PHRD6085 Pharmacotherapy Lecture 5 - HTN Treatment options & Dosages

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daynuhmay
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282144
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PHRD6085 Pharmacotherapy Lecture 5 - HTN Treatment options & Dosages
Updated:
2014-09-05 05:50:49
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hypertension pharmacotherapy
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hypertension pharmacotherapy
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  1. first line option for Stage 1 HTN w/ no compelling indications
    • ARB
    • ACEi
    • CCB
    • thiazide diuretic
  2. ACE inhibitor drug & starting dose
    lisinopril 5mg
  3. ARB drug & starting dose
    losartan 50mg
  4. CCB (dihydropyridine) drug & starting dose
    amlodipine 2.5mg
  5. CCB (non-dihydropyridine) drug & starting dose
    diltiazem 120mg
  6. thiazide diuretic drug & starting dose
    HCTZ 12.5mg
  7. thiazide-like diuretic drug & starting dose
    chlorthalidone 12.5mg
  8. loop diuretic drug & starting dose
    torsemide 5mg
  9. potassium-sparing diuretic drug & starting dose
    triamterene 100mg
  10. beta blocker drug & starting dose
    carvedilol 3.125mg BID
  11. -adrenergic receptor blocker drug & starting dose
    prazosin 1mg BID
  12. vasodilator drug & starting dose for HTN treatment
    minoxidil 2.5mg
  13. central -agonist drug & starting dose
    methyldopa 125mg BID
  14. adrenergic depletor drug & starting dose
    reserpine 0.1mg
  15. list 6 compelling indications
    • HFrEF
    • post-MI
    • CAD
    • diabetes mellitus
    • CKD
    • recurrent (ischemic) stroke prevention
  16. first line option for pt w/ HFrEF
    • 3-drug therapy:
    • diuretic - HCTZ 12.5mg
    • ARB - losartan 50mg
    • beta blocker - carvedilol 3.125mg
  17. 3 FDA approved beta blockers in HFrEF
    • bisoprolol
    • carvedilol
    • metoprolol XL
  18. first line option for post-MI pt
    • carvedilol 3.125mg
    • then add lisinopril 5mg
  19. first line option for pt w/ CAD
    • carvedilol 3.125mg
    • then add lisinopril 5mg

    add-on CCB (ischemia), thiazide (BP)
  20. first line option for pt w/ diabetes mellitus
    lisinopril 5mg

    add-on diuretic, CCB, or beta blocker
  21. first line option for pt w/ CKD
    lisinopril 5mg
  22. first line option for recurrent stroke prevention
    HCTZ 12.5mg

    or

    HCTZ12.5mg/lisinopril5mg
  23. first line option for black or elderly pt
    HCTZ 12.5mg
  24. CKD criteria as defined by JNC7
    • eGFR <60mL/min/1.73m2
    • SCr >1.5mg/dL (men), >1.3mg/dL (women) 
    • persistent albuminuria (>30mg/g)

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