Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Therapeutics P2 > Exam 6 lecture 1 > Flashcards

Exam 6 lecture 1 Flashcards

1
Q

1st line agents for initiation of hypertension agents

A

Thiazides, CCBs, ACE inhibitors, ARBs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Did SPRINT trial include patients with diabetes?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Patients who can not take thiazides should take

A

CCBs or ACE/ARB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Are all 1st line combinations acceptable for HTN?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the preferred combinations for 1st line tx for HTN

A

ACE/CCB

ARB/CCB

ACE/Diuretic

ARB/Diuretic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What combo can we never do for 1st line tx for HTN

A

ACE/ARB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

For a patient with HTN and a patient specific factor for stable ischemic heart disease what is 1st line therapy? What should be added next? And after that?

A

1st line- B blocker

next should be ACE/ARB

Additional needed- DHP CCB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

For a patient with HTN and a patient specific factor for HFrEF, what drug should we avoid?

A

Non DHP CCB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

For a patient with HTN and a patient specific factor for preserved ejection fraction with fluid overload what should we use to treat

A

Diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

For a patient with HTN and a patient specific factor for preserved ejection fraction with elevated BP what should we use to treat

A

ACEi/ARB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

For a patient with HTN and a patient specific factor for preserved ejection fraction with elevated HR what should we use to treat

A

B blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

For a patient with HTN and a patient specific factor for stage 1 or stage 2 CKD and albuminuria (>300mg.day) or >300mg/g-creatine ratio what should we use to treat

A

ACEi (Or ARB if no tolerance)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

For a patient with HTN and a patient specific factor for CKD stage 3 or 4 treatment

A

ACEi (or ARB)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

eGFR cut off for stage 3 or 4 CKD

A

<60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

For a patient with HTN and a patient specific factor for post kidney transplant

A

DHP CCBs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

when to initiate therapy for a patient with HTN and a patient specific factor for secondary CVD (stroke) prevention

A

> 140/90 BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

For a patient with HTN and a patient specific factor for secondary stroke (CVD) prevention what should treatment be

A

Thiazides (1st line)
ACe/ARB
Combo of the above

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

For a patient with HTN and a patient specific factor for diabetes patients

A

If albuminuria (>300 mg/day OR >300 mg/g albumin-to-creatine ratio >300 -ACE/ARB

If not- Thiazide or CCB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

IMPORTANT For a patient with HTN and a patient specific factor for pregnancy how to tx

A

Methyldopa
Nifedipine
Labetalol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Pregnancy is CI in which HTN drugs

A

ACE/ARB
Direct renin inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

For a patient with HTN and a patient specific factor for black people without CKD or HF treatment

A

Thiazide or CCB

2nd line- ACE/ARB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

how to treat HTN pts with stable ischemic heart disease

A

ACEi/ARB and BB 1st line

CCB add if uncontrolled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How to treat HTN pts with HFrEF

A

ACEi/ARB, Diuretic BB(1st)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How to treat HTN pts with HFpEF

A

Diuretic 1st line (if symptomatic)
if persistent HTN, ACE or ARB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
how to treat CKD if albuminuria present
ACE (ARB if no tolerance to ACE)
26
How to treat HTN in renal transplant pts
CCB
27
how to treat HTN for secondary stroke prevention
ONLY START IF BP >140/90 Thiazide, ACE or ARB Combination
28
how to treat HTN for DM patients`
Any 1st line option but ACEi/ARB if albuminuria present
29
How to treat HTN for black patients
Use thiazides or CCBs unless HF or CKD
30
how to treat HTN for pregnant patients
methyldopa, nifedipine, labetalol
31
What are the 2 K wasting diuretics
Thiazides and Loop diuretics
32
Thiazide drug names
Chlorthalidone, hydrochlorothiazide, Indapamide, Metolazone
33
Loop diuretic drug names
Furosemide, torsemide, bumetadine
34
What are the 2 K sparring diuretics
Aldosterone antagonist K sparring diuretics
35
Aldosterone antagonist drug names
Spironolactone, eplerenone
36
K sparring drug names
Amiloride, Triamtrene
37
What are the antihypertensive effects of diuretics due to?
Initially a decrease in SV, but long term a decrease in PVR.
38
Most commonly used thiazide? Most potent thiazide?
HCTZ most common Chlorthalidone most potent
39
In what CRCL are thiazides more effective than loop diuretics
CrCl>30
40
when to dose thiazides
Morning (Avoid nocturnal diuresis)
41
When are thiazides dosed?
All dosed once a day in the AM
42
CI of thiazides
sulfa allergy
43
Drug interaction with thiazides
Li toxicity
44
Adverse effects of thiazides
Hypokalemia, Hypomagnesia, Hypercalcemia, hyperuricemia
45
When are loop diuretics more effective than thiazide drugs
When CrCl<30
46
What do we mean by loop diuretics have a high ceiling dose response curve
May need higher doses in patients with severely reduced renal function. Switching to another loop diuretic or form PO to IV can help
47
Most commonly used loop diuretic
Firosemide
48
Loop diuretic that can be used in sulfa allergy
Ethacrynic acud
49
adverse effects of loop diuretics
Ototoxicity, hypomagnesimia, hypokalemia
50
Aldosterone antagonist drugs
Spironolactone, eplerenone
51
What drug is preferred in resistant HTN? adverse effect of this drug? WHat to replace it with
Spironolactone, Replace with eplerenone, gynecomastia develops in upto 10% of pts
52
NEVER INITIATE aldosterone antagonist if
K>5
53
When to hold or reduce spironolactone dose
K>5.5 or Scr increase by 25%
54
Adverse effcets of aldosterone antagonists
Hyperkalemia, Hyponatremia, gynecomastia
55
Drug i/a of aldosterone antagonists
ACE/ARB/Renin inhibitors/ NSAIDs
56
contraindications of eplerenone
Eplerenone-impaired renal function (CrCl<50 or Scr>2 for males >1.8 for female) T2DM and proteinuria
57
name the K sparring diuretic drug name
Amidoride triamtrene
58
Use of AMidoride triamtrene? What side effects could it cause?
Used in combo with thiazide to combat hypokalemia. Could cause gout (uric acid increase) and hyperkalemia
59
most diuretics are dosed
1 or 2 times a day (thiazide once)
60
Diuretic monitoring paraneters
electrolyte and kidney function
61
Steps to monitoring diuretic
1. Get baseline before starting therapy 2. check 1-2 weeks after initiation (1 week for CKD pts and elderly pts) 3. 3-4 weeks after initiation check again for loop diuretics and aldosterone antagonist Check every 6-12 months
62
what diuretic is 1st line for resistant HTN patients
Spironolactone
63

Therapeutics P2 (41 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions