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43 Cards in this Set
- Front
- Back
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HYPERTENSION
INTRODUCTION AFFLICTS OVER ? MILLION AMERICANS DIAGNOSIS |
60
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HYPERTENSION
DIASTOLIC>? SYSTOLIC>? |
DIASTOLIC>90 SYSTOLIC>140
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HYPERTENSION
DIAGNOSIS -3 |
DIASTOLIC>90 SYSTOLIC>140
AGE # OF READINGS |
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HYPERTENSION
ETIOLOGY -2 |
ESSENTIAL (PRIMARY)
SECONDARY (high renin, Cushing’s, drugs) |
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HYPERTENSION
LONG TERM CONSEQUENCES -3 |
renal, cardiac, vascular
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NON-PHARMACOLOGIC THERAPY -4 |
DIET - decrease weight, decrease sodium, decrease alcohol, decrease fats
DECREASED SMOKING INCREASED EXERCISE RELAXATION TECHNIQUES |
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HYPERTENSION
PHARMACOLOGIC THERAPY SHORT TERM BENEFITS VERSUS LONG TERM |
VHA Coop Study - benefits demonstrated
Mortality and morbidity consequences |
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HYPERTENSION
CAUSES OF THERAPEUTIC FAILURES-5 |
COMPLIANCE - drug side effects
INSUFFICIENT DOSE NON-COMPLIANCE TO DIET/EXERCISE DRUG INTERACTIONS ACQUIRED RESISTANCE |
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HYPERTENSION
STEP APPROACH STEP- 5 |
DIURETIC
BETA BLOCKER ALPHA ADRENERGIC BLOCKER ACE INHIBITOR CALCIUM CHANNEL BLOCKER |
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HYPERTENSION
steP APPROACH STEP 2 |
SYMPATHOLYTIC
BETA BLOCKER ALPHA ADRENERGIC BLOCKER ACE INHIBITOR CALCIUM CHANNEL BLOCKER |
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STEP APPROACH
STEP APPROACH HYPERTENSION STEP 3 |
VASODILATOR
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HYPERTENSION STEP APPROACH
STEP 4 |
SYMAPATHOLYTIC
guanethidine |
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HYPERTENSION
DIURETICS -5 |
Management of edema - CHF, cranial, ascites
Hypertension Maintain Urine Flow - shock Protect from nephrotoxic agent Glaucoma |
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HYPERTENSION
DIURETICS DEFINITION |
- increases formation of urine
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HYPERTENSION
OSMOTIC DIURETICS 5 |
NON-ELECTROLYTE
FREELY FILTERABLE AT GLOMERULUS PHARMACOLOGICALLY INERT OSMOTICALLY PULL ACTIVE PARTICLES INTO BLOOD STREAM AND INTO URINE NO EFFECT ON SERUM ELECTROLYTE BALANCE |
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HYPERTENSION
OSMOTIC DIURETICS TOXICITIES |
- increased cardiac work load
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OSMOTIC DIURETICS USE -4 |
MAINTAIN URINE VOLUME DURING SHOCK OR RENAL FAILURE
PROTECT AGAINST NEPHROTOXIC AGENTS GLAUCOMA CEREBRAL EDEMA |
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HYPERTENSION
CARBONIC ANHYDRASE INHIBITORS PHARMACOLOGY 3 |
INCREASES LOSS OF BICARBONATE IN URINE AND LOSS OF SODIUM
DIURETIC EFFECT WORKS FOR ONLY 3 DAYS DECREASED INTRA OCULAR PRESSURE EFFECT CONTINUES INDEFINITELY |
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HYPERTENSION
CARBONIC ANHYDRASE INHIBITORS THERAPEUTIC USE |
SHORT TERM DIURETIC
GLAUCOMA |
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HYPERTENSION
CARBONIC ANHYDRASE INHIBITORS TOXICITIES |
DROWSINESS
METABOLIC ACIDOSIS |
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HYPERTENSION
THIAZIDE DIURETICS PHARMACOLOGY 3 |
BLOCKS REABSORPTION OF SODIUM AND WATER IN DISTAL TUBULE OF KIDNEY
METOLAZONE ALSO BLOCKS REABSORPTION IN THE PROXIMAL TUBULE OF KIDNEY INCREASES SECRETION OF POTASSIUM INTO URINE |
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HYPERTENSION
THIAZIDE DIURETICS OTHER METABOLIC EFFECTS 3 |
NCREASES BLOOD URIC ACID, SUGAR, CHOLESTEROL AND TRIGLYCERIDE
INCREASES BLOOD CALCIUM DECREASES BLOOD POTASSIUM AND MAGNESIUM |
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HYPERTENSION
THIAZIDE DIURETICS USE 3 |
HYPERTENSION
MANAGEMENT OF EDEMA (metolazone with or without a loop diuretic) CONTRAINDICATION Hypercalcemia |
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HYPERTENSION
LOOP DIURETICS PHARMACOLOGY 2 |
BLOCKS REABSORPTION OF SODIUM AND WATER IN ASCENDING LOOP OF HENLE
INCREASES SECRETION OF POTASSIUM INTO URINE |
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HYPERTENSION
LOOP DIURETICS TOXICITIES 2 |
Ototoxicity, nephrotoxicity
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HYPERTENSION
LOOP DIURETICS OTHER METABOLIC EFFECTS 3 |
INCREASES BLOOD URIC ACID, SUGAR, CHOLESTEROL AND TRIGLYCERIDE
DECREASES BLOOD CALCIUM DECREASES BLOOD POTASSIUM AND MAGNESIUM |
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HYPERTENSION
LOOP DIURETICS USE 3 |
HYPERTENSION
MANAGEMENT OF EDEMA HYPERCALCEMIA |
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HYPERTENSION
POTASSIUM SPARING DIURETICS DIRECT ACTING 3 |
TRIAMTERENE
AMILORIDE BLOCKS REABSORPTION OF SODIUM AND WATER IN COLLECTING DUCT OF NEPHRON |
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HYPERTENSION
POTASSIUM SPARING DIURETICS INDIRECT ACTING 2 |
SPIRONOLACTONE
COMPETITIVE INHIBITOR OF ALDOSTERONE |
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HYPERTENSION
POTASSIUM SPARING DIURETICS PHARMACOLOGY 2 |
MINIMIAL DIURETIC EFFECT
DECREASES SECRETION OF POTASSIUM INTO URINE |
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HYPERTENSION
POTASSIUM SPARING DIURETICS THERAPEUTIC USE 2 |
Spare potassium loss of diuretics
Additional uses of spironolactone - edema associated with liver failure and congestive heart failure |
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HYPERTENSION
POTASSIUM SPARING DIURETICS TOXICITIES |
Hyperkalemia - therefore potassium is not administered concurrently
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THERAPEUTIC HYPERTENSION
POTASSIUM SPARING DIURETICSALTERNATIVES |
Foods high in potassium
potassium supplement caution with IV administration |
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HYPERTENSION
SYMPATHOLYTICS STEP 2 THERAPY SIDE EFFECTS 5 |
SODIUM AND WATER RETENTION
POSTURAL HYPOTENSION CONSTIPATION DRY MOUTH IMPOTENCY |
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HYPERTENSION
SYMPATHOLYTICS 4 |
CLONIDINE
REBOUND HYPERTENSION IF NOT COMPLIANT PATCH ALTERNATIVE MAY BE USED FOR ACUTE HIGH BP METHYLDOPA RESERPINE - noted to cause breast CA GUANETHIDINE - 4th step due to diarrhea |
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HYPERTENSION
BETA BLOCKERS BLOCKS ? RELEASE CAUTION |
RENIN
DIABETICS ASTHMATICS |
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HYPERTENSION
ALPHA ADRENERGIC BLOCKERS DUAL MECHANISM ? First Dose Effect ? USES 2 |
- Blocks alpha receptor and directly causes vascular smooth muscle vasodilation
No rebound tachycardia - caution for syncope Hypertension Prostate hypertrophy |
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HYPERTENSION
VASODILATOR 3 |
DIRECT RELAXATION OF VASCULAR SMOOTH MUSCLE
REBOUND TACHYCARDIA SODIUM AND WATER RETENTION |
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HYPERTENSION
VASODILATOR 3 EXS |
HYDRALAZINE
Side effect - lupus like syndrome MINOXIDIL Side effect - hair growth NITROPRUSSIDE dilates arterioles and venules therapy cannot exceed 3 days or leads to thiocyanate poisoning (muscle spasm,stupor) |
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HYPERTENSION
VASODILATOR DIAZOXIDE side effect - ? |
hyperglycemia
very poor control of the lowering of blood pressure |
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HYPERTENSION
ANGIOTENSIN CONVERTING ENZYME INHIBITOR BLOCKS ? SIDE EFFECT 1 USE 3 |
HCONVERSION OF ANGIOTENSIN 1 TO ANGIOTENSIN 2
- Non-productive cough YPERTENSION CONGESTIVE HEART FAILURE DIABETIC RENAL SPARING |
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HYPERTENSION
ANGIOTENSIN RECEPTOR BLOCKER Utilized for ?Examples:2 |
patients that cannot tolerate side effects of ACE inhibitors
losartan, irbesartan |
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HYPERTENSION
CALCIUM CHANNEL BLOCKER Blocks ? Prevents ? Use 3 |
entry of calcium into cells
contraction of vascular smooth muscle Hypertension Angina Arrhythmia |
