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PHARM2 > HTN > Flashcards

HTN Flashcards

0
Q

WHAT ARE SOME CAUSES OF SECONDARY HTN?

A

PHEOCHROMOCYTOMA, RENAL ARTERY STENOSIS, ALDOSTERONISM, COARCTATION OF THE AORTA

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1
Q

WHAT IS CONSIDERED HTN?

A

140/90

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2
Q

WHAT IS THE BIGGEST RISK FACTOR FOR CV DISEASE?

A

HTN

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3
Q

IF YOU SEE SEVERE HTN IN A CHILD, WHAT SHOULD YOU BE THINKING? (DISEASE WISE)

A

ALDOSERONE INCREASE OR PHEOCHROMOCYTOMA

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4
Q

WHAT IS HTN CRISIS?

A

ACUTE ELEVATION OF BP ASSOCIATED WITH END ORGAN DAMAGE. 190/100 X 2 CONSECUTIVE READINGS PERIOP.

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5
Q

WHAT MARKS THE BEGINING OF CHRONIC HEART DISEASE?

A

ONCE YOU INJURE MUSCLE: MURAL CARDIAC MUSCULATURE

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6
Q

WHAT CAN HAPPEN WITH SEVERE HTN?

A

MI, CVA, RENAL FAILURE, CHF, ENCEPHALOPATHY, AORTIC DISECTION…..ALL ACUTE.

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7
Q

COMMON CAUSES OF SEVERE HTN?

A

WITHDRAWL OF ANTI-HTN IE CLONADINE NITROPRUSSIDE, SLE, REANAL ARTERY STENOSIS, NEOPLASM, PREECLAMPSIA, COCAINE.

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8
Q

WHAT IS THE GOAL OF TREATMENT WITH HTN?

A

HALT VASCULAR DAMAGE BECAUSE THIS WILL BECOME IRREVERSABLE.

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9
Q

HOW WILL PERIPHERAL PULSES FEEL IN A PT WITH COARCTATION OF AORTA?

A

DIFFERENT PERIPHERAL PULSE PALPATION.

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10
Q

WHAT IS AN EXAMPLE OF A PURE ALPH BLOCKER AND WHAT IS IT USED FOR?

A

PHENTOLAMINE. USED FOR HTN CAUSED BY INCREASED CATACHOLAMINE RELEASE IE PHEOCHROMOCYTOMA.

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11
Q

WHAT ARE THE 2 FACTORS THAT DETERMINE BP?

A

CO AND PVR.

BP= CO X PVR

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12
Q

WHAT ARE THE SHORT TERM AND LONG TERM CONTROLS OF BP?

A

SHORT: BARORECEPTOR REFLEXES VIA SNS.
LONG: KIDNEY. REGULATE PLASMA VOL AND RENIN ANGIOTENSIN ALDOSTERONE AXIS.

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13
Q

WHAT EFFECT DO DIURETICS HAVE ON SODIUM?

A

THEY INHIBIT NA REABSORPTION INTO CIRCULATION….NA STAYS IN THE NEPHRON, WHICH CAUSES AN INCREASED SECRETION OF NA IN URINE.

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14
Q

WHERE DO LOOP DIURETICS WORK?

A

ACENDING LIMB OF HENLE BY INHIBITING NA,K, CL REABSORBTION. THESE ARE THE MOST EFFECTIVE DIURETICS.

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15
Q

WHAT ARE LOOP DIURETIC SIDE EFFECTS?

A

HYPOKALEMIA, OTOTOXICITY, DEHYDRATION, HYPOTENSION

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16
Q

WHAT ARE MAJOR DRUG INTERACTIONS WITH LASIX?

A

DIGOXIN, AMINOGLYCOSIDES, LITHIUM, POTASSIUM SPARING DIURETICS.

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17
Q

HOW DO THIAZIDE DIURETICS WORK?

A

BLOCK REABSORPTION OF NA AND CL IN DISTAL CONVOLUTED TUBLE. WHICH INCREASES EXCRETION OF THESE LYTES PLUS WATER.

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18
Q

WHAT ARE 2 MAIN CONSIDERATIONS WHEN USING THIAZIDE DIURETICS?

A

THEYRE NOT EFFECTIVE WHEN IMMEDIATE DIURESIS IS REQIRED. USE CAUTIOUSLY IN PT WITH SULFA DRUG ALLERGY.

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19
Q

WHY ARE THIAZIDES NOT GOOD FOR DIABETICS OR PT WITH GOUT?

A

THIAZIDES ELEVATE PLASMA LEVELS OF URIC ACID AND GLUCOSE.

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20
Q

CAN YOU USE THIAZIDE ON PT WITH KIDNEY FAILURE?

A

NO. EFFECTIVENESS IS DEPENDENT ON KIDNEY FUNCTION.

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21
Q

WHAT ARE 3 MAJOR USES FOR THIAZIDES?

A

ESSENTIAL HTN, EDEMA, DI

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22
Q

CAN YOU USE THIAZIDES DURING PREGNANCY?

A

NO

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23
Q

WHAT IS A CONTRAINDICATION TO THIAZIDES?

A

HYPERSENSITIVITY TO THIAZIDES OR SULFONAMIDES (SULFA DRUGS)

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24
Q

WHAT ARE ADVERSE EFFECTS OF THIAZIDES?

A

ELEVATED URIC ACID, LIPID LEVELS, BLOOD GLUCOSE.

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25
Q

WHAT ARE THE 2 TYPES OF POTASSIUM SPARING DIURETICS?

A

EPITHELIAL SODIUM CHANNEL BLOCKERS AND ALDOSTERONE RECEPTOR ANTAGONISTS.

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26
Q

WHAT WOULD YOU WANT TO AVOID IN PT TAKING POTASSIUM SPARING DIURETICS?

A

POTASSIUM SUPPLEMENTS AND ACE INHIBITORS.

27
Q

DO OSMOTIC DIURETICS HAVE A MOLECULAR TARGET?

A

NO….THATS UNIQUE CHARACTERISTIC. THEY INCREASE OSMOTIC PRESSURE OF TUBULE, WHICH REDUCES WATER REABSORPTION.

28
Q

WHAT EFFECT MAY HIGH POTASSIUM HAVE ON NMB?

A

HIGH POTASSIUM MAY PRODUCE METABOLIC ACIDOSIS WHICH WILL AFFECT DOA OF NMB.

29
Q

WHAT EFFECT DO HIGH DOSES OF LASIX HAVE ON NMB?

A

ANTAGONIZE NMB BY INHIBITING PHOSPHODIESTERASE, INCREASING CAMP, INCREASING MUSCLE CONTRACTION.

30
Q

WHAT IS A COMMON ANNOYING SIDE EFFECT OF LISINOPRIL?

A

COUGH. TAKES 4-6 WEEKS FOR COUGH TO DISAPPEAR.

31
Q

WHAT HAPPENS TO PRELOAD AND AFTERLOAD WHEN ON ACE INHIBITORS?

A

BOTH DECREASE. SO ITS GOOD FOR CARDIAC CONDITIONS TOO.

32
Q

WHAT EFFECT DO NSAIDS HAVE ON ACE INHIBITIORS?

A

DECREASE THE EFFECTIVENESS.

33
Q

WHAT EFFECT DO ANTACIDS HAVE ON CAPTOPRIL?

A

DECREASES THE ABSORPTION OF CAPTAPRIL.

34
Q

WHAT ARE THE EFFECTS OF ACE INHIBITORS ON POTASSIUM?

A

INCREASES POTASSIUM LEVELS. USE CAUTIOUSLY WITH K SUPPLEMENTS AND K SPARING DIURETICS.

35
Q

CONTRAINDICATIONS FOR ACE INHIBITORS?

A

PREGNANCY AND RENAL FAILURE.

36
Q

WHAT WOULD BE A GOOD ANTI HTN FOR PT WITH GOUT OR DM?

A

ANGIOTENSIN 2 RECEPTOR BLOCKERS. THEY DONT INCREASE GLUCOSE OR URIC ACID.

37
Q

WHAT POPULATION SHOUD YOU AVOID GIVING B BLOCKERS TO?

A

PT WITH ASTHMA OR DM.

38
Q

WHAT ARE THE CONTRAINDICATIONS FOR PROPRANALOL?

A

1ST DEGREE HEART BLOCK, CHF, CARDIOGENIC SHOCK, COPD, AND BRONCHIAL ASTHMA.

39
Q

WHY CAN YOU USE LOPRESSOR (METOPROLOL) IN PT WITH ASTHMA, DM?

A

ANTAGONIST AT B1 NOT B2.

40
Q

HOW SHOULD B BLOCKERS BE DISCONTINUED?

A

SLOWLY TAPERED DUE TO POSSIBLE REBOUND HTN AND TACHYCARDIA.

41
Q

WHAT EFFECTS AND SIDE EFFECTS OF B BLOCKERS WILL YOU SEE IN THE OR?

A

BRADYCARDIA ESP. WHEN NMB REVERSAL IS GIVEN. MASKS THE SIGNS OF HYPOGLYCEMAI AND HYPERTHYROIDISM.

42
Q

HOW DO CA CHANNEL BLOCKERS CAUSE THEIR EFFECTS?

A

THEY BLOCK THE CALCIUM ENTRY INTO THE CELL WHICH MEANS SMOOTH MUSCLE (IE: VESSELS) CANT CONTRACT. THEY ALSO BLOCK THE NODES OF THE HEART.

43
Q

WHAT IS CLEVIDIPINE?

A

A CALCIUM CHANNEL BLOCKER USED FOR PERI-OP HYPERTENSION.

44
Q

HOW DOES PSEUDOCHOLINESTERASE DEFICIENCY EFFECT CLIVIDIPINE?

A

IT SLOWS CLEARANCE OF CLEVIDIPINE.

45
Q

WHAT EFFECT DOES CARDIZEM HAVE ON BENZODIAZEPENES?

A

IT INCREASES BENZO’S SEDATIVE EFFECTS.

46
Q

CARIDIZEM AND BETA BLOCKERS USED TOGETHER INCREASES THE CHANCES OF WHAT?

A

BRADYARRYTHMIAS AND HYPOTENSION

47
Q

WHAT RESTRICTIONS ARE THERE FOR CHF?

A

WATER AND NA. LESS THAN 2 L AND 1-3G

48
Q

WHAT IS GOAL OF TREATMENT FOR CHF?

A

DELAY ONSET OF SYMPTOMS.

49
Q

WHAT DO CARDIAC GLYCOSIDES DO FOR CHF? (DIGOXIN)

A

DO NOT DECREASE MORTALITY BUT TREAT SYMPTOMS AND INCREASE QUALITY OF LIFE.

50
Q

WHAT HAS BEEN FOUND TO DECREASE THE MORTALITY FROM CHF?

A

COMBINED USE OF ACE INHIBITORS AND DIURETICS.

51
Q

WHAT DOES IT MEAN TO HAVE A POSITIVE IONOTROPIC AND NEGATIVE CHRONOTROPIC EFFECT…..LIKE DIGOXIN?

A

INCREASE SQUEEZE, DECREASE HR.

52
Q

WHAT DOES IONOTROPIC MEAN?

A

SQUEEZE OF HEART.

53
Q

WHAT TYPE OF RELATIONSHIP DO CA AND NA HAVE AT THE CARDIAC CELL?

A

INVERSE.

54
Q

WHAT ENZYME IS INHIBITED BY DIGOXIN?

A

NA/K ATPASE.

55
Q

HOW IS CALCIUM EFFECTED BY DIGOXIN?

A

IT INCREASES THE AMOUNT OF CALCIUM INTO THE CELL. AND IS RESERVED FOR PT WITH SYSTOLIC FUNCTION.

56
Q

WHAT ARE THINGS TO LOOK OUT FOR DURING SURGERY IF A PT IS ON DIGOXIN?

A

HYPOKALEMIA, ELECTROLYTE IMBALANCES, V FIB, AV BLOCK, SINUS BRADY.

57
Q

WHAT IS A COMMON TOXIC EFFECT OF DIGOXIN?

A

HALOS AND PHOTOPHOBIA.

58
Q

WHAT DO CARDIOSTIMULATORY DRUGS DO?

A

REDUCE AFTERLOAD OR ENHANCE MYOCARDIAL CONTRACTILITY.

59
Q

WHAT IS USED TO TREAT PULMONARY HTN?

A

ENDOTHELIN RECEPTOR AGONIST - BOSENTAN

60
Q

WHAT DOES ENDOTHELIN 1 DO?

A

PULMONARY VASOCONSTRICTION

61
Q

CAN AN ANGINA PT BE SYMPTOM FREE?

A

YES

62
Q

WHEN DO PTS BEGIN TO SHOW SYMPTOMS OF CHEST PAIN…IN TERMS OF CORONARY ARTERIES?

A

90%BLOCKED. DUE TO COLLATERAL SUPPLY.

63
Q

WHAT ARE A COMMON SIDE EFFECT OF NITRATES?

A

HEADACHES.

64
Q

HOW DO YOU PREVENT THE PATIENT FROM DEVELOPING TOLERANCE FROM NITRATE THERAPY?

A

NITRATE FREE PERIOD OF 10-12 HRS.

65
Q

WHAT ARE CLASS 1-4 ANTIARRHYTHMICS?

A

1 NA CHANNEL BLOCKERS
2 BETA BLOCKERS
3 POTASSIUM CHANNEL BLOCKERS
4 CALCIUM CHANNEL BLOCKERS.

66
Q

WHAT CLASS DOES LIDOCAINE FALL INTO?

A

SODIUM CHANNEL BLOCKER

PHARM2 (6 decks)

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