CV-HTN Flashcards
What are BP goals with HTN
<130/80, DM/CKI 130/80
Which is the most effective drug for HTN?
cholorthalidone
What is order agents for heart failure
- ACE 2. Cholorthalidone-sx, HCTZ, 2. BB 3. ARB, AA
What is order agents for POST MI
- BB, 2. ACEI
What is order agents for CAD unstable, stable
- BB or CCB 2. ACEI 3. Cholorthalidone, HCTZ
What is order agents for DM w/ HTN
- ACEI/ARB, 2.Cholorthalidone, HCTZ, 3. BB/CCB
What is order agents for CKD ?
- ACEI/ ARB
What is order agents for recurrent stroke?
- Cholorthalidone, HCTZ, 2. ACEI
What is main effect of ACEI?
DEC BP peripheral. DEC AGII=DEC preload
How does ACEI affect GFR?
Little effect on CO, HR or GFR
What should not be combined with ACEI?
ARB
Which drug DEC contractiliy, and blunts SNS in heart?
BB- NOT 1st line unless comorbitiies
What should be consider in BB?
Lowers SBP 10-20, DBP 10-5
Are BB ok in AA and pregnant women?
Not AA. Atenolol NOT OK
Which block smooth muscle and vasodiates?
Ca channel blockers. Block AV node= DEC HR and contractily
When are CC and Diurectics 1st line?
AA and elderly
Which DEC CO, GFR, RBF?
Diurectic-thaiz
Which is most favorable in renal fucntin for mortaliy?
Cholorthalidone, HCTZ
Diruetcts have ADE of what?
HYPOkalemi, blunted Twaves
Mr. Thal develops hypokalemia, what is DOC?
Cholorthalidone, HCTZ
What is common dose for diuretcis?
12.5-25mg PO
Mr. Thal is taking digoxin, what is important?
Monitor TI
What HTN meds are avoided in pregancy?
ACE, ARB, DRI (direct renin inhib
NSAIDs are caution during Anti HTN bc
NSAIDs blcok Cox 1 and 2. Raise BP d/t NA/H2O retention. Blunt anti-HTN
What is DOC for volume overload?
Loop Diuretics
What is the only DRI for anti-HTN?
Aliskren- renin inhibotr. INC CK/CPK level-inflammatory induce, when tissue damage is rampant
Atrovastatin, ketoconazol due what to DRI?
INC Aliskiren levels
What should not be combined with DRI?
ACE, ARB, in DM or AKI, CKI
What are the alpha-blockers?
Prazosin, Terazosin, Doxazosin
Mr. Mean has PHM of BPH a war veteren w/ h/o PTSD. He is here for his BP of 150/89/ What agent will treat all of d/o?
Zozin- alpha-blocker
What does the alpha recpetor do in the body?
Potent vasocontrcitor. Alpha-blk= vasodiation. LIVER cleared-LFTs?
What are DI with Alpha Blockers?
BB inc orhtostasis, CCB- verapamil- will not get cleared
During pt education with Alpha blockers what is concern?
May cause syncope sit to stand. MSK should constrict when standing help BF to return to brain and heart, thus RX vasodialtes, so no return
Ms. Stacy is 32y preg w/ HTN and risk of preclampsia. What RX is best
Alpha agonist- Methyldopa
Which non-stimulant drug is used for HTN an d ADHD
Clonidine, Guafacine
Mr. Thal HTN is 200/120, what med can be used?
Clonidine, Methydopa, Guanfacine, Guanabenz
How should the alpah agonist be tapered?
Discontine slowly due to rebound HTN, HA, palpitations
What effect do alpha agonist have?
Anit cholinergic- INHIB PNS. dry as a bone, red as beet, mad as hatter, hot, blind
Which NT will alpha agonist block?
NOREpi
What drug is last choic for CKI stage 4-5?
Direct Arterial Vasodialtors- Hydrlazine, Minoxidil
What are some ADE of DAVs
- HA 2. Reflex HTN 3. BB will enhance 4. Check LFTs
What depletes catacholimens with a slow onset of HTN effects?
Peripheral Andrenergic Inhib. 2. Reserpine- 3rd line w/ Diurectics 3. Guanadrel/Guanethidine
What stomach d/o should be avoid w/ Resperine?
Pelvic Ulcer Dz
Which peripheral adreneric (SNS) inhib has BBW for orthostaic hypotension?
Guanadrel/Guanethidine
What med used or ED/urgernt accumulate metabolinte thiocyanate in AKI?
Nitropruside. NO- potent vasodialtor, rapid control for BP
What is adminsraction of HTN ED methods?
IV
What RX is ideal for pheochromocytoma?
malginant HTN TX with PHENTOLAMINE
FENOLDOPAM is a vasodialtor of which receptors?
D1, a2 agonist
What is MC urgern meds for agina and HTN?
Nitroglycerin- dialates venous and coronary artery. BUT severe HA
WHihc drugs are used for RHF?
RHF-SOB, presyncope, edema-legs, abdomen= Pulmonary Arterial Hypertension. 1.Epprostenol 2. Treprostinil 3. Lloprost 4. Bosentan 5. Ambrisentan
What is prostacyclin analog, vasodialotr, platlet aggregator inhbi?
The prost and sentans!
What are common ADE for prosts and sentans?
Jaw pain, GAD, N/V, hypotension
Which prost induce infx d/t IV catheter in for long time?
Epoprostenol
Which sentan is LFT monitored?
Bosentan