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Pharm III final > cardiovascular > Flashcards

cardiovascular Flashcards

1
Q

prehypertension criteria

A
  • systolic: 120-139
  • diastolic: 80-89
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2
Q

Stage 1 hypertension criteria

A
  • systolic: 140-159
  • diastolic: 90-99
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3
Q

stage 2 hypertension criteria

A
  • systolic: > or = 160
  • diastolic: > or = 100
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4
Q

first tx approach to pt with HTN

A
  • lifestyle modification
    • smoking cessation
    • salt restriction
    • Diet (DASH)
    • exercise
    • weight management
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5
Q

BIG 4 medications for tx of HTN

A
  • Thiazide diuretics
  • ACE-I
  • ARB
  • CCB
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6
Q

recommendation treatment threshold BP goal for everyone? The only exception is people over 60 who don’t have kidney disease or diabetes, in which case its

A
  1. 140/90
  2. 150/90
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7
Q

treatment for HTN in patient with CKD

A
  • ACE-I or
  • ARB
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8
Q

treatment for HTN in a black patient

A
  • thiazide or
  • CCB
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9
Q

drug regimen options for tx of HTN

A
  1. ACE, thiazide and CCB
  2. ARB, thiazide, and CCB
  3. consider other classes of medications
    • beta blockers
    • alpha blockers
    • central alpha agonists
    • direct renin inhibitor
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10
Q

Which diuretics are best for HTN

A
  • Thiazide
    • HCTZ
    • Chlorothiazide
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11
Q

Which diuretics are best for getting a large amount of volume removed and are used for pulmonary edema

A
  • Loop diuretics
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12
Q

Torsemide

A

loop diuretic

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13
Q

Furosemide

A

loop diuretic

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14
Q

Bumetanide

A

loop diuretic

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15
Q

side effects of Thiazide diuretics

A
  • hypokalemia
  • hyponatremia
  • hyperuricemia
    • may precipitate gout at high dose
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16
Q

side effects of Loop diuretics

A
  • hypokalemia
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17
Q

List the potassium sparing diuretics

A
  • spironolactone
  • triamterene
  • amiloride
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18
Q

what should you remember when taking patient off beta-blocker

A
  • taper slowly
    • ​abrupt withdrawal can precipitate coronary event
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19
Q

1st generation (non-cardioselective) beta blockers block what receptors

A
  • B1 and B2
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20
Q

2nd generation (cardioselective) beta blockers block what receptors

A

B1

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21
Q

function of beta blockers. When should they be used in tx of HTN

A
  • decrease HR, force of contraction and CO
  • used in pts with a h/o MI, stable HF, angina, AFIB
    • NOT for use in acute HF
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22
Q

side effects of beta blockers

A
  • bronchospasm
  • worsen CHF
  • fatigue, exercise intolerance
  • erectile dysfunction
  • depression
23
Q

List the two combined alpha and beta antagonists

A
  • Labetolol
  • Carvediolol
24
Q

list the cardioselective beta 1 antagonists

A
  • acebutolol
  • atenolol
  • betaxolol
  • bisoprolol
  • metprolol
25
Q

function of ACE-I

A
  • block angiotensin II converting enzyme and stop formation of angiotensin II -> cause vasodilation, reduce peripheral resistance and arterial BP
26
Q

“pril”

A

ACE-I

27
Q

side effects of ACE-I

A
  • dry cough
  • possible orthostatic hypotension
  • hyperkalemia
  • angioedema
28
Q

ACE-I and ARBs are contraindicated in

A

pregnancy

29
Q

“sartan”

A

ARB: angiotensin II receptor blocker

30
Q

side effects of ARB

A
  • hypotension
  • hyperkalemia
31
Q

function of CCB

A
  • cause arterial smooth muscle relaxation and decrease in peripheral vascular resistance
32
Q

function of Dihydropyridines

A
  • CCBs that are potent vasodilators
33
Q

“Dipine”

A
  • Dihydropyridines: CCBs that are potent vasodilators
    • Nifedipine
    • Amlodipine
34
Q

side effects of Dihydropyridines: CCBs

A
  • ankle edema
35
Q

MOA of Verapamil

A
  • Diphenylalkylamines -> negative inotropic and chronotropic properties
    • less vasodilation effect
36
Q

Diltiazem is part of what drug class

A
  • CCB
    • Benzothiazepine
      • cardiac depression effect
37
Q

treat HTN with what class of CCBs

A
  • dihydropyridines: “dipines”
38
Q

use of nondihydropyridine CCB: Verapamil and Diltiazem

A
  • variant angina
  • PSVT
39
Q

side effects of nondihydropyridine CCB: Verapamil and Diltiazem

A
  • bradycardia
  • SA dysfunction
  • heart block
40
Q

List the selective (a1) alpha antagonists

A
  • Prazosin
  • Doxazosin
  • Terazosin
    • *work by arteriolar dilation and vasodilation
41
Q

MOA of Phenoxybenzamine

A

non-selective alpha antagonist

42
Q

alpha antagonists become first line in treatment in HTN in presence of

A

BPH

43
Q

side effects of Alpha antagonists

A
  • first dose syncope
  • orthostatic hypotension
  • nasal congestion and headahce
44
Q

function of central alpha agonists

A
  • reduce sympathetic vasoconstriction and total peripheral vascular resistance
45
Q

list central alpha agonists

A
  • Clonidine
  • Methyldopa
46
Q

side effects of central alpha agonists

A
  • orthostatic hypotension
47
Q

avoid abrupt withdrawl of central alpha agonists due to

A
  • cause rebound hypertension
48
Q

MOA of Aliskiren

A
  • direct renin inhibitors
49
Q

side effects of direct renin inhibitors

A
  • hyperkalemia
  • renal impairment
50
Q

direct renin inhibitors contraindicated in

A
  • pregnancy
51
Q

tx vasospastic (prinzmetals) angina

A

CCB

52
Q

best used for long-term managment of chronic stable angina

A
  • Beta-blocker
  • long acting nitrate: Isosorbide
53
Q

best used for acute angina

A

Nitroglycerin

54
Q

drug titration strategy for HTN tx

A
  1. maximize first medication before adding second OR
  2. add second medication before reaching maximum dose of first medication OR
  3. start with 2 medication classes seperately or as a fixed dose combination

Pharm III final (8 decks)

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