HTN/Lipid Flashcards
BP Treatment Goals
< 140/90 for all
< 150/90 for older than 60
Pregnancy BP Med of choice
Labetalol
ACEi in pregnancy can cause fetal death
What BP meds increase lithium toxicity?
ACEi or ARBs, decrease lithium clearance
Which ACEi can be IV?
Enalapril (Vasotec)
Tekturna generic
Aliskiren
ACEi SE
cough, hyperkalemia, HA
angioedema (more in black pts)
True or False: All ARBs are oral tabs
True
-sartan’s
Which ARB must stay in original container?
Edarbi (Azilsartan)
Which CYP do CCBs affect?
CYP3A4
DHP more potent like amlodipine, nifedipine
Which CCB appears in stool?
Procardia XL (Nifedipine ER)
Contraindication for IV Diltiazem?
avoid IV beta blockers within a few hours
Verapamil many brand names
Calan SR
Covera ER
Verelan ER
(the IR version is TID)
main SE from Verapamil
constipation, gingival hyperplasia
Types of Diuretics
Loop(more potent. use for HF and edema)-Bumetanide, Furosemide, Torsemide.
Thiazide type use for BP-HCTZ, chlorthalidone, indapamide, metolazone
K+ sparing-Amiloride or Triamterene (avoid w/ ACEi, aliskiren, too much K+)
What class of meds interacts with a sulfa allergy?
Thiazide diuretics
Thiazide/HCTZ SE
take in AM hypokalemia, photosensitive (need sunscreen), hyperuricemia could cause glaucoma? avoid with lithium and steroids avoid NSAIDs
Which thiazide is ok if CrCl < 30 ml/min?
Metolazone (Zaroxolyn)
What BP meds cause gynecomastia?
Aldosterone Antags: Spironolactone, Eplerenone
What BP med is on BEERs criteria?
Eplerenone and Spironolactone due to hyperkalemia
K+ sparing diuretics (give w/ HCTZ if potassium too low)
Amiloride or Triamterene
What class of BP meds can cause ototoxicity?
Loop diuretics (Furosemide, Torsemide, Bumetanide)
Furosemide dosing
IV to PO ratio 1:2
ok in CrCl < 30
Tenormin generic
Atenolol
renal excretion
Zebeta generic
Bisoprolol
What Beta blockers are IV?
Esmolol(Brevibloc)
Metoprolol
Lopressor generic
Metoprolol
(Toprol = brand for XL)
Take w/ food. can mask hypoglycemia
Bystolic generic
Nebivolol
* contraindication severe liver impairment
Sectral generic
Acebutolol
Inderal generic
Propranolol
Cholesterol normal levels
LDL < 100
HDL > 60
TC < 200
TG < 150
Adding Gemfibrozil to Statin therapy is not recommended due to what?
Myopathy
No statins in pregnancy
Vytorin generic
Simvastatin + Ezetimibe (Zetia)
Crestor generic
Rosuvastatin
Livalo generic
Pitavastatin
Pravachol generic
Pravastatin
Lescol generic
Fluvastatin
Which statin is not hepatically metabolized?
Pravastatin
*all others are CYP3A4
Lipitor generic
Atorvastatin
*no renal adjustment
CYP3A4 inhibitors
increase myopathy risk bc statin metabolism is reduced when taken together
Ketoconazole, Itraconazole Clarithromycin Nefazodone Fluoxetine, grapefruit juice Cyclosporine Amiodarone
How does Zetia affect Warfarin?
Increases INR (bleed risk)
Welchol generic
Colesevelam (tab) - bile acid seq.
safe in pregnancy
Cholestyramine
bile acid seq. (liquid)
2nd line for LDL lowering
Lopid generic
Gemfibrozil
also risk of myopathy. need to renal dose
Tricor/Trilipix
Fenofibrate
can increase INR
What Niacin is off market?
Simcor-Niacin + Simvastatin
Advicor-Niacin + Lovastatin
no longer recommended with statins*
Mevacor generic
Lovastatin
How to reduce Niacin SE?
Flushing. also pruritus
can pre-treat with ASA or NSAIDs
What do omega-3 fatty acids treat?
TGs* (no effect on LDL)
Lovaza or Vascepa(Icosapent)
