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Pharm II > HTN > Flashcards

HTN Flashcards

1
Q

increasing sodium can lead to what in pts on diuretics

A

increase K loss

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2
Q

SE of diuretics

A

” Hypokelmia
“ Incrased uric acid reabsorption & BSLower DBP 8-15mm Hg
“ Improved long-term survival
can also increase cholesterol but usually is transient

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3
Q

diuretics effect Ca in what way?

A

reabsorption of Ca

can reduce fracture risk

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4
Q

what populations do we see less effected by ACEI and why

A

elderly and AA are more likely to have low renin HTN

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5
Q

these drugs block angiotensin II receptor

A

AIIRB

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6
Q

Aliskiren (Tekturna) MOA

A

direct renin inhibitor (DRI)

just upstream of ACEI target

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7
Q

Aliskiren CI with

A

Avoid concomitant use with ACEI or ARB in pt with diabetes

because of rash and angioedem

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8
Q

Aliskiren indication

A

only if pts have already tried another drug but will probably have the same SE

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9
Q

CCB dihydropyridines have most of their effect where

A

peripheral vascular

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10
Q

CCB nondihydropyridines effect

A

directly on the heart

negative inotropic effect
negative conotropic effect because they directly block at the SA node and AV node

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11
Q

CCB nondihydropyridines CI with

A

BB

because of effect directly on the heart

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12
Q

when would you consider using a loop diuretic for HTN?

A

GFR less than 30

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13
Q

dosing with loops

A

2x daily but not at night because you don’t want to get up an pee
no later than 12 noon

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14
Q

resistant HTN defined as

what is recommended

A

3 drugs with elevated bp
or 4 drugs (max dose)

aldosterone antagonist are recommended here

be careful because a lot of pts would have secondary aldosteronism HTN and this could dramatically drop bp

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15
Q

BB with ISA

A

intrinsic sympathetic activity

partial agonist
makes it look like partial agonist is an antagonist

binds to the receptor but the maximum activity is less than

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16
Q

which bb do we see used most frequently for HTN

A

Atenelol
and
Metoprolol

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17
Q

Alpha 2 agonist

A

will block NE release

Work in the CNS and block sympathetic outflow from the CNS

18
Q

Alpha 1 antagonist will cause what effect

A

Alpha 1 antagonist at the smooth muscle will cause vasodilation

19
Q

Doxazosin
Prazosin
Terazosin

are all

A

Alpha Blockers

20
Q

Doxazosin MOA

A

” Block post-synaptic alpha1 receptor

“ Potent vasodilation

21
Q

why don’t we use alpha blockers for HTN

A

not considered first line therapy

because higher incidence of developing HF

22
Q

Prazosin is also used for

A

PTSD

23
Q

ADE with alpha blockers

A 
"	1st dose syncope (postural hypotension) 
"	Fluid retention
"	Dizziness
"	HA
"	Nausea
"	Floppy iris syndrome
stress incontinance in women
24
Q

counseling for pts on alpha 1 blockers

A

educate that on really hot days with alcohol they will have a higher risk of postural symptoms

feel “tired and washed out”

25
Q

Alpha2 agonist work on __________

A

” Alpha2 agonist work on vasomotor centers of the brain

“ ↓PVR, CO–> ↓BP

26
Q

Clonidine is also used for

-0.2-1.2mg/d

A

will prevent peripheral manifestations of alcohol withdrawal but will not prevent seizures (benzos)

27
Q

Methyldopa is really only used in _____ why?>

A

pregnancy HTN because you need to dose all the time

28
Q

ADE with alpha 2 blockers like clonidine

A 
"	Severe rebound HTN & Insomnia
"	HA w/ palpitations if d/c suddenly
"	All have anticholinergic effect: Sedation, dry mouth,
"	Orthostatic hypotension
"	Bradycardia, fluid retention
29
Q

TCA will have what effect on a2

A

they increase NE levels so they work against each other

30
Q

Hydralazine
Minoxidil

are both

A

Direct Arterial Vasodilator

” Direct arterial vasodilator (alters cellular Ca metabolism)

31
Q

ADE with direct arterial vasodialtors

A 
"	Reflex tachycardia---> 
"	Angina exacerbated
"	HA 
"	Lupus-like syndrome
"	Flushing
"	Fluid retention
32
Q

when would you use a direct arterial vasodilator

A

” Best to give these with BB & DHP CCBs to help with this + diuretic d/t increased HR response from arterial dilation

33
Q

” Minoxidil also used for

A

hair growth (Rogaine)

can also make facial feature more corse

34
Q

Reserpine

Peripheral Adrenergic Inhibitors

A

” Depletes catecholamine stores (Norepi NT) —> ↓PVR

35
Q

Reserpine
(Peripheral Adrenergic Inhibitors)

avoid in

A

peptic ulcer disease

PUL

36
Q

HTN emergency

A

life threatening complications

37
Q

HTN crisis

A

> 180/120

38
Q

goal to reduce MAP by 25% in minutes to hours (NOT < 140/90)

A

goal to reduce MAP by 25% in minutes to hours (NOT < 140/90)

39
Q

Particularly good for elevated BP with myocardial ischemia

dilates venous (primarily) and coronary vessels → decreases . preload, myocardial O2 demand

A

Nitroglycerin

40
Q

Fenoldopam (Corlopam)

A

May be good for kidney insufficiency

selective D1-agonist and a2 receptor agonist; vasodilator and increases renal blood flow.

41
Q

Labetalol – mixed beta/alpha blocker
Onset 5-10 min, duration 30-60 min
Not in acute HF

used for

A

HTN crisis

need person supine b/c of high risk of orthostasis

42
Q

PAH group

A

based on associated etiology with group 1 isiopathic

Pharm II (16 decks)

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