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Pharm Exam 2 > 21-31 Antihypertensive Agents > Flashcards

21-31 Antihypertensive Agents Flashcards

1
Q

a chronic elevation in arterial presssure above an arbitrarily defined normal valvue

A

chronic systemic arterial hypertension

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2
Q

stage 1 HTN

A

140/90

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3
Q

stage 2 HTN

A

160/100

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4
Q

> 180 or >120 with no associated acute end organ damage

A

hypertensive urgency

bp must be reduced over hrs to days

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5
Q

markedly elevated bps with presence of acute end organ damage

A

hypertensive emergency

requires immediate therapy to reduce bp within minutes to hrs

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6
Q

both hypertensive urgencies and emergencies and is more reflective of the the high degree of bp elevation

A

hypertensive crisis

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7
Q

bp that is uncontrolled despite the use of 3 or more antihypertensive drugs, taken at optimal doses, and of which one is a diuretic

A

resistant htn

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8
Q

risk factors for RHTN

A
  • old
  • obese
  • CKD
  • DM
  • obstructive sleep apnea
  • high salt diet
  • african american
  • female
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9
Q

idiopathic htn

A

essential/primary htn

90% of cases

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10
Q

principle of htn treatment

A

treat with intent of reducing risk of cv events and thereby reducing cv morbidity and mortality

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11
Q

bp goal for those over 60 yo

A

150/90

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12
Q

diabetes and HTN –>

A

ACEi or ARB

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13
Q

CKD and HTN –>

A

ACEi or ARB

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14
Q

CAD and HTN –>

A

B blocker and ACEi or ARB

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15
Q

LV dysfunction and HTN –>

A

diuretic and ACEi or ARB and B blocker

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16
Q

previous ischemic stroke and HTN –>

A

ACEi with or without thiazide diuretic

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17
Q

special pharmokinetics for ACEi

A

reduce dose in kidney failure (cleared by kidney)

reduce dose in pts with high plasma renin levels ( cause hyperresponsiveness)

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18
Q

ACEi examples

A

captopril
lisinopril
fosinopril

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19
Q

contraindications for ACEi

A

pregnancy
bilateral renal a. stenosis
hx of angioedema

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20
Q

situations with potentially favorable effects for ACEi

A

low K
prediabetes
albuminuria

unfavorable:
high K
hyperkalemia
volume depletion

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21
Q

common adverse effect of ACEi

A

coughing

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22
Q

poor responders to ACEi

A

elderly african americans

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23
Q

ARBs

A

losartan
valsartan
cadesartan

24
Q

contraindications for ARBs

A

pregnancy

bilateral renal a. stenosis

25
Q

potentially favorable effects of ARBs

A

low K
prediabetes

unfavorable:
high K
hyperkalemia
volume depletion

26
Q

dihydropyridine calcium channel blockers for HTN

A

nifedipine
amlodipine
felodipine

27
Q

contraindications for dihydropyridine CCBs

A

left ventricular dysfunction

28
Q

siturations with potetially favorable effects from DHP- CCBs

A

reynaud syndrome

elderly pts with isolated systolic HTN

cyclosporine induced HTN

potentially unfavaroable: peripheral edema, high HR

29
Q

alternative to b blockers in CAD

A

verapamil
diltiazem

non DHP CCB

30
Q

contraindications for nonDHP-CCB

A

second or third degree heart block

LV dysfunction

31
Q

situations with potentially favorable effects with nonDHP-CCB

A

reynaud’s
migraines
arrhythmia
high HR

unfavorable: peripheral edema, low HR

32
Q

contraindications for thiazides for HTN

A

allergic to sulfa
gout
hyponatremia
hypokalemia

33
Q

first line therapy for compelling indications of HTN and LV dysfunction or previous ischemic stroke

A

thiazide diuretics

34
Q

situations with potentially favorable effects for thiazides

A

osteoporosis
high K+

unfavorable:
gout
prediabetes
low K
elevated glucose
35
Q

situations with potentially favorable effects for b-blockers for HTN

A 
migraines
high HR
hyperthyroidism
tremor
preop HTN
36
Q

aldosterone antagonists

A

spironolactone

eplerenone

37
Q

role of aldosterone antagonists in HTN therapy

A

for RHTN

and those with LV dysfunction and CAD

38
Q

situations with potentially favorable effects for aldosterone antagonists and HTN

A

low K
CKD

unfavorable:
high K

39
Q

alpha1 adrenergic receptor blockers

A

prazosin
doxazosin
terazosin

40
Q

added benefits of prazosin therapy for HTN

A

lowers LDL, TG and cholesterol

41
Q

adverse effects of alpha1 adrenergic receptor blockers

A

tolerance
reflex tachycardia
sexual dysfunction

42
Q

MOA clonidine

A

central alpha2 agonist

43
Q

indications for clonidine

A

labile HTN

early morning surges in HTN

44
Q

MOA a-methyldopa

A

central alpha2 agonist

45
Q

indications for a-methyldopa in HTN

A

pregnancy

46
Q

MOA hydralazine

A

arterial vasodilator

47
Q

adverse effect hydralazine

A

SLE

reflex tachycardia and sodium retention (use with diuretic and beta blocker or NDPH-CCB)

48
Q

MOA minoxidil

A

arterial vasodilator

49
Q

MOA sodium nitroprusside

A

arterial vasodilator

50
Q

indications for sodium nitroprusside

A

HTN emergency or emergency CHF

51
Q

adverse effects sodium nitroprusside

A

cyanide poisoning

methemoglobinemia

52
Q

MOA aliskiren

A

direct renin inhibitor

53
Q

adverse effect aliskiren

A

hyperkalemia if used with other drugs in pathway

54
Q

MOA reserpine

A

blocks transport of NE into storage vacuoles –> decreased sympathetic tone

55
Q

most effect use of reserpine for HTN

A

with a thiazide diuretic

56
Q

side effects reserpine

A

increased parasymp activity

diarrhea, bradycardia, stuffiness

57
Q

most common cause of apparent treatment ressistance

A

inadequate diuretics

Pharm Exam 2 (12 decks)

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