HTN Flashcards
HTN definition?
elevated systolic and/or diastolic BP
Sxs of 2º causes of HTN? (6)
mm weakness tachycardia sweating tremors thinning skin flank pain
Signs of sleep apnea? (4)
morning HA
daytime sleepiness
loud snoring
erratic sleep
During physical exam of pts w/ HTN, look for what?
signs of target organ failure
Signs of target organ failure in general physical exam? (4)
body fat distribution
skin lesions
mm weakness
impaired alertness
Signs of target organ failure in eye exam? (3)
hemorrhage
papilledema
cotton wool spots
Signs of target organ failure in neck exam? (2)
abn carotid pulse
abn thyroid
Signs of target organ failure in respiratory exam? (2)
rhonchi
rales
Signs of target organ failure in cardiac exam? (3)
abn size, rhythm, sounds
dyspnea
claudication
Signs of target organ failure in abdominal exam? (3)
renal masses
renal bruits
abn femoral pulses
Signs of target organ failure in neuro exam? (3)
visual disturbances
focal weakness
confusion
HA
HTN screening guidelines for adults?
every 2 yrs
or annually if pre-HTN
Diagnosing HTN?
average of >=2 seated BP readings
during >=2 office visits
BP classifications: normal? pre? stage 1? stage 2?
Normal: SBP < 120 and DBP < 80
Pre: SBP 120-139,or DBP 80-89
Stage 1: SBP 140-159, or DBP 90-99
Stage 2: SBP >=160, or DBP >=100
Pt’s w/ Masked HTN (normal in office, high everywhere else) have increased what?
cardiovascular risks
Home BP monitoring goal?
<135/85
BP goal for pts w/ DM?
<130
Standard tests to run?
HCT UA blood chemistry lipid panel EKG
HTN tx?
lifestyle intervention
meds
Central α Agonists:
MOA
SE
Cautions
MOA: stim α2 receptors -> ↓ SNS
SE: anticholinergic sxs
Avoid abrupt cessation
α blockers (-zosin):
MOA
SE
Cautions
MOA: block α1 receptors in smooth mm -> vasodilation
SE: orthostatic hypotension
combo drug
β blocker (-lol):
MOA
2 types
SE
Cautions
MOA: block β receptors -> ↓ CO
Types: cardioselective (β1), noncardioselective (β1, β2: heart and lungs)
SE: slows everything down
Not for Unstable HF
Diuretics:
MOA
MOA: inhibit Na reabsorb
Thiazide Diuretics:
SE
Cautions
(Hydrochlorothiazide)
SE: low K+, Na, Mg; high Ca2+
sulfa allergies
DM possibly hyperglycemia
Loop Diuretics:
SE
(Furosemide)
SE: low K+, Mg
Potassium Sparing Diuretics:
SE
(Trimterene)
SE: hyperkalemia
Aldosterone Antagonists:
SE
(Spironolactone)
SE: hyperkalemia, gynecomastia
Ca2+ Channel Blockers (-dipine):
MOA
2 types
SE
MOA: ↓ Ca2+ influx -> ↓ vascular resistance
Types: Dihydropyidine (less card depressant),
Non-dihydro (more card depressant)
SE: HA, peripheral edema
ACE Inhib (-pril):
MOA
SE
MOA: inhib RAAS, stim bardykinin
SE: cough, hyperkalemia, acute renal failure
Angiotensin Receptor Blocker (-sartan):
MOA
SE
MOA: inhib RAAS
SE: cough, hyperkalemia, acute renal failure
Direct Renin Inhib:
MOA
SE
Cautions
MOA: inhib renin
SE: cough, hyperkalemia, acute renal failure
Use w/ ACE or ARB in DM
Resistant HTN definition?
failure to hit goal BP w/ full-dose tx of 3 drugs including thiazide diuretic
Most common cause of resistant HTN?
volume overload
HTNsive Urgency is?
Asymp sever HTN
SBP >=180 and/or DBP >=120
HTNsive Urgency etiology?
(U) non-adherence to meds and lifestyle ∆
HTNsive Urgency tx?
Gradual ↓ of BP:
rest
adjust meds - avoid β block, ACE, ARB
HTNsive Emergency is?
SBP >= 180 abd/or DBP >= 120
a/w acute end-organ damage
HTNsive Emergency tx?
ICU
careful, controlled reduction in BP over 48 hrs
