Hypertension

Front 1

meds that can cuase secondary htn?

Back 1

corticosteroids, alcohol, amphetamines, appetite suppressants, caffeine, cyclosporine, estrogens, nsaids, oral decongestants, thyroid (if too much), venlafaxine, chemo (bevacizumab and sorafenib..bio agents)

Front 2

what is normal BP?

Back 2

under 120/80

Front 3

pre htn?

Back 3

120-140/80-90

Front 4

htn 1?

Back 4

140-160/90-100

Front 5

htn 2

Back 5

over 160/100

Front 6

drug for DM type 1 w/ htn and albunuria

Back 6

ACE

Front 7

DM 2 and htn adn microalb

Back 7

ace or arb

Front 8

DM 2 with htn, macroalbin, and renal insuff

Back 8

ARB

Front 9

HF and HTN meds

Back 9

ACEi, diuretics

Front 10

MI and HTN?

Back 10

BB (non ISA) and ACE

Front 11

isolated systolic HTN (usually elderly)

Back 11

long acting DHP CCP

Front 12

Followup for BP monitoring once med is initiated? after stable? Other things to make sure of (3)

Back 12

monthly, 3-6 months, smoking cessation/manage comorbidities and complications, lipid panel

Front 13

what are the 6 lifestyle things to stop for HTN?

Back 13

weight reduction (5-20 drop SBP), DASH eating (8-14), Na reduction (2-8), physical activity (4-9), moderate consumption of alcohol (2-4), stop smoking

Front 14

waht are the CI to thiazide diuretics?

Back 14

pregnancy, persistant anuria, sulfa allergy

Front 15

4 cautions with thiazide diuretics

Back 15

gout, ClCr under 30, DM, dyslipidemia

Front 16

what are the lab value SE that thiazide diuretics will cuase?

Back 16

hypokalemia, hypERcalcemia, hypOnatremia, hypOmag, hypERuricemia (gout), hyperGlycemia (caution in DM), hyperchol (caution in dyslipid), hypertriglycer (caution in dyslipid), photosensitive

Front 17

Inxs of thiazeds?

Back 17

blood sugar addition with BB, digoxin toxicity with the electrolytes (hypokalemia, hypomagn), additive gout risk with cyclosporine, may increase lithium levels, nsaids/bile acid resins/decongestants can decresae effect

Front 18

brand name of hctz?

Back 18

microzide, oretic

Front 19

brand of chlorthalidone

Back 19

thalitone

Front 20

MOA of thiazides?

Back 20

inh Na reabsorption

Front 21

what is the special use remark on metolazone?

Back 21

use with a loop diuretic

Front 22

name 3 K sparing diuretics

Back 22

spironolactone, amiloride, triamterene

Front 23

spironolactone brand

Back 23

aldactone

Front 24

MOA of K sparing diuretics

Back 24

ald rec antag, works in distal rrenal tubules, Na excretion increased while holding onto K

Front 25

Ci of the ald antag (K sparing)

Back 25

anuria, pregnancy, hyperkalemai, chronic renal insuff

Front 26

general SE considerations of the ald antag (K sparing)

Back 26

increased K, decreased Na

Front 27

spironolactone specific SE

Back 27

gynecomastia, hair loss, menstrual irregu, impotence

Front 28

specific K level where the ald antag (K sparing) are contraindicated?

Back 28

5.5

Front 29

Loop diuretics MOA

Back 29

inh Na and Cl reabsorption in loop of henle and distal renal

Front 30

furosemide and bumetanide brand

Back 30

lasix, bumex

Front 31

oral dose equivalence among loops for furosemide, bumetanide, torsemide?

Back 31

40=1=10

Front 32

CI to loop diuretics?

Back 32

sulfa allergy, anuria, pts with hepatic coma

Front 33

Genergal SE of loops

Back 33

hypOkalemia, otheelectroly, gout etc, OTOTOxicity, ortho hypotension

Front 34

what other meds will have additive ototoxicity?

Back 34

AG, vanco, salicylates, cisplatin

Front 35

loop inxns?

Back 35

additive hypo effects, dig toxicity (hypokalemia), increased lithium levels, MONITOR dehydration

Front 36

what is a sign of hypokalemia?

Back 36

muscle cramps

Front 37

what time in day should you take diuretics? K sparing?

Back 37

mornign, after meals

Front 38

what are the most effective thiazides for pts with impaired renal fxn?

Back 38

metolazone, indapamide

Front 39

brand of benazepril? enalapril? lisinopril? ramipril?

Back 39

lotensin (benz), vasotec (enal) prinivil, zestril (lisin), altace (rami)

Front 40

CI to ACEi

Back 40

pregnancy, angioedema, bilateral renal artery stenosis

Front 41

SE of ACE...CAPTOPRIL

Back 41

Cough, angioedema, proteinuria, tast changes, ortho hypo, preg cat D, rash/renal failure, increase in K, Lithium increase

Front 42

when given electrolyte substitutes waht should you take note of ?

Back 42

KCL rather than NaCl

Front 43

3 monitoring parameters for ACE

Back 43

serum K, fluid staus, renal fxn

Front 44

what ethnic may not benefit as much?

Back 44

blacks

Front 45

brand name of irbesartan

Back 45

avapro

Front 46

brand losartan

Back 46

coazzr

Front 47

valsartan brnad

Back 47

diovan

Front 48

brand olmesartan

Back 48

benicar

Front 49

CI to BB (5)

Back 49

2nd/3rd degree heart block, sinus brady, cardio shock, decomp HF, pulm edema, pregnancy

Front 50

how must BB discontinuing be handled?

Back 50

do not abruptly withdraw

Front 51

waht are the many SE of BB

Back 51

depression, sexual dys, hyperglyc, vivid dreams and hallucination, hyperlipid, brady, ortho hypo, CHF

Front 52

what is an additional warning when pt is DM?

Back 52

can mask hypoglycemic symptoms

Front 53

what is a combined alph and beta blocker?

Back 53

carv (coreg)

Front 54

what are the differences for nebivolol (bystolic?)

Back 54

also an increased NO release with Beta blocking....2d6 inxns

Front 55

name the 4 BB with isa activity

Back 55

carteolol, acebutolol, penbutolol, pindolol

Front 56

what ethinicity many BB not be as good in?

Back 56

black

Front 57

what hypo symtpom sdo BB not mask?

Back 57

hunger and sweating

Front 58

Beta1 selective BB?

Back 58

aten, meto, esomolo, bisoprolol, betaxolol, acebutolol

Front 59

name 3 alpha blockers?

Back 59

prazosin (minipress), terazosin (hytrin), doxazosin (cardura)

Front 60

alpha blocker caution

Back 60

if concurreet use of PDE-5 inh (sildenafil, tadalafil, vardenafil)...avoid concurrent use with tamsulosin, alfuzosin

Front 61

SE of alpha blockers (prazosin, terazosin, doxazosin)

Back 61

post hypo, first dose SYNCOPE, dizzy, vergtigo, HA, weakness, depression, edema, sexual dysfunction

Front 62

what meds when combined with alpha blockers may increase orthostaiss?

Back 62

TCA's and antipsychotics

Front 63

CI to nondihydros?

Back 63

2nd/3rd degree heart block, hypotension, Acute MI, pulm congestion, sick sinus rythm

Front 64

waht are the SE of Nondihydros that are more common with verapamil?

Back 64

constipation, gingival hyperplasia

Front 65

SE of nondihydros?

Back 65

Ha, flushing, dizzy, constipation, edema, gingival hyperplasia, fatigue, bradycardia, nausea

Front 66

Inxns important to the nondihydros

Back 66

Increase CCB levels: azoles, cimetidine, ciproflox, erythromycin, valproid acid, PI....decrease CCB: carbamazepine, bariturates, phenobarb, rifampin, rifabutin

Front 67

what meds can CCB increase the levels of?

Back 67

carbamazepine, cyclosporine, digoxin, statins, lithium

Front 68

what is the mech of the dihydros?

Back 68

purely afterload reducers, no AV node or HR effects

Front 69

name a few dihydros

Back 69

amlodipine, felodipine, nicardipine...IPINE

Front 70

which dihydros are reflex tachy seen?

Back 70

none with amlodipine...felodipine, nicardipine, nisoldipine, IR nifedipine

Front 71

SE of dihydros

Back 71

periph edema, HA, flushing, hypotension, dizzy, rash, gingival hyperplasia

Front 72

name some central acting Alph ag

Back 72

clinidine (catapres), guanfacine, methyldopa

Front 73

waht is the side effect profile of central actin alpha

Back 73

antichol (sedation, dry moth), sexual dysfunction, brady, reboutn htn, constipation, depression

Front 74

inxns of central acting alpha?

Back 74

watch for additived antihyper, CNS depr (antipsycho), methyldopa can increase lithium...methyldopa: LFT changes, hepatitis, hemolytic anemia, lupos like syndrome

Front 75

moa of peripheral adrenergic antags?

Back 75

decrease catecholamines and 5HT decreasing peripheral resistance and increasing plasma volume and decreasing CO

Front 76

what are the SE concerns with the periph adren agents reserpine (serpasil) and guanadresl

Back 76

induce depressoin, park state, nasal congestion, lethargy, brady

Front 77

name the 2 direct vasodilators

Back 77

hydralazine, minoxidil

Front 78

major SE of hydralazine?

Back 78

reflex tachy, lupus like syndrome, dizzy fluid retention

Front 79

major SE of minoxidil?

Back 79

fluid retention, tachy,

Front 80

name the direct renin inh?

Back 80

aliskiren (tekturna)

Front 81

CI to aliskiren?

Back 81

preg, bilateral renal art stenosis

Front 82

SE of aliskirne

Back 82

hyperkalemia, increased Scr, diarrhea, hypo, angioedema

Front 83

typically the direct renin inh and direct vaso are good for combo therapy

Back 83

k

Front 84

goal MAP reduction for hyper emergency?

Back 84

less than 25% reduction in 30-60 min, reach 160/100 within 2-6 hours, measure bp every 5-10 min until goal map achieved,

Front 85

htn emergency vs urgency

Back 85

PO vs IV

Front 86

hyp emergency/urgency meds

Back 86

pg 180

Front 87

pt counseling pg 181

Back 87

k