Hypertension

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Author:
giddyupp
ID:
50511
Filename:
Hypertension
Updated:
2011-01-13 12:19:36
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Hypertension PHPR522
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Hypertension
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  1. What is considered normal blood pressure?
    • <120 mmHg systolic
    • <80 mmHg diastolic
  2. What is considered prehypertension?
    • 120 - 139 mmHg systolic
    • 80 - 89 mmHg diastolic
  3. What is considered Stage 1 HTN?
    • 140 - 159 mmHg systolic
    • 90 - 99 mmHg diastolic
  4. What is considered Stage 2 HTN?
    • at least 160 mmHg systolic
    • at least 100 mmHg diastolic
  5. What drugs can cause secondary HTN?
    • adrenocorticosteroids
    • antidepressants
    • NSAIDs
    • decongestants
  6. What is the goal BP for uncomplicated HTN?
    < 140/90
  7. What is the goal BP for HTN with DM, chronic kidney disease, CAD, high CAD risk, or heart failure?
    < 130/80
  8. Which class of antihypertensives is good to use in all compelling indications?
    ACE inhibitors
  9. Which class of antihypertensives is not good to use in patients with heart failure?
    CCBs
  10. Which classes of antihypertensives are not good to use in pts with hx of MI?
    • diuretics
    • ARBs
    • CCBs
  11. What classes of antihypertensives are not good to use in pts with high coronary disease risk?
    • ARBs
    • aldosterone antagonists
  12. What class of antihypertensives are not good to use in pts with DM?
    aldosterone antagonists
  13. What classes of antihypertensives are not good to use in pts with chronic kidney disease?
    • diuretics
    • B-blockers
    • CCBs
    • aldosterone antagonists
  14. What classes of antihypertensives are not good to use in pts with recurrent stroke?
    • B-blockers
    • ARBs
    • CCBs
    • aldosterone antagonists
  15. How long should you wait before increasing the dose of antihypertensives?
    1-2 mo, if pt is compliant, there is at least some response, and there are no intolerable SE
  16. How often should you follow up on pts once their HTN is controlled?
    every 3-6 months
  17. What are the names of the loops?
    • bemetanide
    • ethacrynic acid
    • furosemide
    • torsemide
  18. What is the most common use of loops?
    heart failure
  19. What are the names of the thiazide diuretics?
    • chlorothiazide
    • hydrochlorothiazide
    • metolazone
    • chlorthalidone
    • indapamide
  20. What are the most used drugs for HTN?
    thiazide diuretics
  21. What is the best thiazide diuretic for HTN?
    chlorthalidone
  22. What is the most prescribed thiazide for HTN?
    HCTZ
  23. What are the names of the potassium-sparing diuretics?
    • amiloride
    • triamterene
  24. What are the names of the aldosterone antagonist diuretics?
    • eplerenone
    • spironolactone
  25. What are aldosterone antagonist diuretics used for most?
    heart failure
  26. What are the names of the carbonic anhydrase inhibitor diuretics?
    acetazolamide
  27. When should electrolytes be monitored when starting loop/thiazide diuretics?
    in 4 wks
  28. When should electrolytes be monitored when starting aldosterone antagonist diuretics?
    in 1 wk
  29. What diuretics are used for recurrent stroke prevention?
    thiazides
  30. Which diuretics are favored for use in chronic renal failure?
    loops (because they don't increase K+, which is already high in renal failure)
  31. Which diuretics are favored for use in osteoporosis prevention?
    thiazides (because they increase Ca levels)
  32. Which diuretics are favored for use in cirrhosis?
    aldosterone antagonists
  33. What are the unfavorable effects of diuretics?
    • hyperkalemia
    • renal insufficiency
    • gout
    • dyslipidemia
    • diabetes (high dose)
  34. Which diuretics should not be used in hyperkalemia?
    • potassium-sparing
    • aldosterone antagonists
  35. Which diuretics should be used with caution in sulfa allergy?
    • loops
    • thiazides
  36. Which diuretics cause photosensitivity?
    • thiazides
    • potassium-sparing
    • aldosterone antagonists
  37. Which diuretics can cause gynecomastia/hirsutism?
    • potassium-sparing
    • aldosterone antagonists
  38. Which diuretics can cause depression?
    carbonic anhydrase inhibitors
  39. Which diuretics can cause ototoxicity?
    loops
  40. Which diuretics can cause urolithiasis?
    carbonic anhydrase inhibitors
  41. What are the names of the B-blockers?
    • acebutolol
    • atenolol
    • betaxolol
    • bisoprolol
    • carteolol
    • carvedilol
    • labetalol
    • metoprolol
    • nadolol
    • nebivolol
    • penbutolol
    • pindolol
    • propranolol
    • timolol
  42. Which B-blockers have intrinsic sympathomimetic activity (ISA)?
    • Acebutolol
    • carteolol
    • penbutolol
    • labetolol
    • pindolol
  43. Which B-blockers also have alpha activity?
    • carvedilol
    • labetolol
  44. Which B-blockers are beta1 selective?
    • acebutolol
    • atenolol
    • betaxolol
    • bisoprolol
    • metoprolol
    • nebivolol (< 10mg)
  45. What are the compelling indications for B-blockers?
    • heart failure
    • post-MI (not with ISA)
    • high-risk coronary disease
    • diabetes
  46. What conditions favor use of B-blockers?
    • tachycardia
    • migraine
  47. What do B-blockers do?
    inhibit chronotropic, inotropic, and vasodilator responses
  48. What conditions are contraindicated for B-blockers?
    • bronchospastic diseases (asthma, COPD)
    • heart block or bradycardia
    • peripheral vascular disease
  49. What are the SE of B-blockers?
    • hypotension
    • bradycardia/heart block
    • bronchospasm
    • aggravation of acute heart failure
    • fatigue
    • decreased exercise tolerance
    • depression
    • impotence
    • peripheral vasoconstriction
    • glucose and lipid abnormalities
  50. What are the names of the CCBs?
    • amlodipine
    • felodipine
    • isradipine
    • nicardipine
    • nifedipine
    • nisoldipine
    • diltiazem
    • verapamil
  51. Which CCBs are non-dihydropyridines?
    • diltiazem
    • verapamil
  52. Which CCBs decrease HR, and therefore should not be used in heart block or heart failure?
    • diltiazem
    • verapamil
  53. What conditions favor use of CCBs?
    • tachycardia
    • a-fib (non-DHP: diltiazem, verapamil)
  54. What are the SE of DHP CCBs?
    • peripheral edema
    • palpitations
    • angina
    • headache
    • dizziness
    • nausea
    • gingival hyperplasia
  55. What are the SE of non-DHP CCBs?
    • peripheral edema
    • headache
    • dizziness
    • nausea
    • constipation
    • bradycardia
    • gingival hyperplasia
  56. What warning is associated with CCBs?
    do not stop abruptly: risk of rebound HTN/angina
  57. In which conditions are CCBs contraindicated?
    • arrhythmias
    • hypotension
    • heart failure
  58. What warning is associated with B-blockers?
    do not stop abruptly
  59. What are the names of the ACE inhibitors?
    • captopril
    • benazepril
    • enalapril
    • moexipril
    • quinapril
    • ramipril
    • fosinopril
    • lisinopril
    • perindopril
    • trandolapril
  60. What is the preferred antihypertensive for pts with diabetes?
    ACE inhibitors
  61. In which conditions are ACE inhibitors contraindicated?
    • PREGNANCY
    • bilateral renal artery stenosis
    • angioedema from previous ACEI
    • hyperkalemia (caution)
  62. What are the SE of ACE inhibitors?
    • hypotension
    • dry cough (swith to ACE w/ lower incidence)
    • insomnia
    • headache
    • dizziness
    • angioedema (DO NOT use another ACE)
    • rash (captopril in sulfa allergy)
    • hyperkalemia
  63. What are the names of the ARBs?
    • candesartan
    • eprosartan
    • irbesartan
    • losartan
    • olmesartan
    • telmisartan
    • valsartan
  64. What are the compelling indications for the use of ARBs?
    • heart failure
    • diabetes
    • chronic kidney disease
  65. What conditions favor the use of ARBs?
    • proteinuria
    • DM nephropathy
    • ACEI-induced cough
  66. In what conditions are ARBs contraindicated?
    • PREGNANCY
    • bilateral renal artery stenosis
    • ACEI-induced angioedema
  67. What are the SE of ARBs?
    • hypotension
    • dizziness
    • hyperkalemia
    • cough
  68. What are the names of the alpha1 receptor blockers?
    • alfuzosin
    • doxazosin
    • prazosin
    • terazosin
    • tamsulosin (NOT for HTN)
  69. What are the best alpha1 blockers to use for HTN?
    • doxazosin
    • terazosin
  70. In what conditions are alpha blockers contraindicated?
    • elderly
    • concurrent use of PDE-5 inhibitors
  71. What are the names of the alpha2 agonists?
    • clonidine
    • methyldopa
  72. Where do alpha1 agents act?
    in the periphery
  73. Where do alpha2 agents act?
    centrally
  74. What conditions favor the use of alpha2 agonists?
    • pregnancy/breastfeeding (methyldopa)
    • drug addiction (clonidine)
  75. What warning is associated with alpha2 agonists?
    do not stop abruptly
  76. What are the SE of alpha2 agonists?
    • sedation
    • dry mouth
    • withdrawal HTN (clonidine more)
    • edema
    • hepatic and autoimmune disorders (methyldopa)
  77. What antihypertensives should be used in pregnant women with chronic HTN?
    • methyldopa
    • labetalol
  78. What antihypertensives should be used in gestational HTN with no proteinuria?
    • methyldopa
    • labetalol
  79. What antihypertensives should be used in preeclampsia (includes proteinuria and/or edema)?
    • Mg SO4 IV for seizure prophylaxis
    • IV labetalol
    • IV nicardipine
  80. What should be used in pts with migraine?
    B-blockers (esp non-selective)
  81. What should not be used in pts with asthma or COPD?
    B-blockers (esp non-selective)
  82. What should not be used in pts with depression?
    • B-blockers
    • alpha2 agonists
  83. What should not be used in pts with bradycardia or AV block?
    • B-blockers
    • CCB (non-DHP)
  84. What should be used in pts with tachycardia or a-fib?
    • B-blockers
    • CCB (non-DHP)
  85. What should be used in pts with DM?
    • ACE
    • ARB
  86. What should be used in pts who are pregnant?
    • methyldopa
    • labetalol
  87. What should not be used in pts who are pregnant?
    • ACE
    • ARB
  88. What should be used in pts with osteoporosis?
    thiazides
  89. What should be used in pts with renal insufficiency?
    • ACE
    • ARB
    • loops
  90. What should not be used in pts with renal insufficiency?
    • potassium-sparing
    • thiazides (don't work well)

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