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40 Cards in this Set
- Front
- Back
Normal BP
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119/79 mmHg or less
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Prehypertension-
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120-‐139/80-89
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Stage 1 hypertension
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140-‐159/90-99
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Stage 2 hypertension
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160 or higher/100 or higher
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-accounts for 10% of all cases of HTN
is the result of another disease &/or medicati ons |
Secondary HTN
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Studies have shown that elevated ___ BP is strongly associated with heart failure, stroke, and renal failure
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SYSTOLIC
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the amount of blood ejected in a single contraction from the left ventricle (LV) measured in L/ min
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Cardiac output (CO)
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the opposing force (resistance) the LV has to overcome to eject its volume of blood
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Systemic Vascular Resistance (SVR)
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Major determinant of DBP
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Systemic Vascular Resistance (SVR)
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Major determinant of SBP
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Cardiac output (CO)
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β-‐blockers and ACE inhibitors have been found to be more effective in ____ than _____
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white patients than
African-‐American patients |
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CCBs and diuretics have been shown to be more effective in _______ patients than in _____ patients
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African-‐ American
white |
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BP=
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CO X SVR
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CO=
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HR X STROKE VOLUME
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Mechanisms that regulate BP can affect either ___ OR ____ OR ___
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CO or SVR or both
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Sympathetic nervous system
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alpha & beta adrenergic receptors
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Cardiovascular system
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HR and force of contractility
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Renal system
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control Na and H2O
renin-‐angiotensin-‐aldosterone system |
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Endocrine system
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adrenal gland (aldosterone, catecholemines, cortisol
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Incidence of HTN is higher for which race?
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African Americans
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what is the initial drug of choice for HTN?
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thiazide diuretics either alone or in combo with another med
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hydrochlorothiazide (Hydrodiuril), metolazone (Zaroxolyn)
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Thiazides
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furosemide (Lasix)
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Loop diuretics
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triamterene (Dyrenium); spironolactone (Aldactone)
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Potassium-‐sparing diuretics
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how do diuretics work?
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• Decreases circulating volume
• Increase Na excretion • Decreases cardiac output • Decreases systemic vascular resistance • Decrease workload of the heart • Decrease BP |
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Inhibit tubular resorption of sodium, chloride, and potassium ions
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Thiazide Diuretics
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Action primarily in the distal convoluted tubule
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Thiazide Diuretics
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Result: water, sodium, and chloride are excreted and potassium to a lesser extent
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Thiazide Diuretics
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Dilate the arterioles by direct relaxation – *Lowered peripheral vascular resistance
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Thiazide Diuretics
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• F&E imbalances: volume depletion; ✓orthosta\c hypotension
decreased Na+, K+, Chloride, Mg increased glucose, calcium, uric acid, metabolic alkalosis • GI: gastric irritation, N/V, change in bowel paoerns • CNS: dizziness, blurred vision, HA, weakness • Sexual dysfunction: erectile dysfunction, decreased libido • Integumentary: photosensi\vity, rash |
Thiazide Diuretics: Adverse Effects
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Act directly on the ascending limb of the loop of Henle to inhibit chloride and sodium reabsorption and thus...increase Na, K+ & Chloride excretion/depletion
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Loop Diuretics
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Increase renal prostaglandins, resulting in the dilation of blood vessels and reduced peripheral vascular resistance
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Loop Diuretics
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More potent than the thiazide diuretics but shorter duration
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Loop Diuretics
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F&E imbalances: same as thiazide diuretics except no hypercalcemia
• CNS: dizziness, orthostatic hypotension • Ototoxicity: tinnitus, hearing impairment, vertigo (usually reversible) • Metabolic:increases glucose, uric acid, LDL, cholesterol, triglycerides, decrease HDL’s • Heme: neutropenia, thrombocytopenia |
Loop Diuretics: Adverse Effects
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Weakling of the diuretics but great to counteract K+ loss from other diure4cs
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Potassium Sparing Diuretics
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Work in collecting ducts and distal convoluted tubules
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Potassium Sparing Diuretics
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Interfere with sodium-‐potassium exchange
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Potassium Sparing Diuretics
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Competitively bind to aldosterone receptors
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Potassium Sparing Diuretics
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Block the resorption of sodium and water
usually induced by aldosterone thus K+ is conserved |
Potassium Sparing Diuretics
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• Hyperkalemia-‐check K+ levels and S&S of hyperkalemia
• Dizziness, HA, weakness, N/V, diarrhea spironolactone • Gynecomastia • Amenorrhea • Irregular menses • Postmenopausal bleeding |
Potassium Sparing Diuretics Adverse Effects
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