Cardiovascular 4 Flashcards
State the drugs used in hypertension
ACDDB
Ace/ARB
CCB
Thiazide diuretics
Low dose spironolactone
Beta blockers
What antihypertensive is preferred for adults of black African origin
ARBs
What antihypertensive should be offered to all patients with diabetes regardless of origin and age
ACEi/ARbs
State what antihypertensive is suitable for patients that are unable to tolerate CCB due to oedema or heart failure
THIAZIDE LIKE DIURETICS eg Indapamide over Bendroflumethazide
State when to avoid ACE inhibitors and ARB in HTN
Afro-Caribbean unless diabetic
Severe renal disease
Pregnancy and BF
Angioedema
Aliskiren with EGFR <60 or diabetic
What are the side effects of ACE inhibitors
Angioedema
Cough
Hyperkalaemia
What are the side effects of ARBs
Hyperkalaemia
Angioedema
State when to avoid CCB in HTN
Oedema
Heart failure except amlodipine
Unstable Angina, uncontrolled HF
What’s the size effect of CCB
Oedema
State when to avoid Thiazide like diuretics
Diabetes
Gout
Egfr <30
Addison disease
Side effect Thiazide diuretics
Hypokalaemia
Hyperuricaemia
Hypercalcaemia
Hyponatraemia
State when to avoid spironolactone
Addison’s Disease
Hyperkaelamia
Side effect of spironolactone
Hyperkalaemia
Gyneacomastia
State when to avoid BB in HTN
COPD
Asthma
Unstable HF
Side effect of BB
Bradycardia
State when to avoid alpha blocker in HTN
Hx of syncope in BPH or postural hypotension
Side effect of alpha blocker
Orthostatic hypotension
Drug tx for HTN with type 1 Diabetes
First line- ACEi/ARB
BB
CCB( only long acting eg Nifidipine or amlodipine)
Diuretics ( low dose in combination) with BB
What’s the target clinical BP in renal disease
<140/90 or < 130/80 in patients with CKD and diabetes or if urine:albumin exceeds 70mg/mmol
What is the first line tx of HTN in pregnancy
Labetolol