HTN Flashcards
What is the cause of primary, or essential, HTN
A
Cause is unknown, but risk factors are usually present (like obesity, smoking, excessive salt intake, etc)
2
Q
What is the cause of secondary HTN
A
Renal disease
3
Q
What is normal BP considered
A
SBP < 120 mmHg and DBP < 80 mmHg
4
Q
What is stage 1 HTN considered
A
SBP 130-139 mmHg or DBP 80-89
5
Q
What is stage 2 HTN considered
A
SBP >/= 140 mmHg or DBP >/= 90 mmHg
6
Q
Lifestyle management of HTN includes reducing Na intake to < _____ mg daily
A
1500
7
Q
Key drugs that can increase BP
A
o Amphetamines and ADHD drugs
o Cocaine
o Decongestants (e.g. pseudoephedrine, phenylephrine)
o Erythropoietin-stimulating agents
o Immunosuppressants (e.g. cyclosporine)
o NSAIDs
o Systemic steroids
8
Q
What are natural products that can be used for HTN
A
Fish oil, Coenzyme Q10, L-arginine, garlic
9
Q
What are the 4 preferred drug classes for initial treatment or titration of treatment
A
ACEi, ARB, CCBs, or thiazide diuretics
10
Q
When to start treatment in Stage 2 HTN
A
When SBP is >/= 140 mmHg or DBP >/= 90 mmHg
11
Q
When to start treatment in Stage 1 HTN
A
SBP 130-139 mmHg or DBP 80-89 and
Clinical CVD (stroke, HF, or CAD)
10-yr ASCVD risk >/= 10%
12
Q
BP goal for all pts
A
< 130/80 mmHg
13
Q
Initial drug selection for Non-black pts
A
thiazide, CCB, ACEi, or ARB
14
Q
Initial drug selection for black pts
A
thiazide or CCB
15
Q
Initial drug selection for pts with CKD (all races)
A
ACEi or ARB
16
Q
Initial drug selection for pts with diabetes with albuminuria (all races)
A
ACEi or ARB
17
Q
How many drugs should a pt be started on in stage 2 HTN when Average SBP and DBP >20/10 mmHg above goal (e.g., 150/90 mmHg)
A
2
18
Q
Which antihypertensives have a boxed warning for fetal toxicity
A
ACEi, ARBs and aliskiren
19
Q
Pregnant patients with chronic HTN should receive drug treatment if SBP is >/= ___ or DBP is >/= ___
A
SBP >/= 160
DBP >/= 105
20
Q
First line treatments for HTN in pregnant pts
A
labetalol and nifedipine ER (methyldopa can be recommended but is less effective)
21
Q
Lisinopril/HCTZ brand name
A
Zestoretic
22
Q
Losartan/HCTZ brand name
A
Hyzaar
23
Q
Olmesartan/HCTZ brand name
A
Benicar HCT
24
Q
Valsartan/HCTZ brand name
A
Diovan HCT
25
Q
Benazepril/amlodipine brand name
A
Lotrel
26
Q
Valsartan/amlodipine brand name
A
Exforge
27
Q
Atenolol/chlorthalidone brand name
A
Tenoretic
28
Q
Bisoprolol/HXTZ brand name
A
Ziac
29
Q
Triamterene/HCTZ brand name
A
Maxzide, Dyazide
30
Q
Thiazide diuretics MOA
A
inhibit Na reabsorption in the DCTs, causing increased excretion of Na, Cl, water and K
31
Q
Chlorthalidone doses
A
12.5-25 mg daily
32
Q
HCTZ doses
A
12.5-50 mg daily
33
Q
Thiazide diuretic CI
A
Hypersensitivity to sulfonamide-derived drugs
34
Q
Thiazide diuretic SE
A
↓ electrolytes: K, Mg, Na
↑ electrolytes/labs: Ca, UA, LDL, TG, BG
Photosensitivity
35
Q
Thiazides are not effective when CrCl < ___
A
30 mL/min
36
Q
Which thiazide diuretic is the only one available IV
A
chlorthalidone
37
Q
Which drug class should be avoided with thiazide diuretics
A
NSAIDs (can cause Na & water retention)
38
Q
Thiazide diuretics can decrease ___ renal clearance and increase risk of toxicity
A
Lithium
39
Q
DHP CCBs are used in what conditions
A
HTN, chronic stable angina and Prinzmetal’s angina
40
Q
DHP CCB MOA
A
Inhibit Ca ions from entering vascular smooth muscle and myocardial cells; this causes peripheral arterial vasodilation
41
Q
Amlodipine brand name
A
Norvasc
42
Q
Nicardipine IV brand name
A
Cardene IV
43
Q
Nifedipine ER brand name
A
Adalat CC, Procardia XL
44
Q
Which CCB should not be used for chronic hypertension or acute BP reduction in non-pregnant adults (profound hypotension, MI, and/or death has occurred)
A
Nifedipine IR
45
Q
CCB SE
A
Can cause peripheral edema/HA/flushing/palpitations/reflex tachycardia/fatigue (worse with Nifedipine IR, can occur with others), gingival hyperplasia
46
Q
____ & ____ are considered the safest if a CCB must be used to lower BP in HFrEF
A
Amlodipine and felodipine
47
Q
____ are used to prevent peripheral vasoconstriction in Raynaud’s
A
DHP CCBs (e.g. nifedipine ER)
48
Q
Clevidipine (Cleviprex) CI
A
Allergy to soybeans, soy products or eggs
49
Q
Clevidipine (Cleviprex) warnings
A
Hypotension, reflex tachycardia, infections
50
Q
Clevidipine (Cleviprex) SE
A
Hypertriglyceridemia
51
Q
A lipid emulsion of Clevidipine (provides __ kcal/mL): it is ____ in color
A
2
milky-white
52
Q
Clevidipine max time of use after vial puncture is ___ hours
A
12
53
Q
___ are primarily used to control HR in certain arrhythmias (e.g. atrial fibrillation), and sometimes used for HTN and angina
A
Non-DHP CCBs
54
Q
Which class of CCBs are more selective for the myocardium
A
non-DHP CCBs
55
Q
The decrease in BP produced by non-DHP CCBs is d/t ____ (↓ force of ventricular contraction) and ____ (↓ HR) effects
A
negative inotropic
negative chronotropic
56
Q
Diltiazem brand name
A
Cardizem, Tiazac
57
Q
Verapamil brand name
A
Calan SR
58
Q
non-DHP CCB warnings
Study These Flashcards
A
HF (may worsen symptoms), bradycardia
59
Q
non-DHP CCB SE
Study These Flashcards
A
Edema, constipation (more with verapamil), gingival hyperplasia
60
Q
Use caution with CCBs & ____
Study These Flashcards
A
other drugs that ↓ HR, including BB, digoxin, clonidine, & amiodarone
61
Q
All CCBs are major substrates of CYP450 ___. Check for drug interactions and do not use with ____
Study These Flashcards
A
3A4
grapefruit juice
62
Q
Diltiazem and verapamil are substrates and inhibitors of ___ and moderate inhibitors of ___
Study These Flashcards
A
Pgp
CYP3A4
63
Q
Patients on diltiazem or verapamil and a statin should use lower doses of which 2 statins
Study These Flashcards
A
simvastatin and lovastatin
64
Q
Which 2 classes of HTN meds have been shown to slow the progression of kidney disease in patients with albuminuria
Study These Flashcards
A
ACEi and ARB
65
Q
How are ACEi and ARBs beneficial in HF
Study These Flashcards
A
protect the myocardium from the remodeling effects of Ang II
66
Q
ACEi MOA
Study These Flashcards
A
block the conversion of angiotensin I to Ang II, resulting in ↓ vasoconstriction and ↓ aldosterone secretion
67
Q
ACEi block the degradation of
Study These Flashcards
A
bradykinin, which is thought to contribute to vasodilatory effects (& SE of dry and hacking cough)
68
Q
Benazepril brand name
Study These Flashcards
A
Lotensin
69
Q
Enalapril brand name
Study These Flashcards
A
Vasotec
70
Q
Enalaprilat brand name
Study These Flashcards
A
Vasotec IV
71
Q
Lisinopril brand name
Study These Flashcards
A
Prinivil, Zestril
72
Q
Quinapril brand name
Study These Flashcards
A
Accupril
73
Q
Ramipril brand name
Study These Flashcards
A
Altace
74
Q
ACEi BW
Study These Flashcards
A
Can cause injury and death to developing fetus when used in 2nd and 3rd trimesters; d/c as soon as pregnancy is detected
75
Q
ACEi should not be used within __ hrs of sacubitril/valsartan (Entresto)
Study These Flashcards
A
36
76
Q
ACEi warnings
Study These Flashcards
A
Angioedema, hyperkalemia, hypotension, renal impairment, bilateral renal artery stenosis (avoid use)
77
Q
ACEi SE
Study These Flashcards
A
cough, hyperkalemia, ↑ SCr, hypotension
78
Q
Irbesartan brand name
Study These Flashcards
A
Avapro
79
Q
Losartan brand name
Study These Flashcards
A
Cozaar
80
Q
Olmesartan brand name
Study These Flashcards
A
Benicar
81
Q
Valsartan brand name
Study These Flashcards
A
Diovan
82
Q
ARB MOA
Study These Flashcards
A
Block Ang II from binding to the angiotensin II type-1 (AT1) receptor on vascular smooth muscle, preventing vasoconstriction
83
Q
Which class of HTN meds does not require a washout period
Study These Flashcards
A
ARBs
84
Q
Which class of HTN meds has less cough and angioedema
Study These Flashcards
A
ARBs
85
Q
Olmesartan warning
Study These Flashcards
A
sprue-like enteropathy
86
Q
Aliskiren CI
Study These Flashcards
A
Do not use with ACEi or ARBs in patients with diabetes
87
Q
All RAAS inhibitors ↑ risk for ____
Study These Flashcards
A
hyperkalemia
88
Q
ACEi and ARBs can ↓ ____ renal clearance and ↑ the risk of toxicity
Study These Flashcards
A
lithium
89
Q
____ is a non-selective aldosterone receptor antagonists that also blocks ___
Study These Flashcards
A
Spironolactone
androgen
90
Q
____ is a selective aldosterone antagonist that does NOT exhibit endocrine side effects
Study These Flashcards
A
Eplerenone
91
Q
Spironolactone brand name
Study These Flashcards
A
Aldactone
92
Q
Amiloride and triamterene BW
Study These Flashcards
A
hyperkalemia (K > 5.5 mEq/L) – more likely in patients with diabetes, renal impairment, or elderly patients
93
Q
K-sparing diuretics CI
Study These Flashcards
A
Do not use if hyperkalemia, severe renal impairment, Addison’s disease (spironolactone)
94
Q
K-sparing diuretics SE (all meds)
Study These Flashcards
A
Hyperkalemia, ↑ SCr, dizziness
95
Q
Spironolactone SE
Study These Flashcards
A
gynecomastia, breast tenderness, impotence
96
Q
Which BB should be used if treating chronic HF
Study These Flashcards
A
Bisoprolol, carvedilol, or metoprolol succinate
97
Q
BB with intrinsic sympathomimetic activity (ISA) like ____ do not ↓ HR to the same degree as BB without ISA and are not recommended in post-MI pts
Study These Flashcards
A
acebutolol
98
Q
Atenolol brand name
Study These Flashcards
A
Tenormin
99
Q
Esmolol brand name
Study These Flashcards
A
Brevibloc
100
Q
Esmolol formulation
Study These Flashcards
A
injection
101
Q
Metoprolol tartrate brand name
Study These Flashcards
A
Lopressor
102
Q
Metoprolol succinate ER brand name
Study These Flashcards
A
Toprol XL
103
Q
Beta-blockers BW
Study These Flashcards
A
Do not d/c abruptly; gradually taper dose over 1-2 weeks to avoid acute tachycardia, HTN, and/or ischemia
104
Q
BB warnings
Study These Flashcards
A
Use caution in pts with diabetes: can worsen hyperglycemia or hypoglycemia and mask hypoglycemic symptoms
Caution with bronchospastic diseases (e.g. asthma, COPD), Beta-1 selective preferred
Caution in Raynaud’s/other peripheral vascular diseases, and HF
105
Q
Beta-blockers side effects
Study These Flashcards
A
Bradycardia, fatigue, hypotension, dizziness, depression, impotence, cold extremities (can exacerbate Raynaud’s)
106
Q
Which 2 BB should be taken with or immediately following food, while the others can be taken without regard to food
Study These Flashcards
A
Lopressor (metoprolol tartrate)
Toprol XL (metoprolol succinate)
107
Q
IV:PO ratio for metoprolol tartrate
Study These Flashcards
A
1:2.5
108
Q
What are the beta-1 selective drugs
Study These Flashcards
A
Remember: AMEBBA
Atenolol
Metoprolol
Esmolol
Bisprolol
Betaxolol
Acebutolol
109
Q
Nebivolol brand name
Study These Flashcards
A
Bystolic
110
Q
Which BB is a B1 selective blocker with Nitric oxide-dependent vasodilation
Study These Flashcards
A
Nebivolol
111
Q
Which BB are B1 and B2 non-selective
Study These Flashcards
A
Propranolol and Nadolol
112
Q
Non-selective BB are used in
Study These Flashcards
A
portal HTN
113
Q
Propranolol brand name
Study These Flashcards
A
Inderal LA, Inderal XL
114
Q
Nadolol brand name
Study These Flashcards
A
Corgard
115
Q
Propranolol has high __ solubility & therefore causes more ____ SE, but this makes it more useful in conditions like ____
Study These Flashcards
A
lipid
CNS
migraine ppx
116
Q
Which BB are non-selective BB and Alpha-1 blockers
Study These Flashcards
A
Carvedilol, labetalol
117
Q
Carvedilol brand name
Study These Flashcards
A
Coreg, Coreg CR
118
Q
How should all forms of carvedilol be taken
Study These Flashcards
A
with food
119
Q
T/F: carvedilol dosing conversions are 1:1 (IR:ER)
Study These Flashcards
A
false
120
Q
Labetalol SE
Study These Flashcards
A
dizziness
121
Q
BB can decrease ___ secretion
Study These Flashcards
A
insulin
122
Q
____ is commonly used for resistant HTN and in pts who cannot swallow since it’s available as a patch
Study These Flashcards
A
Clonidine
123
Q
Clonidine brand name for HTN
Study These Flashcards
A
Catapres, Catapres-TTS patch
124
Q
Clonidine brand name for ADHD
Study These Flashcards
A
Kapvay
125
Q
Guanfacine ER brand name for ADHD
Study These Flashcards
A
Intuniv
126
Q
Methyldopa (Centrally-acting alpha-2 adrenergic agonist) CI
Study These Flashcards
A
concurrent use with MAOi
127
Q
Methyldopa warning
Study These Flashcards
A
risk for hemolytic anemia
128
Q
Centrally-acting alpha-2 adrenergic agonists warning
Study These Flashcards
A
Do not d/c abruptly (can cause rebound HTN); must taper over 2-4 days
129
Q
Centrally-acting alpha-2 adrenergic agonists SE
Study These Flashcards
A
Dry mouth, somnolence, fatigue, dizziness, constipation, ↓ HR, hypotension
130
Q
Methyldopa SE
Study These Flashcards
A
hypersensitivity rxn [e.g. drug-induced lupus erythematosus (DILE)]
131
Q
Clonidine patch is applied how many times per week
Study These Flashcards
A
once
132
Q
Hydralazine warning
Study These Flashcards
A
DILE
133
Q
Hydralazine SE
Study These Flashcards
A
Peripheral edema/HA/flushing/palpitations/reflex tachycardia
134
Q
Minoxidil SE
Study These Flashcards
A
Fluid retention, tachycardia, hair growth
135
Q
Hypertensive crises is BP >/=
Study These Flashcards
A
180/120 mmHg
136
Q
patient has acute target organ damage (e.g. encephalopathy, stroke, acute kidney injury, acute coronary syndrome, aortic dissection, acute pulmonary edema)
Study These Flashcards
A
Hypertensive emergency
137
Q
How is hypertensive emergency treated
Study These Flashcards
A
IV meds (chlorothizaide, clevidipine, diltiazem, enalaprilat, esmolol, hydralazine, labetalol, metoprolol tartrate, nicardipine, nitroglycerin, nitroprusside, propranolol, verapamil)
138
Q
In hypertensie crisis, Decrease BP by no more than __% (within first __), then if stable, decrease to ~160/100 mmHg in the next 2-6 hrs
Study These Flashcards
A
25
hour
139
Q
How is hypertensive urgency treated
Study These Flashcards
A
any oral med that has a short onset of action
140
Q
Hypertensive urgency- decrease BP gradually over ___-___ hrs
Study These Flashcards
A
24-48
e.g. MCAT, pharma, bar exam, Spanish, Series 7
DECKS IN NAPLEX 2023 CLASS (88):
Calculation Conversion Factors
Math Stuff
Autonomic Nervous System
Drug Formulations And Patient Counseling
Therapeutic Drug Levels
“Color” Drug References
Drug Interactions
Iv Medication Principles
Controlled Substance
Naplex Grouping
Practice Exam Naplex #1 (Access Pharmacy)
Naplex Quick Review
Chapter 2: Basic Science Concepts
Chapter 3: Learning Drug Interactions
Chapter 4: Learning Lab Values & Drug Monitoring
Chapter 5: Learning Drug References
Chapter 6: Drug Formulations & Patient Counseling
Chapter 7: Learning Iv Medications
Chapter 8: Answering Case Based Exam Qs
Chapter 14: Biostatistics
Chapter 15: Compounding I: Basics
Chapter 16: Compounding Ii Equipment, Stability & Excipients
Chapter 17: Compounding Iii Documentation And Preparation
Chapter 18: Renal Disease
Chapter 19: Hepatitis & Liver Disease
Chapter 20: Immunizations
Chapter 21: Travelers
Chapter 22: Id I Background And Antibacterials By Class
Chapter 23: Id Ii Bacterial Infections
Chapter 24: Id Iii Antifungals & Antivirals
Chapter 25: Id Iv Opportunistic Infections
Chapter 26: Hiv
Chapter 27: Dyslipidemia
Chapter 28: Hypertension
Chapter 29: Ischemic Heart Disease
Chapter 30: Acute Coronary Syndromes
Chapter 31: Chronic Heart Failure
Chapter 32: Arrhythmias
Chapter 33: Stroke
Chapter 34: Anticoagulation
Chapter 35: Anemia
Chapter 36: Sickle Cell Disease
Chapter 37: Allergic Rhinitis, Cough & Cold
Chapter 38: Common Conditions Of The Eyes And Ears
Chapter 39: Common Skin Conditions
Chapter 40: Pulmonary Arterial Hypertension
Chapter 41: Asthma
Chapter 42: Copd
Chapter 43: Tobacco Cessation
Chapter 44: Diabetes
Chapter 45: Thyroid Disorders
Chapter 46: Systemic Steroids & Autoimmune Conditions
Chapter 47: Contraception & Infertility
Chapter 48: Drugs In Pregnancy & Lactation
Chapter 49: Osteoporosis, Menopause & Testosterone Use
Chapter 50: Sexual Dysfunction
Chapter 51: Bph Copy
Chapter 52: Urinary Incontinence
Chapter 53: Acute & Critical Care Medicine
Chapter 54: Pediatric Conditions
Chapter 55: Cystic Fibrosis
Chapter 56: Transplant
Chapter 57: Weight Loss
Chapter 58: Pain
Chapter 59: Migraine
Chapter 60: Gout
Chapter 61: Oncology I: Overview And Side Effect Management
Chapter 62: Oncology Ii Common Cancers & Cancer Treatment
Chapter 63: Depression
Chapter 64: Schizophrenia/Psychosis
Chapter 65: Bipolar Disorder
Chapter 66: Adhd
Chapter 67: Anxiety Disorders
Chapter 68: Sleep Disorders Insomnia, Rls & Narcolepsy
Chapter 69: Parkinson’s Disease
Chapter 70: Alzheimer’s Disease
Chapter 71: Seizures/Epilepsy
Chapter 72: Gerd & Pud
Chapter 73: Constipation & Diarrhea
Chapter 74: Inflammatory Bowel Disease
Chapter 75: Motion Sickness
Chapter 76: Medication Safety & Quality Improvement
Chapter 77: Drug Allergies & Adverse Drug Reactions
Chapter 78: Pharmacokinetics
Chapter 79: Pharmacogenomics
Chapter 80: Dietary Supplements, Natural & Complementary Medicine
Chapter 81: Emergency Preparedness, Toxicology & Antidotes
Brand/Generic
Key Links
Pricing
Corporate Training
Teachers & Schools
iOS App
Android App
Help Center
Subjects
Medical & Nursing
Law Education
Foreign Languages
All Subjects A-Z
All Certified Classes
Company
About Us
Earn Money!
Academy
Contact
Find Us
apple badge
android badge
twitter badge
twitter badge
facebook badge
youtube badge
pinterest badge
tiktok badge
insta badge
Brainscape helps you realize your greatest personal and professional ambitions through strong habits and hyper-efficient studying.
© 2023 Bold Learning Solutions. Terms and Conditions
