Chapter 2 BNF (Blood Pressure Conditions)

Question 1

First, Second and Third line in hypertension in Caucasian under 55?

Answer 1

First: ACE/ ARB or BB

Second: CCB, Thiazide

Third: ACE, CCB, Thiazide

Question 2

First line in Hypertension in over 55 and Afrocaribbean?

Answer 2

First line: CCB or Thiazide

Second: ACE/ARB (ARB in afrocaribbean)

Third: ACE Thiazide + CCB

Question 3

Thresholds for stages of hypertension?

Answer 3

1: 140/90
2: 160/100
3: 180/110 (hypertensive crisis)

Question 4

Which patients should be treated in stage 1 hypertension?

Answer 4

Target organ damage (LV hypertrophy, CKD, retinopathy)

CVD or 10 year CVD risk of 20%

Renal disease
Diabetes

Question 5

How is hypertensive crises treated in:

Acute organ damage
No organ damage

Answer 5

Organ damage: IV

Oral: over 24/48 hours

Question 6

Over 80 target BP?

Answer 6

150/90

Question 7

Under 80 target BP?

Answer 7

140/90

130/80 in atherosclerotic CVD or diabetes with kidney, eye, or cerebrovascular disease

Question 8

Diabetes target BP?

Answer 8

140/80

130/80 with complications

Question 9

Pregnant target BP?

Answer 9

150/100 in chronic hypertension

140/90 in organ damage or after birth

Question 10

When should methyldopa be stopped after pregnancy?

Answer 10

2 days

Question 11

Which ACE is taken twice daily?

Answer 11

Captoril

Question 12

Which ACE should be taken 30-60 mins before food?

Answer 12

Perindopril

Question 13

How do ace inhibitors affect the liver?

Answer 13

Cholestatic jaundice
Hepatic failure

Stop if liver transaminases 3x baseline or if jaundice occurs

Question 14

Side effects of ACE?

Answer 14

Cough 
Oral ulcer 
Taste disturbance 
Hypoglycaemia 
Angioedema

Question 15

Clonic one side effects?

Answer 15

Flushing

Question 16

Methyldopa side effects?

Answer 16

Drowsiness

Question 17

Hydralazine side effects?

Answer 17

Fluid retention

Tachycardia

Question 18

Minoxidil side effects?

Answer 18

Tachycardia
Fluid retention
Increased Cardiac output

Question 19

Which beta blocker is used in Peru-operative period due to its short half life?

Answer 19

Esmolol

Question 20

Which beta blocker causes hepatotoxicity?

Answer 20

Lane talon

Question 21

Which beta blockers cause less bradycardia and less coldness of extremities?

Answer 21

ISA CAPO?

Celiprolol
Acebutolol
Pindolol
Oxprenolol

Question 22

Water soluble beta blockers?

Answer 22

Celiprolol
Atenolol
Sotalol
Nadolol

Water SNAC

Question 23

Cardioselective beta blockers?

Answer 23

Bisoprolol 
Atenolol
Acebutolol 
Metoprolol 
Nebivolol 

BAAMN

Question 24

Once daily beta blockers?

Answer 24

Bisoprolol
Atenolol
Nadolol
Celiprolol

BANC

Question 25

Beta blockers contraindications?

Answer 25

Asthma Unstable heart failure Heart block

Question 26

Which Dihydropyridine CCB are longer acting ?

Answer 26

Amlodipine | Felodipine

Question 27

Dihydropyridine CCB Side effects?

Answer 27

Ankle swelling Flushing Headaches

Question 28

Which CCBs should be avoided in heart failure?

Answer 28

Verapamil | Diltiazem