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77 Cards in this Set
- Front
- Back
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drug induced htn:
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nsaids
cox2 oral contraceptives adrenocorticoids sympathomimetics erythropoetin cyclosporine/tacrolimus licorice certain otc herbal products |
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nsaids and cox 2 ------- and decrease filtration of --- and ---
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vasoconstrict
na h2o (inhibit renal prostaglandins, which vasodilate and increase GFR) |
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thiazide and ----are part of the calcium path
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ccb
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bb and --- are part of the renin-ang sympath path
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acei
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ccb and ---are part of the calcium path
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thiazide
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young, white sympathetic usu have what type of htn
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ang-renin
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af american and elderly usu have what type of htn
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na/cell membrance
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when do you check bp
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when resting, take 2 mins apart
and have right size cuff |
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when do you recheck bp in 2 yrs
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<120/<80
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when do you recheck bp w/in 2 months
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140/159/
90-99 |
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when do you recheck bp in 1 yr
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120-139/
80-89 |
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when do you immediately or refer for care w/in 1 week, depending on clinical presenttation
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>180/
>110 |
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when do you refer or evaluate for care w/in 1 month
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160-179/
100-109 |
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target uncomplicated bp
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< 140/90
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target bp for dm
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<130/80
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target bp for renal disease
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<130/80
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stage 1 drugs
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#1: thiazide
acei/arb bb ccb |
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stage 2 drugs
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combo
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target uncomplicated bp
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< 140/90
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target bp for dm
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<130/80
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target bp for renal disease
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<130/80
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stage 1 drugs
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#1: thiazide
acei/arb bb ccb |
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stage 2 drugs
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combo
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lifestyle modification
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na restriction
weight reduction increase phy activity smoking cessation dash diet |
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first line drugs:
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diuretics
bb acei ccb arbs |
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t/f
start combo drugs together |
f
ok to start separately to monitor effects |
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oher drug tx for htn
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alpha blockers
aldos antag central acting agents direct vasodilators renin inhibitors |
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which drug can be bumped to arb/acei
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renin inhibitors
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af americans htn is more --- and more ---, w/ --- onset
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common
severe earlier |
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af americans more likely to have low --- and to have --- --- htn
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PRA (plasma renin activity)
salt sensitive htn |
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what's the ideal intial tx for af americans
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diuretics
ccb |
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--- drugs often required for af americans
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multiple
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af americans tend to have more --- organ damage
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target
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t/f
af americans bp lowered at night |
f
less lowering |
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t/f
monotx w/ acei, arbs, and bb effective in af americans |
f
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caucasian bp
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high renin
high CO htn |
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t/f
caucasians likely to be salt-sensitive |
f
less likely |
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what are good initial tx for caucasians
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bb
acei arbs |
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t/f
all first line tx for caucausians work well even ccb and diuretics |
t
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w/ combo drugs racial differences ---
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disappear
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t/f
ok to start atenolol in blacks first when doing combo drugs |
f
cuz less effective |
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htn in elderly
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isolated systolic htn
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--- preferred in elderly
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diuretics
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elderly tend to have --- w/ bp meds
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orthostatic hypotension
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elderly htn more --- based
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vascular
cuz as you age the vessles harden, hypertropy and are less able to vasodilate |
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why orthostatic hypotension in the elderly
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cuz baroreceptors delayed. . . falls and hip fxs can occure due to dizziness/syncope
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what meds can you give to pregnant women
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BB
hydralazine CCB |
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what meds to avoid in pregnancy
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thiazide
ACEI ARBS |
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initial tx w/ preeclamia
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bedrest
then start meds if that doesn't work |
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what do you give ment w/ bph
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alpha blockers
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t/f
when increasing hctz dose there will be an increase in effectiveness |
f
little reduction in bp and there will be more SE |
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if pt on hctz, is it ok to switch to amlodipine
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no!
cuz same pathway |
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t/f
if pt loses weight and bp ok then ok to stop bp meds |
t
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labetalol has --- --- blockade also
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alpha 1
so can cause orthostatic hypotension |
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doxazosin can cause --- ---
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orthostatic hypotension. . . alpha 1 blockade
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a nonselective bb and a1 blocker
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carvedilol
will also cause orthostatic hypotension |
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atenolol is b-- selective receptor antag
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b1
will not cause orthostatic hypotension |
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why can't you give hctz in pregnancy
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might interfere w/ amniotic fl vol
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which med is ok for both bph and bp
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terazosin
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which med is only for bph
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tamsulosin
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which meds will increase lipids
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hctz
bb acei |
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which med is neutral w/ lipids
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diltiazem
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thiazide and bb will increase risk of ---
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dm
particulary those w/ metabolic probs |
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which bb have no lipid effects
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those w/out ISA
nevbilol carvedilol |
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which med will worsen pvd
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atenolol (bb)
can lead to vasoconstriction alpha mediated |
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which med has good long term benetifs w/ pvd
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ramipril (acei)
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which med is good for pvd cuze they dilate
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nifedipine
(dhp dilate cuz they work peripherally) however, they have no long term effects |
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t/f
hctz help w/ pvd |
f
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which diuretic is good for renal disease
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loop
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why give captopril for renal disease
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cuz it slow renal disease
but since decrease GFR, start low and go slow |
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how do bb affect renal disease
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neutral
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hctz might not work w/ renal disease. why
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cuz might not reach site of action
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meds that are ok to use w/ dm
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diltiazem (ndhp. . .neutral)
quinapril (acei. . . slow nephropathy) |
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why shouldn't you give acei in asthma pt
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due to possible ace cough
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meds that are netural in asthma
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diltiazem
hctz |
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bb w/ little effects on dm
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navebilol
carvedilol (but they might still mask hypoglycemic effects, but not same effects on glucose as other bb) |
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is it ok give bb w/ dm, but post mi or hf
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yes
benefit > risk |
