides)
  42. parameters to monitor when taking aldosterone antagonists, ACEi's, or ARB's (3)
    • BP
    • BUN/SCr
    • serum K
  43. parameters to monitor when taking CCB's or BB's (2)
    • BP
    • HR
  44. when to evaluate BP response in clinically stable pts
    2-4 weeks
  45. when to evaluate BP response in unstable pts or for very high BP (>200/110 mmHg)
    1-7 days
  46. how many agents are needed to control most pts?
    2
  47. defintion of resistant hypertension
    pts not at their goal BP on 3+ antiHTN agents

    • or 
    • pt requiring 4+ antiHTN agents to treat, even if at goal BP
  48. what diuretic tx should be preferentially used in resistant HTN?
    chlorthalidone
  49. what diuretic should be considered in pts w/ resistant HTN & signs of compromised kidney fcn (CrCl <30ml/min)?
    loop diuretic
  50. if a BB is used in resistant HTN, what kind should be used?
    mixed alpha-beta blockers (eg: carvedilol, labetalol)
  51. list some alpha-1 blockers (3)
    • doxazosin
    • prazosin
    • terazosin
  52. list a direct renin inhibitor
    aliskiren
  53. list some central alpha-2 agonists (2)
    • clonidine
    • methyldopa
  54. list a peripheral adrenergic antagonist
    reserpine
  55. list some direct arterial vasodilators (2)
    • minoxidil
    • hydralazine

What would you like to do?

Home > Flashcards > Print Preview