Pharm: Htn Review

Front 1

Classifications of HTN

Back 1

Normal: < 80 DP and < 120 SP. Pre-HTN: 80-89 DP or 120-139 SP. Stage1 HTN: 90-99 DP or 140-159 SP. Stage2 HTN: 100+ DP or 160+ SP

Front 2

Causes of 2nd HTN (5)

Back 2

1) renal stenosis. 2) pheochromocytoma. 3) excess aldosterone. 4) adrenal hyperplasia. 5) aortic coarction

Front 3

Severe HTN? What tissues are esp. vulnerable?

Back 3

110+ DP or 180+ SP. Retina, kidneys are especially sensitive; encephalopathies also occur.

Front 4

Some problems caused by chronic HTN (6 listed)

Back 4

1) LV hyperplasia. 2) CAD. 3) inc vascular resistance. 4) stroke. 5) inc in MI. 6) renal dysfxn

Front 5

Benefits of Tx chronic HTN?

Back 5

reduction of systolic pressures by 10-12 mmHg and 5-6 mmHg of DP = reduction of stroke/MI by 40%/20%

Front 6

4 behavioral modifications to Tx high BP

Back 6

1) tobacco. 2) weight. 3) exercise. 4) alcohol

Front 7

Initial therapy for HTN w/ 1) peripheral edema. 2) CHF. 3) Post MI. 4) angina. 5) bad renal dysfunction. 6) high renin

Back 7

1) furosemide or thiazide diuretic. 2) ACE. 3) ACE & Carvediolol. 4) Ca blocker. 5) loop diuretic. 6) ACE

Front 8

Initial therapy for HTN w/ 7) salt-insensitivty. 8) pre-exisiting hypercholesterolemia. 9) asthma. 10) heart block. 11) diabetes. 12) gout

Back 8

7) ACE. 8) Prazosin. 9) NOT BETA-BLOCKER. 10) diuretic (not B-blocker). 11) ACE. 12) DO NOT USE DIURETICS

Front 9

blacks responds better to what 2 things better than what 2 things?

Back 9

better to diuretics and Ca channel blockers than beta-blockers and ACE

Front 10

What 2 things are contraindicated in pregnancy?

Back 10

ACE and ARBs (AT-1 inhibitors)

Front 11

Tx of severe HTN concern? Target? 2 drugs?

Back 11

Avoid too rapid of reduction to avoid loss of perfusion. 25% in 2 hours -> 160/100. Nitroprusside IV!!! Or fenoldiapam (DA agent)

Front 12

ALLHAT results?

Back 12

Thiazide-type diuretics should be preferred first-step therapy for prevention of HF in high-risk pts. w/ HTN

Front 13

What 2 routes start with inc arterial pressure, and end with cerebral edema -> HTN encephalopthy?

Back 13

1) dmg to endothelial membranes/cells -> inc BBB permeability. 2) breakdown vasodilation -> inc local blood flow

Front 14

Give the Prototype, Mechanism, and side effects for: Thiaizide diuretics

Back 14

1) Hydrochlorothiazide. 2) dec vascular volume, dec TPR. 3) hypokalemia, hyperglycemia, lipid abnormalities

Front 15

Give the Prototype, Mechanism, and side effects for: Loop diuretics

Back 15

1) furosemide. 2) dec vascular volume, dec TPR. 3) Hypokalemia, useful in renal-impaired pt.

Front 16

Give the Prototypes (3), Mechanism, and side effects for: K sparing diuretics

Back 16

1) spironolactone, eplerenone, spironolactone. 2) dec vascular volume, dec Na reabsorption, dec aldosterone. 3) hyperkalemia

Front 17

Give the Prototype, Mechanism, and side effects for: Beta-adrenergic antagonists

Back 17

1) atenolol, propranolol. 2) dec CO, dec renin, dec resistance. 3) exacerbates asthma, mask insulin resistance, inc serum TGs, hypotension, impotence, CNS side effects

Front 18

Give the Prototype, Mechanism, and side effects for: Alpha-adrenergic antagonists

Back 18

1) prazosin. 2) inc vasodilation. 3) orthostatic hypotension

Front 19

Give the Prototypes (2), Mechanism, and side effects for: ACE inhibitors

Back 19

1) captopril, enalapril. 2) inc vasodilation, dec aldosterone, dec sympathetic output, dec catecholamine. 3) hyperkalemia, cough

Front 20

Give the Prototype, Mechanism, and side effects for: AT-1 antagonists (ARBs)

Back 20

1) losartan. 2) inc vasodilation - direct dec in RAAS. 3) hyperkalemia, uricosuria

Front 21

Give the Prototype, Mechanism, and side effects for: Ca channel blockers

Back 21

1) nifedipine. 2) inc vasodilation - dec smooth mm. contraction. 3) negative ionotropic effects, HA

Front 22

Give the Prototype, Mechanism, and side effects for: Alpha2-adrenergic agonists

Back 22

1) clonidine. 2) dec sympathetic tone. 3) CNS hypotension and effects

Front 23

Give the Prototype, Mechanism, and side effects for: 2 non-receptor adrenergic antagonists

Back 23

1) guanethidine // reserpine. 2) dec catecholamine release // depletes catechols. 3) orthostatic hypotension at neuron // CNS effects

Front 24

Give the Prototypes (2), Mechanism, and side effects for: arterial vasodilator

Back 24

1) hydralazine, minoxidil. 2) inc vasodilation, inc K channel activity -> hypopolarizes. 3) hypotension (combo w/ beta-blocker and diuretic)

Front 25

Give the Prototype and Mechanism for: mixed anti-alpha/beta

Back 25

1) carvedilol. 2) inc vasodilation

Front 26

Give the Prototype, Mechanism, and side effects for: direct renin antagonist

Back 26

1) aliskiren. 2) inc vasodilation. 3) hyperkalemia