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23 Cards in this Set
- Front
- Back
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HTN diagnosis requirement
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3 readings at 3 different appointments
>140/90 |
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symptoms of HTN
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-usually asymptomatic until progression, HA maybe the only symptom
-cotton-wool spot (fundoscopic) -flame hemorrhage (fundoscopic) -av nicking (fundoscopic) |
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HTN emergency
criteria symptoms tx |
>200/120
-possibly asymptomatic or mild -signs of renal failure -hematuria -mental status change -papilladema -unstable angina *lower DIASTOLIC pressure first and DON"T drop more than 25% of presenting pressure cuz it will cause ischemia (body was used to high pressure so need to lower slowly) |
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Thiazides
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*FIRST-LINE for HTN
-effective in black people SE *EXACERBATE GOUT *HYPERCALCEMIA = thus thiazide good for osteoporosis +HTN *hypokalemia |
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K+ sparing diuretics
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1 spironolactone
2 eplerenone 3 triamtrene 4 amilordie 1+2 are aldosterone antagonist 3+4 are NOT aldosterone antagonist spironolactone is the only one w/ anti-androgenic -first-line for HTN SE *hyperKalemia |
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alpha-blockers
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-alpha-1 primarily control vascular tone. thus a-blocker ↓ TPR
-ends in -zosin *GREAT in patients with BPH (relax urethral tone) SE *POSTURAL HYPOTENSION |
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beta-blockers
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-could be first-line
-more effective in white people SE *sexual dysfunction in males *if non-beta-1 selective, then bronchoconstriction (carefule in asthma) |
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beta-blocker secret !!!!
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all beta-blockers end with -lol
-b-blockers that begin with any letter in the first half of alphabet (A-M) then they are beta-1-selective -if name begins with latter half of alphabet (N-Z) then non-selective -one exception is labetolol, which is non-selective -beta-1 is priedominantly cardiac |
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Calcium Channel Blockers
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-non-dihydropyridine works at heart, dihydropyridine works at smooth muscle to cause vasodilation
-SECOND LINE agent SE *PEDAL EDEMA |
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hydralazine
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vasodilator @ arterioles (unique)
-ADJUNCT -less commonly used SE -reflex tachycardia (vasodilating peripheral and not doing anything for HR then heart will start to increase HR) |
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minoxidil
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vasodilator
-ADJUNCT -less commonly used SE -reflex tachycardia (vasodilating peripheral and not doing anything for HR then heart will start to increase HR) |
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nitroprusside
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vasodilator @ arteries + veins
-ADJUNCT -less commonly used SE *CYANIDE TOXICITY -reflex tachycardia (vasodilating peripheral and not doing anything for HR then heart will start to increase HR) |
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ACE-I
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-pril drugs
*could be FIRST LINE *past MI or CHF then should be on ACEI (↓ mortality) SE *DRY COUGH (due to bradykinin) *ANGIOEDEMA (due to bradykinin) *AZOTEMIA *HYPERKALEMIA *Teratogenic |
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ARB
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-second line
SE *no dry cough or angioedema cuz no bradykinin -teratogenic |
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recommendation + contraindication for HTN tx in DM
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recommend
-ACEI (delay renal damage) contraindication -beta blocker (mask hypoglycemia) |
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recommended tx for HTN in CHF
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recommend (improve mortality)
-beta blocker -ACEI -spironolactone |
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recommended tx for HTN in BPH
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recommend
-selective alpha-1 blocker contraindication |
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recommended tx for HTN in post-MI
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recommended (improve mortality)
-ACEI -beta blocker |
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recommendation for HTN in osteoporosis
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thiazide (SE is hypercalcemia)
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contraindication for HTN tx in asthma or COPD
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contraindicated
-non-selective beta blocker |
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safe HTN drug for PREGNANT
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*LABETOLOL
*METHYLDOPA *HYDRALAZINE *NIFEDIPINE |
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contraindication for HTN in gout
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thiazide (SE is hyperurecemia)
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contraindication for HTN in depression
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contraindication
-beta blocker |
