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Cardiology > HTN Path and Mgmt > Flashcards

HTN Path and Mgmt Flashcards

1
Q

What is HTN (give me a number)?

A

at least 140/90

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2
Q

Should a hypertensive person lift weights?

A

No, it raises BP

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3
Q

Where is renin released? What does it do?

A

Kidneys: Juxtaglomerular apparatus
Stimulated formation of angiotensin
Stimulates release of aldosterone from adrenal cortex

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4
Q

PreHTN

A

120-139/80-89

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5
Q

Stage 1 HTN

A

140-159/90-99

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6
Q

Stage 2 HTN

A

> 160 / >100

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7
Q

Most common adverse affect of diuretics?

A

Hypokalemia

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8
Q

Hydrochlorothiazide (HCTZ)

A

Inhibits NaCl absorption in the DCT of the nephron.
May precipitate hyponatremia
Generally first-line
Ineffective if creatanine in >2.5
Patients allergic to sulfa may be allergic

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9
Q

Loop diuretics

A

Selectively inhibit NaCl absorption in the ascending thick loop of henle.
Used when renal fxn declines
Stronger incidence of hypokalemia
Reserve for patients with chronic renal dz

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10
Q

Loop diuretic types

A

Furosemide (Lasix)
Torsemide (Demedex)
Bumetanide (Bumex)
Metolazone (Zaroxolyn)

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11
Q

K+ Sparing Diuretics

A

Antagonize the effects of aldosterone at the late distal and cortical collecting tubule in the nephron.
Weak when used alone

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12
Q

K+ sparing diuretic types

A

Aldactone (Spironolactone)
Midamor (Amiloride)
Dyrenium (Triamterene)
All can be combined with HCTZ

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13
Q

Beta Blockers

A 
Effect is on the ANS
Reduced HR and CO
Antagonize catecholamine at Beta receptors
Decrease renin release
Cardioprotective
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14
Q

What does cardioprotective mean?

A

Negative inotropic effect (Decreased squeeze, man)

Negative chronotropic effect (lower rate)

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15
Q

Beta blocker SE

A 
Bradycardia
Heart failure
Bronchospasm
Impotence
Depression
Sedation/fatigue
Cold extremities
Hypotension
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16
Q

Do not use Beta blockers with…

A

NSAIDS
Epi
CCB

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17
Q

ACE Inhibitors

A

Block the conversion of angiotensin I to angiotensin II.
Leads to dilation, decreased cardiac workload
Renal Protective
Cardioprotective

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18
Q

Types of ACE Inhibitors

A

Captopril
Lisinopril (Zestril)
Enalapril
Others

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19
Q

When are ACE inhibitors first-line?

A

Diabetics
CHF
Chronic kidney failure
MI

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20
Q

ACE inhibitor SE

A 
Cough
Acute renal failure (bilateral renal artery stenosis)
Angioedema
Hypotension
Rash
Hyperkalemia
***Contraindicated in pregnancy***
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21
Q

Angiotensin II Receptor Blockade (ARB’s)

A

Alternative to AVE inhibitors
Block angiotensin II receotirs
Same profile as ACE
DOes no cause cough

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22
Q

ARB types

A

Irbesartan (Avapro)
Candesartan (Atacand)
Losartan (Cozaar)

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23
Q

Calcium Channel Blockers (CCB’s)

A

Dilate peripheral arterioles by blocking calcium influx into smooth muscle cells.
Decrease contractile force
Reduce cardiac work load
Good in combo w/ diuretics for black pts

24
Q

Dihydropyridine CCB’s

A 
Highly vascular selective
end in dipine
Amlodipine (norvasc)
Felodipine (Plendil)
Nifedipine (Procardia)
25
Q

Dihydropyridine SE

A 
Reflex tachycardia
flushing
HA
Hypotension
Edema
26
Q

Non-dihydropyridine CCB’s

A

Verapamil

DIltiazem

27
Q

Non-dihydropyridine SE

A

Excessive bradycardia
Impaired electrical conduction
depressed contractility
concern with beta blockers

28
Q

Alpha 1 Blockers

A

Block alpha receptors in small arterioles and venules
Lower peripheral vascular resistance
May cause orthostatic hypotension
Used for men with prostate issues

29
Q

Alpha 1 blocker types

A

Prazosin (minipress)
Terazosin (Hytrin)
Doxazosin (cardura)

30
Q

Alpha 2 Receptor Agonists

A

Stimulate alpha 2 receptors in brain
Decreased sympathetic outflow from vasomotor center
Causes decreased vasoconstriction
May cause fluid retention

31
Q

Alpha 2 Receptor Agonist Types

A

Clonidine (Catapres) 2nd or 3rd line

Methyldopa (Aldomet) Frequently used in pregnancy

32
Q

Vasodilators

A

Causes direct arteriolar smooth muscle relaxation by increasing cGMP
Have to take along side another antihypertensive agent long-term

33
Q

Vasodilator types

A

Hydralazine
Minoxadil
Reserpine

34
Q

Moderate HTN emergency Tx

A

Captopril oral

Amlodipine

35
Q

Severe HTN Mgmt

A

Admission
Nitroprusside IV drip
Nitroglycerine IV drip

36
Q

Nitroprusside

A 
IV only
Short 1/2 life
Immediate onset of action
ICU only
Start slow, go slow
37
Q

Which type of therapy should be used for a BP above 160/100?

A

2 drug therapy

38
Q

Average BP at birth?

A

78 systolic

39
Q

Which group is HTN more common in?

A

African Americans
Around 35% of the pop has it
Also women over the age of 60

40
Q

BP Circadian Rhythm

A

Lowest in the morning and midday
Highest at end of the day
Also higher in cold weather

41
Q

HTN Eye damage

A 
Hard exudates
Flame hemorrhage
Cotton wool spots
AV nipping
Copper wiring
42
Q

Oral contraceptives cause?

A

HTN

43
Q

Most common cause of secondary HTN

A

Renovascular HTN

44
Q

Which meds are contraindicated for renovascular dz?

A

ACE and ARB’s.

Make the renal failure worse.

45
Q

Alpha 1 blockers end in?

A

Zosin

46
Q

Which med is used in pregnancy?

A

Methyldopa: Alpha 2 Blocker

47
Q

Spironolactone causes what?

A

Gynecomastia in males

K+ sparing diuretic

48
Q

Why shouldn’t ACE inhibitors be used in women of child bearing age?

A

Pregnancy category X

49
Q

Which meds cause angioedema?

A

ACE and ARB

50
Q

ARB’s end in?

A

Sartan

51
Q

Dihydropyridines are highly _______ selective.

A

Vascular

52
Q

Dihydropyridine CCB’s all end in

A

ipine

53
Q

CCB’s are contraindicated in?

A

CHF

54
Q

Which med should be used in pregnancy?

A

Methyldopa: Alpha 2 antagonist

55
Q

What do you need to watch for with nitroprusside?

A

Cyanide Toxicity

Cardiology (14 decks)

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