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148 Cards in this Set
- Front
- Back
What is the most common cardiovascular disease? This affects what % of Americans? |
* Hypertension is the most common cardiovascular disease. * It affects 29.1% of Americans (NHANES 2000 11 to 2000 12) |
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Hypertension: What is associated with an increase in morbidity and mortality? |
* Elevated blood pressure (of over 120 over 80 mmHg) is associated with an increase in morbidity and mortality |
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Hypertension: What does elevated blood pressure eventually do? |
* Eventually, elevated blood pressure damages internal organs. |
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Hypertension: A patient with hypertension is more likely to have what other 3 conditions? |
* Kidney disease * Heart disease * Cardiovascular problems |
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Hypertension: Hypertension is divided into categories based on what? What are the 3 categories? |
* Based on the cause or progression of the disease, hypertension is divided into categories: -- Primary (a.k.a. idiopathic, or essential) -- Secondary and -- Malignant |
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Hypertension: What is Primary (a.k.a idiopathic or essential) Hypertension caused by? What % of patients are affected? |
* Primary (a.k.a idiopathic or essential): is from an unknown cause. -- 85 to 90% of patients are affected |
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Hypertension: |
* Secondary: is identified and associated with a disease process of the endocrine or renal system. |
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Hypertension: What is Malignant Hypertension caused by? What % of patients are affected? |
* Malignant: is high or rapidly rising blood pressure. -- about 5% of patients with primary or secondary hypertension are affected |
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Hypertension: New guidelines were defined by the 2014 JNC 8. What was not addressed and what was defined? |
* Definitions of hypertension and prehypertension were not addressed, but thresholds for pharmacologic treatment were defined. |
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Hypertension: The recommended selection was among what 4 spacific medication classes? |
* Recommended selection among 4 specific medication class (A.C.E.I. or A.R.B., C.C.B. or Diuretics). |
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Treatment of Hypertension - JNC 8: Strong evidence supports treating patients 60 years and older up to what BP? |
* Strong evidential support - Age 60 years and older, treat to a BP goal of less than 150 over 90 mmHg |
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Treatment of Hypertension - JNC 8: Strong evidence supports treating patients 30-59 years with hypertension up to what BP? |
* Strong evidential support - Age 30 to 59 years with hypertension, treat to diastolic goal of under 90 mmHg |
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Treatment of Hypertension - JNC 8: What is there not enough evidence to support treating? |
* Not enough evidence to support treating: -- to a specific systolic goal in patients under 60 years of age -- or in treating patients younger than 30 years of age to a diastolic goal |
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Treatment of Hypertension - JNC 8: In the General population, patients 60 years or older should be treated to what BP? |
* less than 150 mmHg over 90 mmHg |
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Treatment of Hypertension - JNC 8: In the General population, patients under 60 years should be treated to what BP? |
* less than 140 over 90 mmHg |
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Treatment of Hypertension - JNC 8: In the Diabetic or CKD (chronic kidney disease), patients all ages should be treated to what BP? |
* less than 140 over 90 mmHg |
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Treatment of Hypertension: What should be used as BP becomes greater than goal? |
* Use a step-care approach as BP become greater than goal |
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Treatment of Hypertension: What lifestyle modifications are recommended in treatment of hypertension? |
* Lifestyle modifications include: -- Weight reduction -- Physical activity -- A diet rich in fruits and vegetables -- Reduced contents of saturated and total fats -- Sodium restriction |
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Treatment of Hypertension: What diets support the lifestyle modifications recommended in treatment of hypertension? |
* DASH diet, USDA Food Pattern or AHA diet |
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Treatment of Hypertension: Lifestyle modifications should be initiated at what hypertension staging? |
* This should be initiated regardless of hypertensive staging |
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Treatment of Hypertension - Initial Drug Choices: What is the most common treatment for hypertension? How is it often used to help increase control while reducing side effects? |
* Thiazide diuretics most common treatment * Often a 2 drug regiment is used to help increase control while reducing side effects
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Treatment of Hypertension - Initial Drug Choices: What 6 compelling indications help influence the agents that are selected for treatment? |
* Compelling indications such as: -- Heart failure -- Post-MI -- High cardiovascular risk -- Diabetes -- Chronic kidney disease -- Recurrent stroke prevention
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Treatment of Hypertension - Initial Drug Choices: In heart failure, which is the order of best treatment in improving outcomes?
a.) ACEI over CCB over thiazide? b.) CCB over thiazide over ACEI? or c.) thiazide over ACIE over CCB
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* c) In heart failure hiazide over ACEI over CCB in improving outcomes |
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Treatment of Hypertension: What are the big four antihypertensive groups? What is group is no longer included? |
* The Big Four antihypertensive groups are: -- Diuretics -- CCBs -- ACIEs -- ARBs * Beta-adrenergic blocking agents are no longer included. |
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Treatment of Hypertension: According to JNC 8, what diuretics are included as recommendations for treatment of hypertension? |
*Per JNC, only the thiazide diuretics, chlorthalidone and indapamide are included |
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Treatment of Hypertension: According to JNC8, what are no longer included in the diuretic recommendations?
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* Loop and potassium sparing diuretics are not included in the recommendation |
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What is among the most common agents for treatment of hypertension? |
* Thiazide Diuretics |
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Thiazide Diuretics: What is the most commonly used thyazide? |
* hydrochlorothiazide (HCTZ) is the most commonly used thiazide |
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Thiazide Diuretics: How are many patients with hypertension treated? |
* Many patients with hypertension are treated soley with hydrochlorothiazide (HCTZ) |
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Thiazide Diuretics - MOA: What is the MOA of thiazide Diuretics? |
* Mechanism of Action (MOA) - exact MOA unknown |
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Thiazide Diuretics - MOA: What does thiazide initially inhibit and where? |
* Thiazide initially inhibits sodium reabsorption from the distal confoluted tubule of the kidneys |
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Thiazide Diuretics - MOA: What passively accompanies the sodium and what does it produce? |
* Water and chloride ions passively accompany the sodium, producing diuresis (increased urine production) |
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Thiazide Diuretics - Adverse Reactions: What may be needed from taking tiazide diuretics? |
* Potassium supplementation may be needed due to loss of K+ from diuretics |
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Thiazide Diuretics - Adverse Reactions: What can 3 drugs can increase risk of arrhythmia? |
* Hypokalemia * Digoxin * Epinephrine |
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Thiazide Diuretics - Adverse Reactions: When should epinephrine be limited to the cardiac dose |
* Limit to cardiac dose if digoxin toxicity present & thiazide is taken |
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Thiazide Diuretics - Adverse Reactions: What are 5 other side effects to using thiazide diuretics? |
* Other side effects include: -- Hyperglycemia -- Hyperlipidemia -- Hypercalcemia -- Anorexia -- Xerostomia
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Thiazide Diuretics - Adverse Reactions: What is of special concern if the patient has gout? |
* Hyperuricemia is of special concern if the patient has gout |
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Thiazide Diuretics: What can reduce the antihypertensive effect of thiazide diuretics? |
* Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce the antihypertensive effect of thiazide diuretics |
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Thiazide Diuretics: Because it takes a few days to develop, use of NSAIDs to reduce the antihypertensive ffect is ok for what? |
* It takes a few days to develop so use of NSAIDs ok for acute, short term use |
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Loop Diuretics: What is the most common loop diuretic? |
* Furosemide (Lasix) is the most common loop diuretic |
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Loop Diuretics - MOA: What does loop diuretics act on? |
* Acts on the ascending limb of the loop of henle and has some effect on the distal dubule |
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Loop Diuretics: What does loop inhibit reabsorption of? |
* Inhibits reabsorption of sodium with concurrent loss of fluids and potassium |
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Loop Diuretics: What is usually prescribed to take with florsemide? |
* Usually potassium is prescribed to take with the flurosemide to replace lost potassium |
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Loop Diuretics: Besides furosemide, what are also included as loop diuretics? |
* Other loop diuretics include bumetanide and torsemide |
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Loop Diuretics: What are loop diuretics more potent than and at a higher risk of? |
* More potent than thiazides, higher risk of adverse effects |
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Loop Diuretics - Adverse effects: What are loop diuretics' adverse effects similar to? |
* Adverse effects are similar to those from thiazide diuretics |
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Loop Diuretics: What are loop diuretics used in treatment of? |
* Used in treatment of hypertensive patients with heart failure |
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Loop Diuretics: What do loop diuretics cause? |
* Rapid diuresis |
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Loop Diuretics: What is the efficacy of loop diuretics decreased by? |
* Decreased efficacy when NSAIDs are used |
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Potassium-Sparing Diuretics: What type of diuretic action do potassium-sparing diuretics have? |
* Weak diuretics action |
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Potassium-Sparing Diuretics: What two drugs are potassium-sparing diuretics? |
Spironolactone and Triamterene |
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Potassium-Sparing Diuretics: What is spironolactone MOA? What does it result in and what is reabsorbed? |
* Spironolactone: aldostrone antagonist -- results in sodium excretion through duresis and loss of fluid volume -- Potasium is reabsorbed |
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Potassium-Sparing Diuretics: What is triamterene MOA? What does it inhibit? |
* Interferes with potassium-sodium exchange by inhibiting sodium-potassium adenosine triphosphate (ATPase)
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Potassium-Sparing Diuretics: What is used to reduce potassium loss? |
*Combo of triamterene and hctz used to reduce potassium loss |
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Calcium Channel Blockers: What is the MOA of CCBs? |
* MOA - inhibits movement of extracellular calcium ions into cells |
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Calcium Channel Blockers: How do CCBs affect smooth muscle? |
* Relaxes vascular smooth muscle and dilates coronary and peripheral arteries and arterioles, reducing afterload |
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Calcium Channel Blockers: What uncommon with CCBs? |
* Orthostatic hypotension is uncommon |
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Calcium Channel Blockers: How do CCBs affect cardiac muscle? |
* May reduce heart rate, decrease myocardial contractillity (negative inotropic effect), and slow AV nodal conduction |
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Calcium Channel Blockers: What are CCBs used to treat? |
* Used to treat hypertension and other cardiac conditions such as arrhythmia and angina |
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Calcium Channel Blockers - Adverse Reactions: What are the CNS side effects of CCBs? |
* CNS: can produce excessive hypotension, which can cause dizziness, lightheadedness, and headache |
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Calcium Channel Blockers - Adverse Reactions: What are the GI side effects of CCBs? |
* GI: nausea, vomiting, and constipation |
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Calcium Channel Blockers - Adverse Reactions: What are the Cardiovascular side effects of CCBs? |
* Cardiovascular: bradycardia and edema |
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Calcium Channel Blockers - Adverse Reactions: What are the Nasal side effects of CCBs? |
* Nasal: Nasal congestion and rhinitis (may interfere with nitrous oxide) |
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Calcium Channel Blockers - Oral Effects: What are the oral effects of CCBs? |
* Xerostomia, dysgeusia, gingival enlargement |
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Calcium Channel Blockers - Oral Effects: What may be a significant oral effect of CCBs? |
* Gingival enlargement may be significant and extend onto grown surfaces |
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Calcium Channel Blockers - Oral Effects: On discontinuation of the CCBs, what usually happens to gingival enlargement? |
* On discontinuation of the CCBs, the gingival enlargement usually reverts to normal tissue and does not reappear. |
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Calcium Channel Blockers - Oral Effects: What does changing to another CCB NOT do? |
* Changing to another CCB does not appear to resolve gingival enlargement (class effect) |
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Calcium Channel Blockers - Oral Effects: What may be required if gingival enlargement does not revert to normal? |
* A gingivalectomy or gingivoplasty may be required |
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Calcium Channel Blockers - Examples: What are the two main classes of CCBs? |
Non-dihydropyridine CCBs and Dihydropyridine CCBs |
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Calcium Channel Blockers - Examples: What two drugs are in the Non-dihydropyridine CCBs class? |
* Diltiazem and verapamil |
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Calcium Channel Blockers - Examples: What is the suffix of the 6 drugs in the Dihydropyridine CCBs class? |
* Dihydropyridine CCBs end in -dipine
(amlodipine, felodipine, isradipine, nicardipine, nifedipine, nisoldipine) |
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Beta-Adrenergic Blocking Agents: Is Beta-adrenergic stimulation considered "fight or flight" or "rest and digest"? |
* Beta-adrenergic blocking agents are "fight or flight" |
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Beta-Adrenergic Blocking Agents: What is Beta1-receptor stimulation associated with? |
* Beta1-receptor stimulation is associated with increased heart rate, cardiac contractility, and AV conduction |
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Beta-Adrenergic Blocking Agents: What does Beta2-receptor stimulation cause? |
* Beta2-receptor stimulation causes bronchodilation in pulmonary tissues and vasodilation of skeletal muscles |
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Beta-Adrenergic Blocking Agents: What do nonselective Beta-adrenergic blockers block? |
* Nonselective Beta-adrenergic blocking drugs such as propranolol block both beta1- and beta2-receptors |
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Beta-Adrenergic Blocking Agents: In usual doses, what do selective beta-adrenergic blocking drugs block? |
* In usual doses select beta-adrenergic blocking drugs such as metoprolol block beta1-receports more than beta2-receptors |
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Beta-Adrenergic Blocking Agents: What beta-adrenergic blockers are preferred for asthmatic patients and why? |
* selective beta-adrenergic blocking drugs are preferred in asthatic patients (don't block beta2), less likely to interact with epi |
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Beta-Adrenergic Blocking Agents: At large doses, what dissappears from selective beta-adrenergic blocking drugs? |
* At larger doses, the selectivity disappears |
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Beta-Adrenergic Blocking Agents: How do Beta-Adrenergic Blockers lower blood pressure? |
* Beta-adrenergic blockers lower blood pressure by decreasing cardiac output |
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Beta-Adrenergic Blocking Agents: In addition to lowering blood pressure, what else do beta-adrenergic blockers do? |
* Reduce plasma volume and venous return * Decrease sympathetic outflow from CNS and reduces peripheral resistance |
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Beta-Adrenergic Blocking Agents - Side Effects: What are the 3 side effects by reduction? |
* bradychardia, mental depression, and decreased sexual ability |
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Beta-Adrenergic Blocking Agents - Side Effects: What do CNS side effects include? |
* CNS effects: confusion, hallucinations, dizziness, and fatigue have been reported |
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Beta-Adrenergic Blocking Agents - Side Effects: What do GI tract effect include? |
* GI tract effects: diarrhea, nausea/vomiting, may produce mild xerostomia |
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Beta-Adrenergic Blocking Agents - Side Effects: What may beta-adrenergic blocking agents exacerbate? |
* May exacerbate asthma, angina or peripheral vascular disease |
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Beta-Adrenergic Blocking Agents - Side Effects: When should patients taking beta-adrenergic blocking agents be limited to cardiac dose of epi? And what is that dose? |
* Patients that use non-selective beta-blockers should be limited to cardiac dose of epi if there is cardiovascular disease or higher blood pressure (unless careful blood pressure monitoring is done) * 0.04 mg |
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Beta-Adrenergic Blocking Agents - Side Effects: When can usual doses of epi be given to patients with cardiovascular disease or higher blood pressure? |
* When taking selective beta1-blockers -- BUT... remember they lose selectivity at higher doses |
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Beta-Adrenergic Blocking Agents - Side Effects: When cardiovascular disease or higher blood pressure patients on non-selective beta-blockers are given the cardiac dose of epi, what may happen with the vasopressor? |
* May have a two- to fourfold increase in vasopressor response resulting in hupertension |
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Beta-Adrenergic Blocking Agents - Side Effects: When cardiovascular disease or higher blood pressure patients on non-selective beta-blockers are given the cardiac dose of epi, what leads to a hypertensive response? |
* Non select beta blockers prevent the vasodilation which leaves the alpha vasoconstriction from the epi unopposed, leading to a hypertensive response |
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Beta-Adrenergic Blocking Agents - Side Effects: When cardiovascular disease or higher blood pressure patients on non-selective beta-blockers are given the cardiac dose of epi, which patients are at risk of having a stroke? |
May not be harmful in majority of patients ( can cause headache), but those with vascular abnormalities present in the brain may have a stroke |
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Beta-Adrenergic Blocking Agents: What are 4 generic beta1-selective blockers? |
* Metaprozolol (Lopressor/Toprol XL) * Atenolol (Tenormin) * Mizoprolol (Zebeta) * Nebivolol (bystolic) |
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Beta-Adrenergic Blocking Agents: What are 4 generic non-selective beta-blockers? |
* Propranolol (Inderal LA) * Nadolol (Corgard) * Sotolol * Timolol (Blocadren) |
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Beta-Adrenergic Blocking Agents: What are 3 beta-blockers with intrinsic sympathomomimetic activities? |
* Acebutolol (Sectral) Penbutolol (Levatol) Pindolol (Visken) |
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Beta-Adrenergic Blocking Agents: What are 2 generic beta-blockers with alpha-blocking activity? |
* Carvedillol (Coreg) * Labetalol |
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Antiotensin-Related Agents: What are two types of drugs whos mechanism involves antiotensin?
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* ACEIs and ARBS |
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Antiotensin-Related Agents: What are ACEIs |
* ACEIs - An enzyme that converts angiotensin I to II, which results in vasoconstriction as part of normal regulation of blood pressure system |
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Antiotensin-Related Agents: What do ACEIs prevent? |
* ACEIs prevent the convenrsion of angiotensin I to angiotension II |
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Antiotensin-Related Agents: What do many ACEIs end in? |
* Many ACESIs end in -pril e.g. lisingpril |
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Antiotensin-Related Agents: What do ARBs attach to and what do they block the effect of? |
* Arbs attach to the angiotensin II receptor and block the effect of angiotensin II. |
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Antiotensin-Related Agents: What is the common suffix for ARBs? |
* The common suffix for ARBs is -artan |
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Antiotensin-Related Agents: What is the prototype for ARBs? |
* Losartan (Cozaar) is the prototype for ARBs |
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Antiotensin-Related Agents: Are angiotensin-related agents safe during pregnancy? |
* No. Angiotensin-related agents are teratogenic and should be avoided in pregnancy |
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Angiotensin-Converting Enzyme Inhibitors (ACEIs) - Adverse Reactions: What are the cardiovascular adverse reactions?
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* Cardiovascular: hypotension has produced lightheadedness, and fainting. Tachycardia and chest pain have been noted. |
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Angiotensin-Converting Enzyme Inhibitors (ACEIs) - Adverse Reactions: What are the CNS adverse reactions? |
* CNS: may include dizziness, insomnia, fatigue, and headache |
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Angiotensin-Converting Enzyme Inhibitors (ACEIs) - Adverse Reactions: What are the GI adverse reactions? |
* GI: nausea, vomiting and diarrhea can occur |
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Angiotensin-Converting Enzyme Inhibitors (ACEIs) - Adverse Reactions: What is the most notable adverse reaction? |
* A dry, hacking cough can occur |
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Angiotensin-Converting Enzyme Inhibitors (ACEIs): Are ACEIs safe during pregnancy? |
* No, they are teratogenic and should be avoided in pregnancy |
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Angiotensin-Converting Enzyme Inhibitors (ACEIs): What is the suffix for ASEIs drugs? |
* ACEIs drugs end in -pril
e.g. benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Zestril, Prinivil), moexipril (Univasc), iperindopril (Aceon), quinaqril (Accupril), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik) |
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Angiotensin Receptor Blockers (ARBs): Because ARBs are more specific than ACEIs, what may be expected? |
* ARBs are more specific than ACEIs and may be expected to have fewer adverse reactions |
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Angiotensin Receptor Blockers (ARBs) - Adverse Reactions: What are the CNS adverse reactions? |
* CNS: can include dizziness, fatigue, insomnia, and headache |
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Angiotensin Receptor Blockers (ARBs) - Adverse Reactions: What are the GI adverse reactions? |
* GI: losartan can produce diarrhea |
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Angiotensin Receptor Blockers (ARBs) - Adverse Reactions: What are the Pain adverse reactions? |
* Pain: both muscle cramps, leg and back pain have been reported with losartan |
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Angiotensin Receptor Blockers (ARBs) - Adverse Reactions: What adverse reaction rarely occurs? |
* Angioedema can occur, rarely |
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Angiotensin Receptor Blockers (ARBs): Are ARBs save for pregnancy? |
* No, they are taratogenic and should be avoided in pregnancy |
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Angiotensin Receptor Blockers (ARBs): What is the suffix for ARBs drugs?
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* ARBs drugs end in -sartan
e.g. candesartan (Atacand), eprosartan (Tevetan), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan) |
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Renin Inhibitors: What are renin inhibitors? |
* A new class of drugs approved by the U.S. Food and Drug Administration for treatment of hypertension |
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Renin Inhibitors: What is aliskiren (Tekturna)? |
* The first of a new class of drugs, the renin inhibitors |
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Renin Inhibitors: How do renin inhibitors work? |
* Work by binding to renin (Direct renin inhibitor) whic hthen reduces the level of angiotensin I, angiotensin II, and aldostrone |
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Renin Inhibitors: Are renin inhibitors safe for pregnancy? |
No, teratogenic and are contraindicated in pregnancy |
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Renin Inhibitors: In which patients should renin inhibitors NOT be used in conjunction with ACEIs and ARBS? |
* Do not use in conjunction with ACEIs or ARBs in diabetics or in patients whos GFR <60mL/min/1.73m2 |
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Renin Inhibitors: In which patients should renin inhibitors be used with caution? |
* Use wit hcaution in patients: -- who have a history of angioedema -- with worsening renal function -- with low renal blood flow |
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alpha1-Adrenergic Blocking Agents for Hypertension: What do adrenergic blockers include? |
* the adrenergic blockers include the alpha-blockers and the beta-blockers previously described -- alpha1 and alpha2 |
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alpha1-Adrenergic Blocking Agents for Hypertension: Alpha1-blocking agents produce what? |
* Alpha1-blocking agents produce peripheral vasodilation in the arteriols and venules that decreases peripheral vascular resistance |
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alpha1-Adrenergic Blocking Agents for Hypertension: What do they have a minimal effect on? |
* Minimal effect on cardiac output or renal blood flow |
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alpha1-Adrenergic Blocking Agents for Hypertension: alpha1-Adrenergic blockers result in a reduction in what? |
* Result in a reduction in urethral resistance and pressure, bladder outlet resistance, and urinary symptoms |
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alpha1-Adrenergic Blocking Agents for Hypertension: What are alpha1-adrenergic blockers used in management of? |
* Used in management of older men who have an enlarged prostate gland |
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alpha1-Adrenergic Blocking Agents - Adverse Reactions: What can the orthostatic hypotension adverse reaction result in? |
* Orthostatic Hypotension: can result in dizziness and syncope |
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alpha1-Adrenergic Blocking Agents - Adverse Reactions: What are the CNS adverse reactions? |
* CNS: can cause CNS depression, producing either drowsiness or excitation and headache |
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alpha1-Adrenergic Blocking Agents - Adverse Reactions: What are the Cardiovascular adverse reactions? What is another side effect? |
* Cardiovascular: tachycardia, arrhythmias, and palpitations can occure -- Peripheral edema is another side effect |
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alpha1-Adrenergic Blocking Agents: What do alpha1-adrenergic blockers end in? |
* alpha1-adrenergic drugs end in -azosin
e.g. doxazosin (Cardura), prazosin (Minipress), and terazosin (Hytrin) |
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alpha1-Adrenergic Blocking Agents: In addition to hypertension, Doxazosin and Terazosin are both indicated for the management of what? |
In addition to the treatment of hypertension, Daxazosin and Terazosin are both indicated for the management of benign prostetic hypertrophy (BPH) |
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Other Anti-hypertensive Agents: Why are these other anti-hypertensive agents used less often than the previous drug classes? |
* Because they generally have more or less tolerated adverse reactions |
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Other Anti-hypertensive Agents: "Other anti-hypertensive agents" includes what other centrally acting agents? |
* Clonidine * Guanethidine * Reserpine * Hydralazine |
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clonidine (Catapres): What is clonidine (Catapres)? |
* A CNS- mediated (centrally acting) antihypertensive drug that reduces peripheral resistance through a CNS-mediated action on the alpha receptor |
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clonidine (Catapres): What does timulation of presynaptic central alpha2- adrenergic receptors result in? |
* results in a decreased sympathetic outflow |
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clonidine (Catapres): How does it affect hypertension? |
* Reduces heart rate, cardiac output, and total peripheral resistance |
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clonidine (Catapres): How is it administered? |
* May be administered orally or by transdermal patch |
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clonidine (Catapres) - Adverse Reactions: Adverse reactions inclused a high incidence of what? |
* sedation and dizziness |
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clonidine (Catapres) - Adverse Reactions: Why can abrupt discontinuation result in? |
* Rapid elevation of blood pressure has occurred with abrupt discontinuation |
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clonidine (Catapres) - Adverse Reactions: What contributes to postural hypotension when used in a patient taking clonidine? |
* CNS depressants employed in dental conscious-sedation techniques may contribute to postural hypotension when used in a patient taking clonidine |
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clonidine (Catapres) - Adverse Reactions: clonidine has a high incidence of what (?%) ? |
* A high incidence of xerostomia (40%), parotid gland swelling, and pain |
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Other Centrally Acting Anti-hypertensive Agents: What are the other two centrally acting antihypertensive agents available? |
* methyldopa (Aldomet) and guanabenz (Wytensin) |
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Other Centrally Acting Anti-hypertensive Agents: What are the adverse effects of methyldopa and guanabenz? |
* adverse effects are similar and indications are similar to clonidine |
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Other Centrally Acting Anti-hypertensive Agents: What may methyldopa and guanabenz be combined with in essential hypertension management? |
* may be combined with diuretics in essential hypertension management |
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Management of the Dental Patient Taking Anti-hypertensive Agents: What should be checked for and managed? |
* Xerostomia |
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Management of the Dental Patient Taking Anti-hypertensive Agents: If taking CCB's, what should be checked for? |
* Gingival enlargement |
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Management of the Dental Patient Taking Anti-hypertensive Agents: What should be checked at each appointment |
* Blood pressure |
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Management of the Dental Patient Taking Anti-hypertensive Agents: What may be indicated for high stressed patients? |
* stress reduction protocol, anti-anxiety medication |
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Management of the Dental Patient Taking Anti-hypertensive Agents: If on diuretics, what symptoms should be checked for? |
* check for symptoms of hypokalemia, which may exacerbate arrhythmias from epinephrine |