Cardiovascular System

Front 1

Stage 1 hypertension

Back 1

140-159/90-99

start with monotherapy

Front 2

Stage 2 hypertension

Back 2

over 160/100

dual therapy

Front 3

Primary HTN

Back 3

cause unknown

Front 4

secondary HTN

Back 4

caused by medical conditions, prescription and nonprescription medications, lifestyle factors

Front 5

Thiazide Diuretic

Back 5

Hydrochlorothiazide, Metolazone (Like)

increase sodium and chloride in the proximal/distal renal tubules and Loop of Henle

Side effects: HYPOKALEMIA, orthostatic hypotension

Front 6

Loop Diuretic

Back 6

Furosemide (Lasix)

prevent absorption of sodium and chloride in the proximal/distal renal tubules

Side effects: HYPOKALEMIA, orthostatic hypotension

Front 7

Aldosterone Receptor Antagonist

Back 7

Spironolactone

increase sodium and water excretion and decrease potassium excretion

Side Effects: GYNECOMASTIA, hyperkalemia, dehydration, orthostatic hypotension

Avoid salt substitutes

Front 8

Diuretics

Back 8

thiazide, loop, aldosterone receptor antagonist

decrease EF and thereby decrease CO and total peripheral resistance

Front 9

Cardioselective, B1, receptor blocker

Back 9

atenolol, metroprolol tartrate, metoprolol succinate, carvedilol

Act specifically on the heart to decrease heart rate and force of contraction

Front 10

Nonselective B1 and B2 receptor blocker

Back 10

propranlol

act on b1 and b2 receptors to decrease heart rate and contractility and act on B2 receptors to lead to bronchoconstriction and vasoconstriction

Front 11

Beta Blockers

Back 11

"ol"

Indications: hypertension, MI, HF, Angina, dysrhythmia

Contraindications: hypotension, bradycardia, heart block, ADHF, pregnancy, RAYNAUDS DISEASE, severe pulmonary disease

Monitor: blood pressure and HR

Avoid abrupt discontinuation

Side Effects: Hypotension, bradycardia, heart failure, fatigue, depression, IMPOTENCE

Front 12

Angiotensin Converting Enzyme Inhibitors

ACE-I

Back 12

"prils"

indications: hypertension, HF, acute MI, diabetic neuropathy

inhibits the conversion of angiotensin I to angiotensin II, resulting in reduce vasoconstriction and aldosterone

Side effects: hypotension, hyperkalemia, acute renal failure, angioedema, COUGH

Contraindications: pregnancy, angioedema, acute renal failure, hyperkalemia

Monitor: BP, renal functions, potassium, cough

Black Box Warning: do not use in pregnancy, serum creatinine will increase... if increase is greater than 45% suspect acute renal failure, avoid salt substitutes containing potassium

combined with thiazide diuretics to improve compliance

Front 13

Angiotensin II Receptor Blockers (ARBS)

Back 13

sartan

Indications: hypertension, HF, cerebrovascular accident and diabetic neuropathy

Works in the Renin-Angiotensin-Aldosterone system, as an angiotensin II receptor antagonist blocking the binding of angiotensin II; decreased tpr and blocks aldosterone

Side Effects: hypotension, angioedema, hyperkalemia

Contraindications: drug allergy, pregnancy, hyperkalemia, CAUTIOUS WITH IMPAIRED RENAL/HEPATIC FUNCTION

Monitor: BP, renal function, hepatic function, electrolytes

Avoid salt substitutes and not w/ pregnancy

NO COUGH

Front 14

Direct Renin Inhibitor

Back 14

aliskirin (tekturna)

Hypertension

Works in the RAAS to directly inhibit renin and to inhibit the conversion of angiotensinogen to angiotensin I, resulting in decreased TPR

Side Effects: Cough, angioedema

Contraindications: PRICE, pregnancy, angioedema

Monitor: BP, renal function, electrolytes w/ ACE-I

Black Box: pregnancy

Front 15

Dihydropyridine (Calcium Channel Blocker)

Back 15

Amiodipine, felodipine, nifedipine

"pines"

Hypertension, Angina

Cause relaxation of cardiac and vascular smooth muscle by blocking flow of calcium which decreases blood pressure

Side effects: reflex tachycardia, peripheral edema

Contraindications: systolic HF

Front 16

Non-dihydropridine (Calcium Channel Blocker)

Back 16

Diltiazem (IV) verapamil

Hypertension, angina, diastolic HF, atrial fibrilation

cause slowed AV node conduction and decreased HR by blocking the flow of calcium which in turn decreases BP

Side Effects: Bradycardia, AV block, peripheral edema, GINGIVAL HYPERPLASIA (diltiazem), constipation (verapamil)

Contraindications: administer IV beta blocker within a few hours of diltiazem, avoid concurrent use of beta blockers and digoxin, hypotension

Front 17

Calcium Blocker

Back 17

Monitor BP, HR

- It is not contraindicated to use a beta blocker with a calcium blocker, combined therapies lead to effects on BP and HR

EFFECTIVE FOR AFRICAN AMERICANS

AVOID EATING GRAPEFRUITS w/ felodipine and nifedipine

DON'T DRINK ALCOHOL

Front 18

Alpha Adrenergic Blockers

Back 18

Terazosin, Prazosin, Doxazosin, Tamsulosin (Flomax)

"SIN"

Hypertension, Benign Prostatic Hyperplasia

Decrease TPR by inhibiting alpha-1 adrenergic receptors in the peripheral blood vessels. Vasodilation leads to decreased BP. ALPHA-1 ALSO IN BLADDER LEADS TO EASY EMPTYING

Side Effects: First dose dizziness/palpitations after medication initiation, orthostatic hypotension

Give @ HS

Monitor BP, side effects

Do not use as monotherapy for the treatment of hypertension

Front 19

Central Acting Alpha Agonist

Back 19

Clonidine (Catapres) - oral, patch

Hypertension

Acts on Alpha 2 adrenergic receptors in the vasomotor center of the brain to decrease TPR and HR

Side Effects: skin irritation (patch), dry mouth, sedation/drowsiness, constipation

Contraindications: recent myocardial infarction

Monitor: BP and HR

Sudden discontinuation can lead to rebound HTN, do not drink alcohol, keep patches out of reach of children