Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm HTN > HTN intro > Flashcards

HTN intro Flashcards

1
Q

Who is at risk for HTN?

A
  • Elderly
  • Blacks
  • Pregnancy
  • Teens now emerging (problem)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the factors for HTN?

A
  • Obesity
  • Lack of physical activity
  • Too much salt in our diet
  • Older age
  • Family history of hypertension
  • Chronic kidney disease
  • Too much alcohol consumption
  • Insufficient intake of potassium, magnesium and calcium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is BP?

A

Cardiac Output x Peripheral Resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is normal BP?

By the JNC-7

A

Systolic (mm Hg) = Less than 120
AND
Diastolic (mm Hg) = Less than 80

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is Prehypertension?
(By the JNC-7)

  • What do you do for Prehypertension?
A

Systolic (mm Hg) = 120-139
OR
Diastolic (mm Hg) = 80-89

  • No drug therapy, only lifestyle modifications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is Stage 1 HTN?

By the JNC-7

A

Systolic (mm Hg) = 140-159
OR
Diastolic (mm Hg) = 90-99

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is Stage 2 HTN?

By the JNC-7

A

Systolic (mm Hg) = 160 or greater
OR
Diastolic (mm Hg) = 100 or greater

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are compelling Indications in HTN?

A

Uncontrolled Diabetes, MI, stroke, other cormorbidities etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the first thing you should do? (According to JNC-7)

A

lifestyle modifications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

If not goal BP, after lifestyle modifications, what do you do if patient has no compelling indications? (According to JNC-7)

A

1.) Stage 1 Hypertension?
Thiazide-Type Diuretic for most.
May consider ACEI, ARB, Beta-blocker, CCB or
combination

2.) Stage 2 Hypertension?
2 drug combination for most.
(Usually thiazide and ACEI or ARB or beta-blocker
or CCB)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

If not goal BP, after lifestyle modifications, what do you do if patient DOES HAVE compelling indications? (According to JNC-7)

A

Drug(s) for the Compelling Indications.

Other antihypertensive drugs (diuretics, ACEI, ARB, beta-blockers, CCB as needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

If not goal BP, after first drug interventions what do you do ? (According to JNC-7)

A
  • Optimize Dosages or Add Additional Drugs Until Goal BP is Achieved.
  • Consider Consultation with Hypertension Specialist (when on 2-3 drugs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the goal BP?

A

< 140

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What MUST be done for the antihypertensive drugs to be effective?

A

Must be used while doing lifestyle modifications!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

According to the ESH ‘13 what are the risk factors for HTN?

A
  • Male
  • Smoker
  • Age (men 55 and older, women 65 and older)
  • Dyslipidemia
  • Fasting plasma glucose (102- 125 mg/dL)
  • Abnormal glucose tolerance test
  • Obesity (BMI 30 kg/m2 or greater)
  • Abdominal obesity (waist circumference men 102 cm or more; women 88 cm or more*)
  • Family history of premature cardiovascular disease (men ages less than 55 years; women aged less than 65 years)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does ESH ‘13 define as Dyslipidemia

A
  • Total cholesterol greater than 190 mg/dL and/or
  • Low-density lipoprotein cholesterol greater than 115 mg/dL and/or
  • High-density lipoprotein cholesterol: men less than 40 mg/dL, women less than 46 mg/dL and/or
  • Triglycerides greater than 150 mg/dL
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q
  1. ) What is the optimal BP?
  2. ) What is the normal BP?
  3. ) What is the High normal BP?

(According to the ESH’13)

A
  1. ) Less than 120/Less than 80
  2. ) 120-129/80-84
  3. ) 130-139/85-89
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is Grade 1 HTN?

According to the ESH’13

A

140-159/90-99

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is Grade 2 HTN?

According to the ESH’13

A

160-179/100-109

20
Q

What is Grade 3 HTN?

According to the ESH’13

A

180 or greater/110 or greater

21
Q

What is Isolated Systolic HTN?

According to the ESH’13

A

140 or greater/Less than 90

22
Q

What do you do for High Normal BP with NO risk factors?

According to the ESH’13

A

No BP intervention

23
Q

What do you do for High Normal BP with risk factors?

According to the ESH’13

A
  • Lifestyle changes

- No BP intervention

24
Q

What do you do for Grade 1 HTN or Grade 2 HTN with no Risk factors?
(According to the ESH’13)

A
  • Lifestyle changes for several months

- Then add BP drugs targeting <140/90

25
Q

What do you do for Grade 1 HTN with risk factors or Grade 2 HTN with 1-2 risk factors?
(According to the ESH’13)

A
  • Lifestyle changes for several weeks

- Then add BP drugs targeting <140/90

26
Q

What do you do for Grade 2 HTN with 3 or more risk factors?

According to the ESH’13

A
  • Lifestyle changes

- BP drugs targeting <140/90

27
Q

What do you do for Grade 3 HTN?

According to the ESH’13

A
  • Lifestyle changes

- Immediate BP drugs targeting <140/90

28
Q

What do you do for High Normal BP AND Organ damage, chronic kidney disease stage 3 or diabetes OR Symptomatic CVD, CKD stage 4 or greater or diabetes with OD/RFs?
(According to the ESH’13)

A
  • Life style changes

- No BP intervention

29
Q

What do you do for Grade 1 HTN or Grade 2 HTN AND Organ damage, chronic kidney disease stage 3 or diabetes OR Symptomatic CVD, CKD stage 4 or greater or diabetes with OD/RFs?

(According to the ESH’13)

A
  • Lifestyle changes

- BP drugs targeting

30
Q

What do you do for Grade 3 HTN AND Organ damage, chronic kidney disease stage 3 or diabetes OR Symptomatic CVD, CKD stage 4 or greater or diabetes with OD/RFs?

(According to the ESH’13)

A
  • Lifestyle changes

- Immediate BP drugs targeting <140/90

31
Q

What are Lifestyle modifications?

A
  • Weight reduction
  • Sodium restriction
  • Reduced alcohol intake
  • Stop smoking
  • Reduce dietary saturated fats and cholesterol
  • Maintain adequate potassium, calcium, magnesium
  • Reduce stress
32
Q

What meds do African Americans respond better to?

A

Better response to calcium channel blockers and diuretics compared with beta blockers, ACEI or ARB monotherapy

33
Q

What is a good med for Pregnancy?

A
  • methyldopa, beta blocker, and vasodilators

- Avoid ACE inhibitors and angiotensin receptor blockers

34
Q

What are the contraindications of Diuretics?

A
  • Possible contraindications: Dyslipidemia, diabetes*

- Compelling contraindications: Gout, allergy to sulfa-based diuretics

35
Q

What are the contraindications of Beta Blockers?

A
  • Possible contraindications: Asthma, COPD, dyslipidemia, severe peripheral vascular disease
  • Compelling contraindications: Bronchospastic disease, second or third-degree heart block
36
Q

What are the contraindications of ACEI or ARBs?

A
  • Possible contraindications: Bilateral renal artery stenosis, renal insufficiency
  • Compelling contraindications:Pregnancy, hyperkalemia
37
Q

What are the contraindications of Calcium channel blockers?

A
  • Possible contraindications: none

- Compelling contraindications: Second or third-degree heart block, heart failure

38
Q

What are the contraindications of Alpha blockers?

A
  • Possible contraindications: Postural hypotension

- Compelling contraindications: Urinary incontinence

39
Q

When does the JNC 7 suggest that a two drug regimen is appropriate to use at initiation?

A
  • Blood pressure more than 20 mm Hg systolic or 10 mm Hg systolic (DIASTOLIC?) above the treatment goal
  • A two-drug regimen would include a diuretic
40
Q

When is caution urged for using combination BP meds at initiation?

A
  • Elderly patients

- Combinations mask if one agent would have been sufficient

41
Q

What is HEXAMETHONIUM?

A
  • Block the action of acetylcholine at nicotinic receptors at sympathetic and parasympathetic autonomic ganglia –> Good or bad?
  • Reduce arteriolar and venomotor tone
42
Q

What are side effects of HEXAMETHONIUM?

A
  • It looks like neuro-muscular blocker so it can paralyze the muscles of respiration
  • Urinary retention
  • Tachcardya
  • Blocks everything on parasympathetic and sympathetic side
43
Q

What is Reserpine?

A
  • Neurotransmitter reuptake blockade: Norepinephrine, Dopamine, Serotonin
  • Irreversible effect
44
Q

What are the adverse drug reactions of Reserpine?

A
  • Central nervous system: Sedation, depression, nightmares, suicide
  • Extrapyramidal effects, e.g. tremor
45
Q

What is Guanethidine?

A
  • Norepinephrine release inhibition: Gradual depletion of norepinephrine in nerve endings
  • Drug-drug interactions
  • Can’t prescribe it anymore
46
Q

What are the adverse drug reactions of Guanethidine?

A

Hypotension; postural and post-exercise

Pharm HTN (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions