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Pharmacy Pre-reg > Chapter 2: BP > Flashcards

Chapter 2: BP Flashcards

1
Q

What are the Benefits of lowering high BP?

A

Decreases risk of:

stroke, coronary events, HF and renal impairment.

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2
Q

What are the possible causes of HTN?

A

Secondary causes: endocrine, renal disease

Contributory factors, risk factors and the presence of any complications should be established.

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3
Q

What lifestyle advice should be offered to reduce HTN?

A 
Smoking cessation
Weight loss
Reduce excessive alcohol and caffeine intake
Reduce dietary salt
Reduce total and sutured fats
Increases excerise
Increase fruit and veg intake
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4
Q

What is stage 1 HTN and the initial advice?

A

Clinic BP= 140/90mmHg or higher

ABPM= 135/85mmgHg or higher

Lifestyle advice is offered and review annually.

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5
Q

When do you treat patients that have stage 1 HTN?

A

UNDER 80 YEARS: with target organ failure (left ventricular hypertrophy, CKD, hypertensive retinopathy)

CVD, Renal disease, Diabetes, QRISK2 score of 20% or more.

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6
Q

What do you do if a patient is under 40 and has stage 1 HTN with no target organ damage, no CVD, no renal disease and no diabetes?

A

Seek specialist advice

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7
Q

What is stage 2 HTN and do we treat them?

A

Clinic BP = 160/100 mmHg or higher

ABPM= 150/95 mmHg or higher

Yes, treat all patients regardless of age

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8
Q

What is severe HTN?

A

CLINIC systolic BP: >= 180mmHg or

Clinic diastolic >= 110mmgHg

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9
Q

What is the target BP is a patient is less than 80 years old?

A

Clinic Less than 140/90

ABPM: less than 135/85

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10
Q

What is the target bp for patients with established atherosclerotic CVD, Diabetes in the presence of kidney disease, eye disease, and cerebrovascular disease, CKD and if proteinuria exceeds 1g in 24 hours?

A

less than 130/80mmgHg

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11
Q

What is the target BP for type 1 and 2 diabetes and additional medication that may be needed?

A

140/80mmgHg

type 1: An ACEi/ARB for the presence of diabetic nepthropathy

Type 2: an ACEi/ARB for the management of nepthropathy. Can delay the progression of microalbumuria to nepthropathy.

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12
Q

What are the BP targets for elderly (over 80 years)patients?

A

Clinic: 150/90

ABPM (during waking hours): less than 145/85mmgHg

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13
Q

What is the BP target in HTN in renal disease and the additional medications needed?

A

Less than 140/90mmgHg

ACEi/ARB: for proteinuria

ACEi: use with caution in renal impairment

High doses of loop diuretics may be required
Thiazide like diuretics may be ineffective

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14
Q

What are the conditions for patients that require a target BP of less than 130/80mmgHg?

A

patients with established atherosclerotic CVD, Diabetes in the presence of kidney disease, eye disease, and cerebrovascular disease, CKD and if proteinuria exceeds 1g in 24 hours.

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15
Q

What is the target BP for pregnant women with uncomplicated chronic HTN?

A

Less than 150/100mmgHg

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16
Q

What is the BP range for pregnant women with target organ damage as a result of chronic HTN?

A

Less than 140/90

17
Q

What is the target BP for a woman that has just given birth with chronic HTN?

A

Less than 140/90

18
Q

What is step 1 treatment for HTN for patients under 55?

A

ACEi/ARBS

If CI: give B-blockers

19
Q

What can b-blockers not be given with if a patient has diabetes or at a high risk of developing diabetes?

A

AVOID with Thiazide diuretics

20
Q

What is step 2 for the treatment of HTN for patients under 55?

A

ACEI/ARB + CCB OR

B-BLOCKER + CCB

IF CCB IS CI OR IF THE PATIENT IS AT HIGH RISK OF DEVELOPING HF: Give thiazide like diuretic

21
Q

What is step 3 for treatment of HTN under 55?

A

ACEI/ARB + CCB + THIAZIDE LIKE DIURETIC

22
Q

What is step 4 for the treatment of HTN?

A

RESISTANT HTN
AFFECTS ALL PATIENTS REGARDLESS OF AGE AND RACE.
Consider Seeking specialist advice

+ low dose spironolactone or if the K+ levels is over 4.5mmol/L add thiazide like diuretic.

Monitor renal function and electrolytes

If there is CI to the options: and alpha or b-blocker.

23
Q

What is step 1 for treatment of HTN in under 55 and Afro-Caribbean patients?

A

CCB

OR IF HIGH RISK OF HF: thiazide diuretic

24
Q

What is step 2 of treatment of HTN in over 55 and Afro-Caribbean?

A

ARB (PREFERRED)/ ACEI + CCB/THIAZIDE

CCB+ ARB is preferred in Afro-Caribbean

25
Q

What is step 3 in over 55 and blacks?

A

ARBS + CCB + THIAZIDE DIURETICS

26
Q

What drug should be given to reduce CV risk and MI?

A

Aspirin

27
Q

When should Methyldopa be avoided in pregnant women?

If used, when should it be stopped?

A

In a depressive state.

Stop within 2 days of birth to avoid postnatal depression.

28
Q

When should labetalol not be used in pregnancy

A

In the 1st trimester

29
Q

What is step 1 for a black pregnant woman with diabetes?

A

CCB

Avoid ACEi/ARB= teratogenic

Pharmacy Pre-reg (19 decks)

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