Chapter 28 Hypertension

Front 1

T/F: Hypertension is largely symptomatic, which can delay diagnosis and contribute to medication non-adherence in treated patients.

Back 1

FALSE!!!!

Hypertension is largely Asymptomatic, which can delay diagnosis and contribute to medication non-adherence in treated patients.

Front 2

Uncontrolled hypertension places the patient at greater risk for________?

Back 2

-Heart disease

-Stroke

-Kidney disease

Front 3

Hypertension is also know as_______?

Back 3

High blood pressure (BP)

Front 4

T/F: Most patient have primary, or essential, hypertension.

Back 4

TRUE

Front 5

The cause of _____ hypertension is unknown but a combination of risk factors such as Obesity, sedentary lifestyle, excessive salt intake, smoking, family history, diabetes and dyslipidemia is usually present.

Back 5

Primary or essential hypertension

Front 6

Secondary hypertension can be caused by______.

Back 6

Renal disease

Front 7

T/F: There is an increased activity of the sympathetic nervous system (SNS) and Renin-angiotensin-aldosterone system (RAAS), leading to increased levels of neurohormones that can increase blood pressure.

Back 7

TRUE

Front 8

List the neurohormones.

Back 8

-Norepinephrine

-Angiotensin II

-Aldosterone

Front 9

T/F: BP readings in the same individual can vary during the day, due to stress, exercise, medications, eating and other activities of daily living.

Back 9

TRUE

Front 10

BP assessments should be based on an an average of at least ____on two separate occasions, preferably standardized to the timing of medication administration.

Back 10

two readings

Front 11

T/F:BP assessments should be based on an an average of at least two readings on one separate occasions, preferably standardized to the timing of medication administration.

Back 11

FALSE!!!

BP assessments should be based on an an average of at least TWO readings on two separate occasions, preferably standardized to the timing of medication administration.

Front 12

T/F: Self-monitoring of BP, using an automated home or ambulatory monitoring device is not Preferred.

Back 12

False!!

Self-monitoring of BP, using an automated home or ambulatory monitoring device is Preferred.

Front 13

The (ACC/AHA) has defined ____ in adult, based on systolic BP (SBP) and/ or diastolic BP (DBP) readings.

Back 13

FOUR categories of BP

Front 14

What is a normal BP? SBP and DBP

Back 14

NORMAL: SBP < 120mmHg and DBP < 80mmHg

120/80

Front 15

What is considered Elevated BP? SBP and DBP

Back 15

SBP- 120-129 mmHg and DBP < 80mmHg

Front 16

How many stages are in Hypertension?

Back 16

Two!!

Stage 1: SBP 130-139 mmHg or DBP 80-89mmHg

Stage 2: SBP ≥ 140 mmHg or DBP ≥ 90mmHg

Front 17

what is the BP for stage 1 hypertension?

Back 17

Stage 1: SBP 130-139 mmHg or DBP 80-89mmHg

Front 18

what is the BP for stage 2 hypertension?

Back 18

Stage 2: SBP ≥ 140 mmHg or DBP ≥ 90mmHg

Front 19

About how much weight loss is need to decrease BP?

Back 19

weight loss of 1kg decrease BP by 1mmHg

Front 20

A heart healthy diet consist of____?

Back 20

DASH Diet (Dietary Approaches to stop Hypertension) that is high in fruits, vegetables, fiber, low dairy products and low in saturated fats and sugar.

Front 21

It is important to reduce sodium intake by ___?

Back 21

<1500mg daily

*as well as TOBACCO CESSATION

Front 22

Blood pressure Monitoring Dos and Don’t!!

Back 22

Back (Definition)

Front 23

Drugs that can increase Blood Pressure

Back 23

Back (Definition)

Front 24

List the natural products used to treat hypertension?

Back 24

-Fish oil

-Coenzyme Q10

-L-arginine

-Garlic

*guideline does not recommend it

Front 25

T/F: Life style modifications should be emphasized throughout treatment.

Back 25

TRUE

Front 26

Once daily regimens are preferred for increased ____.

Back 26

Medication adherence

Front 27

There are four preferred drug classes recommended for initial and/or titration of treatment before selecting medications from alternate drug classes for hypertension , WHAT ARE THEY?

Back 27

-ACEI

-ARBs

-CCBs

-Thiazide diuretics

*Drug selection is based on patient specific criteria

Front 28

T/F: You can use ACE inhibitors and ARBs in combination.

Back 28

FALSE!!!

DO NOT use ACE inhibitors and ARBs in combination.

Front 29

If pregnancy is detected _______ should be discontinued immediately as there is a boxed warning for fetal toxicity in pregnant patients.

Back 29

-ACEI

-ARBs

-Direct renin inhibitor (aliskiren)

Front 30

When should pregnant patient with chronic hypertension receive drug treatment?

Back 30

Pregnant patient with CHRONIC HYPERTENSION should receive drug treatment if SBP ≥ 160mmHg or DBP is ≥ 105 mmHg

*basically(≥160/105)

Front 31

What is the recommended first line agents, according to the American College of Obstetricians and Gynecologists (ACOG) for pregnancy?

Back 31

-Labetalol

-Nifedipine ER

-Methyldopa

Front 32

List the combination drugs under ACEI +DIURETIC.

Back 32

Lisinopril/Hydrochlorothiazide (Zestoric)

Front 33

Know these hypertension Guidelines!!!

Back 33

Back (Definition)

Front 34

List the combination drugs under ARBs +DIURETIC.

Back 34

-Losartan/Hydrochlorothiazide (HYzaar)

-Olmesartan/ Hydrochlorothiazide (Benicar HCT)

-Valsartan / Hydrochlorothiazide (Diovan HCT)

Front 35

Losartan/Hydrochlorothiazide

Back 35

HYzaar

Front 36

Olmesartan/ Hydrochlorothiazide

Back 36

Benicar HCT

Front 37

Valsartan / Hydrochlorothiazide

Back 37

Diovan HCT

Front 38

Lisinopril/Hydrochlorothiazide

Back 38

Zestoric

Front 39

List the combination drugs under ACEI+CCB.

Back 39

Benazepril/Amlodipine (Lotrel)

Front 40

Benazepril/Amlodipine

Back 40

Lotrel

Front 41

List the Direct Renin Inhibitor + Diuretic combo drug.

Back 41

Aliskiren/Hydrochlorothiazide (Tekturna HCT)

Front 42

List the Alpha-2 Agonist + Diuretic combo drug.

Back 42

Methyldopa/Hydrochlorothiazide

Front 43

List the Beta Blocker + Diuretic combo drugs.

Back 43

Atenolol/Chlorthalidone (Tenoretic)

Bisoprolol / Hydrochlorothiazide (Ziac)

Front 44

Atenolol/Chlorthalidone

Back 44

Tenoretic

Front 45

Bisoprolol / Hydrochlorothiazide

Back 45

Ziac

Front 46

Betablocker + ARB drug

Back 46

Nebivolol/Valsartan (Byvalson)

Front 47

K-Sparing +Thiazide-type diuretic

Back 47

Triamterene / Hydrochlorothiazide (Maxzide,Maxzide-25, Dyazide)

Front 48

What is the MOA of Thiazide and thiazide type diuretics ?

Back 48

Thiazide and thiazide type diuretics inhibits sodium reabsorption in the distal convoluted tubules, causing increased excretion of sodium, chloride, water and potassium.

Front 49

What are the drugs in the Thiazide diuretic class?

Back 49

Chlorthalidone

Hydrochlorothiazide (Microzide)

Front 50

What is the dose for Chlorthalidone?

Back 50

12.5-25mg Daily

Front 51

What is the dose for Hydrochlorothiazide (Microzide) ?

Back 51

12.5-50mg Daily

Front 52

What is the CONTRAINDICATION for all Thiazide diuretics ?

Back 52

Hypersensitiity to sulfonamide derived drugs

Front 53

List the side effects for Thiazide diuretics drugs?

Back 53

-Hypokalemia

-Hypomagnesemia

-Hyponatremia

-HYPERcalcemia

-HYPERuricemia

-Elevated Lipids (High LDL,TG)

-HYPERglycemia (High BG)

Front 54

What are some lab values to monitor when taking Thiazide diuretics?

Back 54

-Electrolytes

-Renal function

Front 55

T/F: Chlorthalidone has better evidence than hydrochlorothiazide and is preferred by some clinicians.

Back 55

TRUE

*but if a patient is doing well on hydrochlorothiazide, do not switch.

Front 56

Thiazides are not effective when CrCL is _____

Back 56

< 30ml/min

*except metolazone, which may work in patients with reduced renal function or diuretic resistance.

Front 57

Thiazide diuretics should be taken early in the day to avoid____.

Back 57

Nocturia

Front 58

Chlorothiazide is the only medication in this class that is available ______.

Back 58

IV

Front 59

Avoid drugs that can cause sodium and water retention such as _____, as they can decrease the effectiveness of antihypertensive medications.

Back 59

NSAID

Front 60

Thiazide diuretics can decrease lithium renal clearance and ______ the risk of lithium toxicity.

Back 60

INCREASE

*Avoid if possible

Front 61

There are two types of Calcium channel blockers (CCB), what are they?

Back 61

-Dihydropyridines (DHP)

-Non-dihydropyridines (non-DHP)

Front 62

Dihydropyridines (DHP) Calcium channel Blockers drugs ends with ______.

Back 62

"pine"

Front 63

Dihydropyridines (DHP) CCBs are used to treat____.

Back 63

-Hypertension

-Chronic stable angina

-Prinzmetal angina

Front 64

Whats the MOA for Dihydropyridines (DHP) CCBs?

Back 64

They inhibit Ca ions from entering vascular smooth muscle and mycardial cells; this causes peripheral arterial vasodilation (which decrease SVR and BP) and coronary artery vasodilation.

Front 65

Peripheral vasodilation leads many common side effects, what are they?

Back 65

-Reflex tachycardia

-Headache

-Flushing

-Peripheral edema

Front 66

List the Dihydropyridines (DHP) CCBs drugs.

Back 66

-Amlodipine (Norvasc)

-Nifedipine ER (Adalat CC, Procardia XL), Nifedipine IR (Procardia)

-Nicardipine IV (Cardene IV)

Front 67

Amlodipine

Back 67

(Norvasc)

Front 68

Nifedipine ER

Back 68

Adalat CC, Procardia XL

Front 69

Nicardipine IV

Back 69

Cardene IV

Front 70

What is the Primary warning signs for Dihydropyridines (DHP) CCBs drugs ?

Back 70

-Hypotension

Front 71

Which Dihydropyridines (DHP) CCBs drug do you not use for the treatment of Chronic hypertension or acute BP reduction in non-pregnant adults due to its effect of causing profound hypotension, MI and/ or death.

Back 71

Nifedipine IR (Procardia)

Front 72

List the side effects of Dihydropyridines (DHP) CCBs drugs.

Back 72

-Peripheral edema

-Flushing

-Headache

-Palpitations/Tachycardia

-gingival hyperplasia

Front 73

What should you monitor when taking Dihydropyridines (DHP) CCBs drugs?

Back 73

Peripheral edema

Front 74

What are the drugs that is considered to be safest, if CCB must be used to lower BP in patients with Heart failure with reduced ejection fraction?

Back 74

-Amlodipine (Norvasc)

-Felodipine

Front 75

Which DHP drug has its own CONTRAINDICATION,WARNINGS, AND SPECIAL NOTEs?

Back 75

Clevidipine (Cleviprex)

Front 76

Clevidipine (Cleviprex) CONTRAINDICATION

Back 76

-Allergy to soybeans, Soy products or eggs

Front 77

Clevidipine (Cleviprex) WARNINGS

Back 77

-Hypotension

-Reflex tachycardia

-Hypertriglyceridemia

-Infections

Front 78

Clevidipine (Cleviprex) is given via what route ?

Back 78

IV

*lipid emulsion (provides 2kcal/ml)

Front 79

What is the color of Clevidipine (Cleviprex)?

Back 79

Milky-white in color

Front 80

What technique should you use when administering Clevidipine (Cleviprex)?

Back 80

Use strict aseptic technique due to infection risk

Front 81

What is the maximum time of use after vial has been punchered?

Back 81

12 hours

Front 82

Practice this problem.

Back 82

Back (Definition)

Front 83

List the Non-dihydropyridines (non-DHP) drugs.

Back 83

-Verapimil (Calan, Calan SR) ----> causes CONSTIPATION

-Diltiazem (Cardizem, Cardizem CD,Cardizem LA, Cartia XT,Tiazac)

Front 84

Non-dihydropyridines (non-DHP) are primarily used to ________ in certain arrhythmia(atrial fibrillation) and sometimes used for hypertension and angina.

Back 84

Control Heart rate

Front 85

T/F: Non-dihydropyridines (non-DHP) inhibit Ca ions from entering vascular smooth muscle and myocardial cells, but they are more selective for myocardium than the DHP CCBs.

Back 85

TRUE!!

Front 86

The decrease in BP produced by non DHP CCBs is due to _____ and ______ effects.

Back 86

-negative inotropic (decrease force of ventricular contraction)

-Negative chronotropic (decrease HR)

Front 87

What is the warning signs for Non-dihydropyridines (non-DHP)?

Back 87

-Heart failure (may worsen symptoms)

Front 88

List the side effects of Non-dihydropyridines (non-DHP).

Back 88

-Edema

-Constipation (more with Verapamil)

-Gingival hyperplasia

Front 89

What are some drugs or drug classes you should watch out for when taking calcium channel blockers?

Back 89

-Beta-blockers

-Digoxin

-Clonidine

-Amiodarone

Front 90

All CCBs, both DHP and Non-DHP are major substrates of _____

Back 90

CYP3A4

Front 91

What should you check for when initiating CCB or when other medications are added to CCB?

Back 91

Drug interaction

*Grapefruit juice or Grapefruit should be avoided.

Front 92

T/F: Diltiazem and Verapamil are substrates of P-gp and moderate inhibitors of CYP3A4.

Back 92

TRUE!

Front 93

Patient who take statins should lower doses of _____

Back 93

-Simvastatin

-Lovastatin

*or use a statin that is not metabolized by CYP3A4 (pitavastatin,pravastatin, rosuvastatin)

Front 94

What agents have been shown to slow the progression of kidney disease in patients with albuminuria (e.g., due to diabetes, hypertension) ?

Back 94

-ACEI

-ARBs

Front 95

T/F: In heart failure, ACEI and ARBs protect the myocardium from remodeling effects of And II.

Back 95

TRUE

Front 96

T/F:Renin-Angiotensin Aldosterone system inhibitor (RAAS) should not be used in combination with (e.g., ACEI+/- ARB+/-Aliskiren +/- ARNI) due to an increase risk for adverse effects.

Back 96

TRUE

Front 97

____ is a potentially fatal adverse effect that can occur with use of any agent, but it is more common in ACEI than ARBs ,Aliskiren, and African American patients have a higher risk.

Back 97

-Angioedema

Front 98

T/F: For testing purposes, if a patient develops angioedema with RAAS inhibitor, other agents in the class is Okay to use.

Back 98

FALSE!!!

For testing purposes, if a patient develops angioedema with RAAS inhibitor, other agents in the class SHOULD BE AVOIDED!

Front 99

ACEI drugs end in ______

Back 99

"pril"

Front 100

T/F: ACEI block the conversion of angiotensin I to And II, resulting in decrease vasoconstriction and decrease aldosterone secretion, and they block the degradation of Bradykinin.

Back 100

TRUE

*Which is taught to contribute to the vasodilatory effects (the cough and angioedema)

Front 101

List All the ACEI drugs.

Back 101

Benazepril (Lotensin)

Enalapril (Vasotec) (Vasotec IV)

Lisinopril (prinivil, zestril)

Quinapril (Accupril)

Ramipril (Altace)

Front 102

Benazepril

Back 102

Lotensin

Front 103

Enalapril

Back 103

Vasotecm Vasotec IV

Front 104

Lisinopril

Back 104

prinivil, zestril

Front 105

Quinapril

Back 105

Accupril

Front 106

Ramipril

Back 106

Altace

Front 107

ACEI BOX WARNINGS!!

Back 107

-Can cause injury and death to the developing fetus when used in the 2nd and 3rd trimesters

*Discontinue as soon as pregnancy is detected

Front 108

ACEI CONTRAINDICATIONS!!

Back 108

- History of angioedema

-Use within 36 hours of an angiotensin receptor and neprilysin inhibitor (ARNI---->Sacubitril/valsartan)

Front 109

ACEI WARNINGS!!

Back 109

-Angioedema

-Hyperkalemia

-Hypotension

-Renal impairment

-Bilateral renal artery stenosis (avoid used)

Front 110

ACEI SIDE EFFECTS!!

Back 110

-Cough

Front 111

What are the labs to Monitoring for ACEI?

Back 111

-BP

-K

-Renal function

Front 112

ARBs end in ____?

Back 112

"sartan"

Front 113

T/F: Angiotensin receptor blockers (ARBs) blocks AngII from binding to the angiotensin II type -I (ATI) receptor on vascular smooth muscle, preventing vasoconstriction.

Back 113

True

Front 114

LIST all the ARBs drugs.

Back 114

-Irbesartan (Avapro)

-Losartan (Cozaar)

-Olmesartan (Benicar)

-Valsartan (Diovan)

Front 115

T/F: ARBs have less cough and angioedema than ACEI.

Back 115

TRUE

*No washout period required with neprilysin inhibitor

Front 116

ARBs WARNINGS

Back 116

Olmesartan (Benicar) causes sprue- like enteropathy

*its severe, chronic diarrhea with substantial weight loss; can occur months to years after drug initiation

Front 117

T/F: ARBs have the same safety/side effects/monitoring as ACEI.

Back 117

TRUE!!

Monitor: (BP,K, and Renal function)

Side effects : Cough

Front 118

List the only drug under DIRECT RENIN INHIBITOR.

Back 118

Aliskiren (Tekturna)

Front 119

CONTRAINDICATION OF DIRECT RENIN INHIBITOR.

Back 119

DO NOT use with ACEI or ARBs in patient with diabetes

Front 120

T/F: All RAAS inhibitors increase the risk of Hyperkalemia

Back 120

True

Front 121

T/F: It is important to avoid using more than one RAAS inhibitor together (ACEI+/- ARB+/- Aliskiren) due to an increase risk of renal impairment, hypotension and hyperkalemia.

Back 121

TRUE

Front 122

If switching from an ACEI to Entresto, or vice versa, what is the washout period?

Back 122

36 hour washout period

Front 123

ACEI and ARBs can ____ lithium renal clearance and ____ the risk of lithium toxicity.

Back 123

Decrease, Increase

*Its listed multiple times on this flashcard KNOW IT

Front 124

T/F: The potassium sparing diuretics triamterene and amiloride have minimal BP lowering effects and are most commonly used in combination with hydrochlorothiazide (e.g, Maxzide,dyazide) to counteract the mild potassium losses seen with thiazide diuretics.

Back 124

TRUE

Front 125

The aldosterone receptor antagonists, spironolactone and eplerenone are preferred add-on drugs _____patients.

Back 125

Resistant hypertension (uncontrolled BP despite maximum tolerated dose of CCB + Thiazide diuretics +ACEI or ARB)

*they are commonly used in Heart failure

Front 126

T/F: Spironolactone is a selective aldosterone receptor antagonist and also blocks androgen.

Back 126

FALSE!!

Spironolactone is a NON-selective aldosterone receptor antagonist and also blocks androgen.

Front 127

T/F: Eplerenone is a selective aldosterone receptor antagonist that does not exhibit endocrine effects.

Back 127

TRUE!!

Front 128

LIST the potassium SPARING DIURETICS.

Back 128

-Spironolactone (Aldactone)

-Triamterene + HCTZ (Maxzide-25, Dyazide)

Front 129

Boxed warning for Potassium SPARING DIURETICS.

Back 129

Hyperkalemia (K> 5.5 MEq/L)

*more likely in patient with diabetes, renal impairment, or elderly patients

Front 130

CONTRAINDICATIONS for Potassium SPARING DIURETICS.

Back 130

-Hyperkalemia (K> 5.5 MEq/L)

-Anuria

-Renal impairment

Front 131

What the side effects of Potassium SPARING DIURETICS?

Back 131

-Gynecomastia

-Breast tenderness

-Impotence

Front 132

Monitoring for Potassium SPARING DIURETICS.

Back 132

-check potassium (K) before starting and frequently thereafter.

Front 133

T/F: Potassium SPARING DIURETICS increase the risk of hyperkalemia

Back 133

TRUE

Front 134

T/F: Diuretics can decrease lithium renal clearance and increase the risk of lithium toxicity.

Back 134

TRUE!!

*Again they mentioned it but last time it was in regards to ACEIs

Front 135

What does Beta-Blockers end with?

Back 135

"olol"

Front 136

T/F: Beta-Blockers are no longer recommended FIRST-LINE for uncomplicated hypertension unless the patient has a comorbid condition, for which beta-blockers are recommended 1st line.

Back 136

TRUE

* conditions: POST MI, stable ischemic heart disease, heart failure

Front 137

For most conditions, any beta-blocker can be selected, but ____ should be used if treating chronic heart failure.

Back 137

-Bisoprolol

-Carvedilol

-Metoprolol succinate

Front 138

Beta-blockers with intrinsic sympathomimetic activity (ISA) _______ stimulate beta receptors while blocking the effects of catecholamines such as norepinephrine.

Back 138

PARTIALLY

*why? because they do not decrease HR to the same degree as beta-blockers without ISA.

Front 139

T/F: Beta-blockers without intrinsic sympathomimetic activity (ISA) are not recommended in post-MI patients.

Back 139

True

Front 140

What is the Beta-Blockers with intrinsic sympathomimetic activity (ISA)?

Back 140

-Acebutolol

Front 141

List the Beta-1-selective blockers.

Back 141

-Atenolol (Ternomin)

-Esmolol (Brevibloc)

-Metoprolol tartrate (Lopressor)

-Metoprolol succinate ER (Toprol XL)

Hint: MAtE

Front 142

Boxed Warning for Beta-1-selective blockers

Back 142

Do not discontinue abruptly

Front 143

Warnings for Beta-1-selective blockers

Back 143

-Cautiin in patients with diabetes (can worsen hyperglycemia or hypoglycemia and mask hypoglycemia symptoms)

-use caution with bronchospastic disease (asthma, COPD)

Front 144

Side effects for Beta-1-selective blockers

Back 144

-Decrease hypotension

-Fatigue

-Dizziness

-Depression

-Decrease libido

Front 145

Should Metoprolol tartrate (Lopressor) and Metoprolol succinate (toprol XL) be take be taken with or without food?

Back 145

They should be taken with or immediately following food

Front 146

T/F: Metoprolol tartrate IV is equivalent to PO.

Back 146

FALSE!!!! A WHOLE LIEEEEE

Metoprolol tartrate IV is NOT equivalent to PO (IV:PO ratio is 1:2:5)

Front 147

Name a Beta-1-selective blocker with Nitric Oxide-Dependent Vasodilation.

Back 147

Nebivolol (Bystolic)

Front 148

List the Beta-1 and Beta-2 (Non-selective) blocker.

Back 148

Propranolol (Inderal LA, Inderal XL)

Front 149

T/F: Propranolol has high lipid solubility (lipophilic) and crosses the blood brain barrier.

Back 149

TRUE

*it may be associated with more CNS side effects but this makes it useful for other conditions like migraine prophylaxis.

Front 150

LIST Non-selective Beta- blocker and Alpha-1 blockers.

Back 150

-Carvedilol (Coreg, Coreg CR)

-Labetalol

Front 151

T/F: You should take all forms of Carvedilol with food to decrease the rate of absorption and the risk of orthostatic hypotension

Back 151

TRUE

*Carvedilol CR has less bioavailability than carvedilol IR: dosing conversions are NOT 1:1

Front 152

T/F: Carvedilol CR has less bioavailability than carvedilol IR and dosing conversions are NOT 1:1

Back 152

TRUE

Front 153

Which Non-selective Beta- blocker and Alpha-1 blocker is the drug of choice for Pregnancy?

Back 153

Labetalol

Front 154

T/F: Beta-blockers can enhance the hypoglycemic effects of insulin and sulfonylureas and can mask some of the symptoms of Hypoglycemia such as shakiness, palpitation, anxiety, sweating and hunger.

Back 154

FALSEEEEEE: WHY YOU ALWAYS LYING

*SWEATING AND HUNGER SYMPTOMS ARE NOT MASKED!!

Front 155

Beta-blockers can decrease insulin secretion causing _____?

Back 155

HYPERglycemia

Front 156

What are the drugs to Watch for additive effects when administering other drugs that decrease HR?

Back 156

-Diltiazem

-Digoxin

-Amiodarone

-Clonidine

-Verapamil

Front 157

T/F: Clonidine is commonly used for resistant hypertension and in patients who can not swallow due to dysphagia, dementia.

Back 157

TRUE

*since it is available as patch formulation

Front 158

LIST the Centrally-acting alpha-2 adrenergic Agonist.

Back 158

-Clonidine (Catapres,Catapress TTS patch, Kapvay)

-Methyldopa

*Kapvay-for ADHD)

Front 159

CONTRAINDICATION for Centrally-acting alpha-2 adrenergic Agonist

Back 159

Methyldopa: active liver disease and concurrent use with MAO inhibitors.

Front 160

WARNINGS for Centrally-acting alpha-2 adrenergic Agonist

Back 160

-Do not discontinue abruptly (can cause rebound hypertension)

*must taper gradually over 2-4 days

-Methyldopa: risk for hemolytic anemia

Front 161

SIDE EFFECTS for Centrally-acting alpha-2 adrenergic Agonist

Back 161

-Dry mouth

-Somnolence

-Fatigue

-Dizziness

-Constipation

-Decrease HR

-Hypotension

*Methyldopa can cause drug induced lupus erythematous (DILE)

Front 162

What is the side effect associated with Clonidine patch?

Back 162

-Skin rash

-Pruritus

-Erythema

Front 163

How often do you apply clonidine patch?

Back 163

apply weekly

*remove before MRI

Front 164

Amongst the Centrally-acting alpha-2 adrenergic Agonist , which one is the preferred drug for pregnancy?

Back 164

Methyldopa

Front 165

List the Direct Vasodilators

Back 165

-Hydralazine

-Minoxidil

Front 166

Minoxidil OTC topical is used for _____?

Back 166

Hair growth

Front 167

WARNING for hydralazine

Back 167

Drug induced lupus erythematous (DILE)

Front 168

SIDE EFFECTS for hydralazine

Back 168

-Headache

-Hypotension

-reflex tachycardia

-Palpitations

Front 169

What is the Boxed warning for Minoxidil?

Back 169

Potent antihypertensive

Front 170

What is the side effect for Minoxidil?

Back 170

-Fluid retention

-Tachycardia

-Hair growth

Front 171

What are the Alpha blockers drugs?

Back 171

-Doxazosin

-Prazosin

-Terazosin

Front 172

Alpha blockers drugs are not recommended for hypertension but may be used in men who have ______ and ___?

Back 172

-Hypertension and Benign prostatic Hypertrophy

Front 173

How is Hypertensive crisis defined?

Back 173

Hypertensive crisis is defined as rapidly accelerating BP (generally ≥ 180/120 mmHg)

Front 174

There are two types of Hypertensive crisis, what are they?

Back 174

- Hypertensive Emergency

-Hypertensive Urgency

Front 175

When a patient has acute target organ damage that may be life-threatening such as (e.g., encephalopathy, stroke, acute kidney injury, acute coronary syndrome)it is called?

Back 175

Hypertensive emergency

Front 176

How do you treat Hypertensive emergency ?

Back 176

-Treat with IV medication

-Decrease BP by no more than 25% (within the first hour)

-Then If stable decrease to -160/100 mmHg in the next 2-6 hours.

Front 177

What are the IV drugs used to treat Hypertensive emergency?

Back 177

Back (Definition)

Front 178

Having no evidence of acute target organ damage is called?

Back 178

Hypertensive Urgency

Front 179

How do you treat Hypertensive Urgency?

Back 179

-Treat with any oral medication that has short onset of action (e.g., 15-30 minutes)

- Decrease BP gradually over 24-48 hours.

Front 180

What drug class can decrease the amount of potassium in your body?

Back 180

DIURETCS

*Potassium supplements may be needed while you are on this medication to ensure you have enough potassium for your heart.

Front 181

What should you avoid while on calcium channel blockers?

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-Avoid eating Grapefruit juice or Grapefruit while using this medication.

Front 182

T/F: ACEI can cause birth defects if taken during pregnancy.

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TRUE

Front 183

____ medications can INCREASE the amount of potassium in your body.

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-ACEI

-ARBs

- Aliskiren

Front 184

T/F: Do not abruptly discontinue Beta-blockers.

Back 184

True

*without consulting without consulting your healthcare provider as stopping suddenly can worsen your condition.

Front 185

Which drug should you not stop suddenly because your blood pressure can become dangerously high.

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Clonidine

Front 186

How should you apply to the clonidine patch (catapres -TTS) ?

Back 186

-WEEKLY to a hairless area of the skin on the upper outer arm or chest.

-After seven days, remove the used patch and apply a new patch to a different area than the previous site to avoid skin irritation.