Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

UBSPPS PHM601 Flashcards Renal-Primary Prevention > HTN > Flashcards

HTN Flashcards

1
Q

How do you treat primary HTN?

A

Medically managed, cannot be attributed to another cause

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

How do you treat secondary HTN?

A
  1. Treat underlying diseases (primary aldosteronism, obstructive sleep apnea etc.)
  2. Remove any medications causing HTN if possible (ex: SNRIs, TCA & MAIOs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Stage 1 HTN BP readings:

A

130-139/80-89 mm Hg

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

Stage 2 HTN BP readings:

A

> 140/>90 mm Hg

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

Hypertensive crisis BP readings:

A

> 180/>120 mm Hg

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

Black patients with HTN but NO CKD or HF should be treated with which first line class(es) of anti-HTN?

A

Thiazide-type diuretics OR CCB
(ACEi/ARB don’t work as well!)

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

Safe anti-HTN in pregnant patients (3)

A
  1. Labetalol
  2. Nifedipine ER
  3. Methyldopa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Beta blockers to be used in pts with HTN and indication of HFrEF? (3)

A
  1. Carvedilol
  2. Metoprolol succinate
  3. Bisoprolol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Chlorthalidone (Hydroton) Dosing?

A

12.5-25 mg Daily

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

Hydrochlorothiazide (Hydrodiuril) Dosing?

A

25-50 mg Daily

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

Thiazide and thiazide-like diuretic mechanism of action

A

Inhibits Na and Cl reabsorption in the distal convoluted tubule leading to increased excretion of Na, Cl, H2O, and K

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

Thiazide and thiazide-like diuretic monitoring

A

Electrolyte and renal function 2-4 weeks after initiating or changing therapy

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

Adverse Effects of Thiazide diuretics?

A

Hyper: Calcemia, uricermia, glycemia
Hypo: volemia, natremia, kalemia, magnesemia

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

Major DDI for NON-DHP CCBs?

A

CYP3A4 (Adjust dose for simvastatin and lovastatin)

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

Amlodipine (Norvasc) Dose?

A

2.5-10mg Daily (DHP)

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

Nifedipine ER (Procardia) Dose?

A

30-120 mg Daily (DHP)

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

Diltiazem ER (Cardizem) Dose?

A

120-360mg Daily (Non-DHP)

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

ACEi contraindications?

A
  1. Pregnancy
  2. Angioedema history
  3. Bilateral renal artery stenosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

ACEi and ARBs major adverse effect

A

Hyperkalemia

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

Lisinopril (Prinivil/Zestril) dosing

A

10-40 mg Daily

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

Losartan (Cozar) dosing?

A

50-100 mg in 1-2 divided doses

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

Valsartan (Diovan) dosing?

A

80-320 mg daily

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

Direct Renin Inhibitor (DRI) adverse effects

A

Hyperkalemia

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

Aliskiren (Tekturna) dosing?

A

150-300 mg daily

25
Q

Beta Blockers adverse effects

A

Bradycardia, Bronchospasm, heart block, worsening HF

26
Q

What must be done when discontinuing a beta blocker?

A

Taper down dose

27
Q

Metoprolol Succinate (Toprolol XL) dose

A

50-200mg daily (cardioselective)

28
Q

Bisoprolol (Zebeta) dose

A

2.5-10mg daily (cardioselective-)

29
Q

Carvedilol (coreg) dose

A

12.5-50mg over two divided doses (alpha and beta blockade)

30
Q

Thiazide and thiazide-like use in patients with gout

A

OK if uric acid is within normal range, avoid is uric acid elevated

31
Q

DHP CCB Mechanism of Action

A

Inhibits Ca ions from entering vascular smooth muscle and myocardial cells leading to peripheral arterial and coronary artery vasodilation

32
Q

Non-DHP CCB Mechanism of Action

A

Inhibits Ca ions from entering vascular smooth muscle and myocardial cells (more selective for the myocardium) leading to vasodilation, negative inotropy, and negative chronotropy

33
Q

ACEi mechanism of action

A

Decreases angiotensin-II production leading to vasodilation and decreased aldosterone secretion

34
Q

ARB mechanism of action

A

Blocks angiotensin-II activity at the angiotensin receptor n vascular smooth muscle preventing vasoconstriction

35
Q

DHP CCB onset of action

A

Up to one week to see the full BP effect

36
Q

DHP CCB that should be avoided in HTN

A

Nifedipine IR - increased hypotension, MI, and death!

37
Q

DHP CCB AE

A

Peripheral edema, headache, dizziness

38
Q

Non-DHP CCB should be avoided in which disease state?

A

HFrEF

39
Q

Which class of drugs requires a wash-out before ANRI (Entresto) initiation, and for how long?

A

ACEi - 36 hours
Does NOT apply to ARBs

40
Q

Serum creatinine increase EXPECTED with ACEI/ARB?

A

Less than or equal to 35%

41
Q

Direct renin inhibitor mechanism of action

A

Inhibits renin leading to an overall decrease in angiotensin II

42
Q

Beta-blocker mechanism of action

A

Inhibits B1/B2 receptors leading to a decrease in inotropy and chronotropy

43
Q

Alpha1-blocker mechanism of action

A

Blocks alpha-1 adrenergic receptors leading to peripheral vasodilation

44
Q

Central Alpha-2 agonist mechanism of action

A

Stimulates central alpha2 adrenergic receptors leading to a decrease in sympathetic outflow (norepinephrine), leading to vasodilation and decrease inotropy/chronotropy

45
Q

Loop diuretic mechanism of action

A

Inhibits Na, K, Cl reabsorption in the thick ascending loop of henle

46
Q

Potassium sparing diuretic mechanism of action

A

Competitive inhibition of epithelial sodium channels in the collecting duct of the nephron, leading to a decrease in sodium reabsorption and increase in potassium reabsorption

47
Q

Mineralocorticoid receptor antagonist mechanism of action

A

Competitive antagonist of the mineralocorticoid receptor which decreases reabsorption of Na and increases reabsorption of K
Eplerenone = selective
Spironolactone = non-selective

48
Q

Direct vasodilators

A

Direct vasodilation of arteries

49
Q

Alpha1 blocker adverse effects

A

Syncope, orthostatic hypotension

50
Q

Doxazosin (Cardura) dose

A

1-16 mg daily

51
Q

Central alpha2-agonists method of discontinuation

A

Slow taper to avoid rebound hypertension

52
Q

MRA adverse effects

A

Spironolactone: gynecomastia, breast tenderness, impotence - if these occur, switch to eplerenone!

53
Q

Which anti-hypertensives require renal/electrolyte monitoring in 2-4 weeks after initiation? (6)

A
  1. ACEi/ARB
  2. Thiazides and thiazide-type diuretics
  3. Direct renin inhibitors
  4. Loop diuretics
  5. Potassium sparing diuretics
  6. Mineralocorticoid receptor antagonists
54
Q

What is a normal blood pressure?

A

< 120 / < 80 mm Hg

55
Q

What is an elevated BP?

A

120-129/ < 80 mm Hg

56
Q

What is the general blood pressure goal for patients?

A

< 130/80 mm Hg

57
Q

What occurs in HTN emergency that does not occur in HTN urgency?

A

End organ damage! Look for things like elevated SCr, LFTs, etc!

58
Q

Treatment approach for HTN urgency

A

Timing: Lower BP slowly in 24-48 hours of presentation
Agent: ORAL anti-HTN
Location: No ICU

UBSPPS PHM601 Flashcards Renal-Primary Prevention (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions