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naplex > HTN > Flashcards

HTN Flashcards

1
Q

bp goal for everyone

A

< 130/80

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2
Q

aa

A

thiazides and CCBs

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3
Q

CKD

A

ace or arb

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4
Q

dialysis

A

thiazide or CCBs, nothing left to preserve

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5
Q

gen population 1st line tx

A

thiazide, ace, arb, ccb

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6
Q

mean arterial pressure (MAP)

A

systolic + 2(diastolic) / 3

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7
Q

bp can be reduced by

A
  1. volume of fluid or
  2. dilate the vessels (- inotrope, - chonotrope)
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8
Q

decrease volume via kidneys

A

diuretics (ex. thiazide, loops, k sparing)
electrolyte disturbances

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9
Q

meds that increase bp

A
  1. estrogen
  2. corticosteroids (nsaids, COX2)
  3. SNRI’s
  4. migraine meds
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10
Q

lifestyle modifications for weight loss

A
  1. lose weight
  2. sodium intake <2.4 g a day
  3. dash diet
  4. less alcohol
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11
Q

bb ONLY for pts with

A

heart disease, not recommended for initial tx of uncomplicated htn

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12
Q

HTN in patients with CAD

A
  1. BB with ace/arb
    good for patients with:
  2. angina
  3. post MI
  4. after heart attack
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13
Q

HTN in patients with CHF

A
  1. low dose BB
  2. ace/arb
  3. entresto (sacubitril + arb (valsartan)
  4. aldosterone antagonist
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14
Q

diruretics for htn

A

thiazides

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15
Q

duretics for hf

A

loops

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16
Q

crcl <30

A

use loops or metolazone (zaroxolyn)

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17
Q

thiazides (proximal DCT)

A

hydrochlorothiazide (microzide)
chlorothiaizde (diuril)

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18
Q

thiazide like diuretics (proximal DCT)

A

chlorthalidone
indapamide (lozol)
metolazone (zaroxolyn)

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19
Q

loops (thick asc loop of henle)

A

bumetanide (bumex)
ethacrynic acid (edecrin)
furosemide (lasix)
torsemide (demadex)

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20
Q

k sparing diuretics (distal dct and collecting ducts)

A

amiloride (midamor)
triamterene (dyrenium)
spironolactone (aldactone)
eplerenone (inspra)

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21
Q

thiazide side effects

A

↓ nacl
↓ k
↓ mg

↑ glucose
↑ uric acid
↑ ca

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22
Q

caution with thiazides

A

DM
gout
preg category B
sulfa allergy
sexual dysfunction

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23
Q

drug interactions with thiazides

A

risk of lithium toxicity due to ↓ na
risk of digoxin toxicity due to↓ k and↓ mg
risk of allopurinol hypersensitivity

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24
Q

chlorothalidone

A

longer acting and more potent than hydrochlorothiazide

25
Q

bumetanide (bumex)

A

for edema
1 mg oral bumetanide = 40 mg oral furosemide
1 mg iv bumetanide = 20 mg iv furosemide

26
Q

ethacrynic acid (edecrin)

A

for edema
causes more ototoxicity than other loops
can give in pts with sulfa allergy

27
Q

furosemide (lasix) and torsemide (Demadex) indication

A

edema and HTN
with fursemide IV/IM, protect from light

28
Q

loop slide effects

A

↓ nacl
↓ k
↓ mg
↓ ca

↑ glucose
↑ uric acid

sexual dysfunction
rash
lupus
ototoxicity

29
Q

ALL aldosterone antagonists

A

spironolactone (aldactone)
eplerenone (inspra)
taz/tazmin (has drosperenone - analog of spironolactone)

30
Q

amiloride (midamor) and triampterene (dyrenium) indication?

A

edema

31
Q

spironolactone and eplerenone indication?

A

spironlactone: HTN, edema, CHF, off label: acne and hirtuism in women
eplerenone: HTN, chf after MI

32
Q

spironolactone and eplerenone dosage for htn and hf?

A

HTN: 50 mg qd to start, 50 mg BID max
HF: 12.5-25 mg qd to start, 50 mg qd max

33
Q

side effects of k sparing diuretics?

A

hyperkalemia, spironolactone: gynecomastia

34
Q

meds that decrease testosterone cause gynecomastia, which are?

A

spironolactone, ketoconazole, and cimetidine (tagamet)

35
Q

spironolactone does not affect?

A

glucose or uric acid

36
Q

k sparing diuretics are always additives

A

to thiazides/loops to prevent hypokalemia

37
Q

beta blockers

A
  • acebutolol (sectral) - can cause drug induced lupus (+ ANA test)
  • atenolol (tenormin) - orange juice, apple juice, and green tea decrease effects of drug by 40%, take within 4 hours of each other
  • betaxolol (kerlone) - renal elimination
  • bisoprolol (zebeta)
  • esmolol (brevibloc) - iv can be used for SVT, HTN emergency, tachycardia, HTN
  • metoprolol: lopressor is metoprolol tartrate (w food) and toprol xl is metoprolol succinate. IV available
  • nadolol (corgard) - same as atenolol
  • penbutolol (levatol_
  • pindolol
  • propanolol (hemangeol, inderal la/xl, innopran x)
  • sotalol (betaspace) - for ventricular arrythmias, do not sub betaspace for betaspace af
    -nebivolol (bystolic) - nitric oxide
  • carvedilol (coreg) - with food. start 3.125 mg BID for HF and 6.25 mg BID for HTN
  • labetolol (trandate)
38
Q

propanolol IR vs ER?

A

IR: empty stomach
ER: with or without food
do not sub er for ir on mg for mg basis

39
Q

beta 1 selective BB

A

MAN BABE
metoprolol
atenolol
nebivolol
betaxolol
acebutolol
bisoprolol
esmolol
beta 1 blockers are better for COPD patients

40
Q

beta blockers that come in IV

A

MAPLES
metoprolol
atenolol (injection not available in the US)
propanolol
labetolol
esmolol
sotalol - only for arrhythmias

41
Q

ISA’s intrinsic sympathomimetic activity

A

decreases hr less
acebutolol
penbutolol
pindolol

42
Q

when to use BB
CHF?

A

BB, ace/arb, diuretics, aldosterone antagonists

43
Q

when to use BB
post MI

A

BB, ace/arb, aldosterone antagonists

44
Q

when to use BB
angina pectoric

A

BB, CCB

45
Q

when to use BB
Afib or flutter

A

ABCD
A - amiodarone or dronedarone (multaq)
B - BB
C - non CCB’s
D - digoxin

46
Q

bb used in chf

A
  1. carvedilol
    3.125 mg =10 mg ER
    6.25 mg = 20 mg ER
    12.5 mg = 40 mg ER
    25 mg = 80 mg ER
    take with food
  2. metoprolol succinate - they can be scored
  3. bisoprolol (zebeta)
47
Q

bb side effects

A

B bradycardia, bronchospasm
L decrease libido, increase lipids
O orthostatic hypotension
C av block
K raynauds phenomenon (TX with ccb)
E exhaustion/emotional depression

48
Q

BB contraindicated in

A

ergots

49
Q

non - dihydropyridine CCB
diltiazem

A

diltiazem - cardizem, cardizem CD, cardizem LA, dilt xr, cartia xt, tiazac, taztia xt, matzim la

50
Q

non - dihydropyridine CCB
verapamil

A

calen, calen sr, isoptin sr, verelan, verelan pm

51
Q

CCBs

A

amlodipine (norvasc) - does not affect the heart
felodipine (pendil) - always er, dont crush or chew
nisoldipine (sular) - always er, dont crush or chew
isradipine (dynacirc) - BID
nicardipine - cardene - IV
nifedipine - procardia xl, atalat cc (DECREASES BP MORE THAN ANY OTHER CCB)
nimodipine - nimotop nymalize - oral (ONLY FOR SUBARACHNOID HEMMORHAGE)
clevidipine - cleviprex - iv emulsion

52
Q

taztia xt, and tiazac

A

caps may be opened and sprinkled

53
Q

verelan and verelan PM

A

caps may be opened and sprinkled

54
Q

verapamil affects
diltiazem affects

both of these drugs can also cause ____ and not be used in patients with ____

A

heart (can cause constipation)
heart and vessels
they are negative inotrope and chronotrope effects

bradycardia/av block; hf patients

55
Q

nifedipine er

A

empty stomach

56
Q

celvidipine (cleviprex)

A

milky appearing lipid emulsion
do not exceed > 1000 mL in 24 hours due to lipid load
CI in soy or egg allergy
same with dipovan/propofol

57
Q

if its drug induced, it will always be

A

bilateral edema

58
Q
A

naplex (2 decks)

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