Cardio 10 Deck 2 Flashcards
ACE and ARBs are
cario protective
Do you have to wait until the full dose of the first drug is achieved before starting a second drug for HTN
no
If BP is not controlled
Add a second drug, or
Substitute a drug in a different class.
Choose the second drug for HTN based on
its being different from the adverse drug reaction (ADR) profile and action of the first drug.
Children and adolescents
HTN managment
Definition of HTN are based on age, height, and BP.
Lifestyle modification is initial therapy.
Drugs are similar to those for adults.
Older adults
HTN Managment
HTN occurs in two out of three adults older than age 65 years.
Begin with lifestyle modifications.
Target BP goals less stringent than young adult
Definition of HTN in children and adolescents are based on
age, height, and BP.
Patient Variables: Women -Contraceptives
Oral contraceptives and hormone replacement therapy may increase BP due because of weight gain.
During pregnancy there may be
increased risks to mother and fetus.
HTN drugs of choice with pregnant women
Methyldopa, beta blockers, and vasodilators are drugs of choice.
Patient Variables: Women AVOID in pregnancy
ACEIs, ARBs, and direct renin inhibitors.
Preeclampsia occurs after the
20th week of gestation and requires intensive monitoring; preexisting HTN is NOT the same.
Native Americans have the (HTN)
same or slightly higher prevalence rates compared with the Caucasian population.
Hispanics have the (HTN)
same to slightly lower prevalence rates as caucasions
Asians (HTN)
have about the same prevalence rate as Caucasians.
African Americans have (HTN)
a higher and earlier HTN incidence.
African Americans Reduced response to
monotherapy, beta blockers, ACEIs, and ARBs
African Americans equal reqsponse if
mixed with a diuretic
BiDil was the first drug
suggested for African American patients specifically
What is the first line drug to treat HTN in African Americans
CCB
BP Measurement Caffeine, exercise, and smoking to be avoided for at least
30 minutes prior to measurement with home or clinicl measuments
Laboratory values monitored if any ADRs for HTN medications
Electrolytes
Renal function
Complete blood count
Self-Care Monitoring HTN
May unmask true white coat syndrome
May increase adherence to regimen
Fosters implementation of Chronic Care Model
Patient activation may “spill over” into other self-care activities
How to unmask white coat syndorme
have them take BP at home and log the results
check every other day until they come back
Adherence issues ADR
Sexual dysfunction, fatigue, and depression
Other adherence issues
Complexity of drug regimen
Use of combined drugs when possible
More flexibility with goals to keep patient on medications
