file.txt

Card Set Information

Author:
Anonymous
ID:
349
Filename:
file.txt
Updated:
2009-10-18 07:53:23
Tags:
HTN
Folders:

Description:
HTN
Show Answers:

Home > Flashcards > Print Preview

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


  1. Chlorthalidone
    HYGROTON; THALITONE

    Thiazide diuretic
  2. Reduction in CHD & stroke risk shown w/:
    • 1) Thiazide diuretics
    • 2) ACEi
    • 3) ARBs
    • 4) CCBs (both classes)
    • 5) β Blockers (esp post-MI)
  3. THIAZIDE DIURETICS
    • First line treatment for HTN
    • Increase excretion of H2O, Na, Cl and Mg
    • Decrease excretion of Ca
    • Dosed in AM to reduce nocturnal diuresis

    • Chlorthalidone (HYGROTON; THALITONE)
    • Chlorothiazide (DIURIL)
    • Hydrochlorothiazide/HCTZ (MICROZIDE; HYDRODIURIL)
    • Indapamide (LOZOL)
    • Metolazone (ZAROLOXYN)
  4. Chlorothiazide
    DIURIL

    Thiazide diuretic
  5. Hydrochlorothiazide/HCTZ
    MICROZIDE; HYDRODIURIL

    Thiazide diuretic
  6. Indapamide
    LOZOL

    Thiazide diuretic
  7. Metolazone
    ZAROLOXYN

    Thiazide diuretic
  8. LOOP DIURETICS
    Increase excretion of H2O, Na, Cl, Mg, and Ca

    Used for more severe forms of HTN, with drugs that cause Na retention

    • 2nd dose given in early afternoon to avoid nocturnal diuresis
    • Ethacrynic acid (EDECRIN)
    • Furosemide (LASIX)
    • Bumetanide (BUMEX)
    • Torsemide (DEMADEX)
  9. Ethacrynic acid
    EDECRIN

    Loop diuretic
  10. Furosemide
    LASIX

    Loop diuretic
  11. Bumetanide
    BUMEX

    Loop diuretic
  12. Torsemide
    DEMADEX

    Loop diuretic
  13. K SPARING DIURETICS
    • Useful for avoiding K depletion and augment the effects of other diuretics
    • Most frequently used w/HCTZ

    • Dosed in AM or afternoon to avoid nocturnal diuresis
    • Amiloride (MIDAMOR)
    • Triamterene (DYRENIUM)
  14. Amiloride
    MIDAMOR

    K sparing diuretic
  15. Triamterene
    DYRENIUM

    K sparing diuretic
  16. ALDOSTERONE RECEPTOR ANTAGONISTS
    • Dosing depends on indication; low dose for HTN
    • Spironolactone (ALDACTONE)
    • Eplerenone (INSPRA)

    • Contraindications:
    • - Hypersensitivity - Severe hyperkalemia
    • - Pregnancy (anything interfering w/RAS DO NOT USE in pregnancy)
    • - Anuria/renal failure
  17. DIRECT RENIN INHIBITOR
    • Dosing: 150-300mg daily
    • Aliskiren (TEKTURNA)
    • Aliskiren/HCTZ (TEKTURNA HCT)
    • Aliskiren/Valsartan (VALTURNA)
  18. ANGIOTENSIN CONVERTING ENZYME INHIBITORS (ACEi)
    • IV and oral dosing are not always equal
    • Captopril (CAPOTEN)
    • Benazepril
    • Enalapril & Enalaprilat
    • Fosinopril
    • Lisinopril (PRINIVIL; ZESTRIL)
    • Quinapril
    • Ramipril (ALATACE)
    • Trandolapril
    • Moexipril
    • Perindopril

    • S/E:
    • - Dry cough (most effective: change to ARBs)
    • - Angioedema
    • - Dizziness/lightheadedness
    • - Hyperkalemia
    • - increase in Scr (25-35%)
  19. Captopril
    CAPOTEN

    ACEi
  20. Lisinopril
    PRINIVIL; ZESTRIL

    ACEi
  21. Ramipril
    ALATACE

    ACEi
  22. ANGIOTENSIN II RECEPTOR ANTAGONISTS (ARBs)
    • Generally 1-2 times daily
    • Losartan (COZAAR)
    • Candesartan (ATACAND)
    • Irbesartan (AVAPRO)
    • Valsartan (DIOVAN)
    • Telmisartan (MICARDIS)
    • Eprosartan (TEVETEN)
    • Olmesartan (BENICAR)

    S/E: similar to ACEi; no cough; angioedema (?)
  23. Losartan
    COZAAR

    ARBs
  24. Candesartan
    ATACAND

    ARBs
  25. Irbesartan
    AVAPRO

    ARBs
  26. Valsartan
    DIOVAN

    ARBs
  27. Telmisartan
    MICARDIS

    ARBs
  28. Olmesartan
    BENICAR

    ARBs
  29. CALCIUM CHANNEL BLOCKERS (CCBs)
    • Dihydropyridines (-pine)
    • Generally 1-2 times daily for long acting DHPs
    • • Amlodipine (NORVASC)
    • • Felodipine (PLENDIL)
    • • Isradipine (DYNACIRC)
    • • Nicardipine (CARDENE)
    • • Nisoldipine (SULAR)
    • • Nifedipine (ADALAT, PROCARDIA)
    • - vasodilate SM
    • For HTN, angina (chest pain), Raynaud’s phenomenon (Nifedipine), pre-term labor (Nifedipine)
    • Non-Dihydropyridines
    • Avoid combination w/β blocker and non DHP (both cause bradycardia)
    • Non-DHPs usually given IV in emergencies
    • • Diltiazem (CARDIZEM)
    • • Verapamil (CALAN, ISOPTEN)
    • - works at SM and heart (CO)
    • For HTN, angina, arrhythmias, migraines (treat/prevent-verapamil)

    • S/E:
    • Bradycardia (non-DHPs) Reflex tachycardia (DHPs)
    • Edema (DHP) Hypotension
    • Gingival hyperplasia Constipation
  30. beta ADRENERGIC BLOCKERS
    • Dosing usually 1-2 times daily
    • IV dose < PO
    • Non-selective
    • • Propranolol (INDERAL, INDERAL LA) Dosed up to QID
    • • Nadolol (CORGARD) ↓ dose in kidney impairment
    • • Timolol (BLOCADREN)


    • ISA (Intrinsic Symapathomimetic Activity)
    • Partial agonists
    • Resting HR, CO and peripheral blood flow are not reduced
    • May increase mortality
    • • Pindolol (VISKEN)
    • • Acebutolol (SECTRAL)
    • • Penbutolol (LEVATOL)
    • • Carteolol (CARTROL)
    • Cardioselective
    • Dose dependent (higher doses=decrease in selectivity)
    • • Metoprolol (LOPRESSOR, TOPROLOL XL)
    • • Atenolol (TENORMIN) ↓ dose in kidney impairment
    • • Betaxolol (KERLONE)
    • • Bisoprolol (ZEBETA)
    • • Nebivolol (BYSTOLIC)
  31. MIXED alpha/beta ADRENERGIC BLOCKERS
    • Labetalol (TRANDATE; NORMODYNE)
    • Carvedilol (COREG; COREG CR)
    • These agents also inhibit α1 adrenoceptors
    • Less effect on HR and CO
    • Don’t use w/asthma/COPD
    • Labetalol preferred in pregnancy
  32. alpha ADRENERGIC BLOCKERS
    • Give 1st dose HS to avoid orthostatic hypotension (head rush, dizzy when stand up)
    • Usually avoided in women
    • More effective if used w/beta blocker or diuretic
    • Prazosin (MINIPRES) 2-3 times daily
    • Terazosin (HYTRIN) 1-2 times daily
    • Doxazosin (CARDURA) daily
  33. VASODILATORS
    Should always be used w/beta blocker and diuretic

    • Hydralazine (APRESOLINE)
    • Minoxidil (LONITEN; ROGAINE)
  34. Heart failure
    • Goal: < 120/80 mmHg
    • First line therapy: ACEi and diuretic (Loop in advanced disease)
    • Add on therapy:
    • • beta blocker: Bisoprolol, Carvedilol and Metoprolol succinate
    • • ARBs no better than ACEi but may provide added benefit; Candesartan and Valsartan
    • • Aldosterone antagonists: Spironolactone and eplerenone
  35. Post MI
    • Goal: < 130/80 mmHg
    • First line therapy: beta blockers (w/o ISA) and ACEi
    • Alternative therapy: ARBs
    • Add on therapy: Aldosterone antagonists
  36. Coronary Artery Disease (CAD)
    • Chronic stable angina
    • Goal: < 130/80 mmHg
    • First line therapy: beta blocker
    • Alternative/Add on: CCBs (long acting-Verapamil, Diltiazem); ACEi/ARB; Thiazides

    • Acute coronary syndrome (ACS)
    • Goal: < 130/80 mmHg
    • Alternative therapy: Non-DHP CCBs; ARBs
    • Add on therapy: DHP CCBs; Thiazides
  37. Diabetes
    • Goal: < 130/80 mmHg
    • First line theraphy: ACEi or ARB
    • Thiazide considered 2nd line
    • Alternative: Non-DHP CCBs
    • Add on therapy: DHP CCBs; beta blocker (Cardioselective or carvedilol)
    • Combinations of drugs are usually needed to achieve target BP goal
  38. Chronic Kidney Disease (CKD)
    • Goal: < 130/80 mmHg
    • First line therapy: ACEi or ARB (combo may be more effective)
    • Alternative: Non-DHP CCBs
    • Add on therapy: DHP CCBs; beta blocker (Cardioselective)
    • Combinations of drugs are usually needed to achieve target BP goal
  39. Stroke Prevention
    • Goal: < 130/80 mmHg
    • First line therapy: Thiazide and ACEi combo
    • Alternative: ARB (Losartan)
    • Add on therapy: others may be effective
  40. Pregnancy
    • Bed rest and lifestyle medications (decrease Na, more fruits and veggies)
    • Medications:
    • First line agent- Methyldopa (central alpha2 agonist)
    • Alternative- Labetalol (beta blocker)
    • CCBs (NOT immediate release Nifedipine)- Hypotension w/fetal distress

    AVOID: ACEi, ARBs, direct renin inhibitors

What would you like to do?

Home > Flashcards > Print Preview