HTN - Quiz 3 Flashcards
What is the difference between primary and secondary HTN?
Primary: unknown with combination of RF
Secondary: identifiable underlying cause
HTN includes the activation of ___ and ___?
SNS and RAAS
Describe the components of the RAAS system?
Drugs that can increase BP?
Increased sympathomimetic activity: ADHD drugs, recreational, antidepressants
Increased sodium and water retention: NSAIDs, immunosuppressants, systemic steroids
Increased blood viscosity: ESAs
Oral contraceptives, VGEF inhibitors
How is HTN diagnosed?
Based on the average of at least 2 readings on 2 separate occasions
What is normal BP?
<120/80
What is elevated BP?
SBP 120-129 and DBP <80
What is stage 1 HTN?
SBP 130-139 or DBP 80-89
What is stage 2 HTN?
SBP≥140 or DBP ≥90
Lifestyle management for HTN?
- Weight loss
- DASH diet
- Potassium intake
- Reduced sodium intake (<1500 mg QD)
- Physical activity
- Limited alcohol (≤1 drink QD for women, ≤2 drinks QD for men)
Natural products used for HTN?
- Garlic oil
- Fish oil
What are the preferred regimens for adherence?
QD regimens or combo products
When do you treat stage 1 HTN?
SBP 130-139 or DBP 80-89 and one of the following:
1. Clinical CVD
2. 10 yr ASCVD risk ≥10%
3. Hasn’t met BP goals after 6 months of lifestyle mods
When do you treat stage 2 HTN?
SBP≥140 or DBP ≥90
What is BO goal?
<130/80
What are the preferred drug classes?
- THiazides
- DHP CCB
- ACE
- ARBs
Preferred agents for CKD?
- ACEI
- ARBs
When do you start a second drug?
BP >20/10 above goal
What anti-HTN has fetal toxicity?
- ACEI
- ARBs
Anti-HTN used for pregnancy?
- Labetalol
- Nifedipine ER
- Methyldopa
Medication given to those at risk for preeclampsia?
Daily low-dose aspirin after first trimester
Lisinopril/HCTZ
Zestoretic
Losartan/HCTZ
Hyzaar
Olmesartan/HCTZ
Benicar HCT
Valsartan/HCTZ
Diovan HCT
Benazepril/Amlodipine
Lotrel
Valsartan/Amlodipine
Exforge
Atenolol/Chlorthalidone
Tenoretic
Bisoprolol/HCTZ
Ziac
Triamterene/HCTZ
Maxzide-25
Chlorthalidone
Thalitone
MOA for thiazides?
Inhibit sodium reabsoprtion in the DCT leading to the increased excretion of sodium, chloride, water, and potassium
HCTZ
Hydrodiuril
Dose of chlrothalidone?
12.5-25mg QD
Dose of HCTZ?
12.5-50mg QD
Chlorothiazide
Diuril
CI for thiazides?
Sulfonamide hypersensitivity
* Exacerbations of SLE, gout, dyslipidemia, diabetes
ADRs of thiazides?
Decreased: K, Mg, Na
Increased: Ca, UA, LDLD, TG, BG
Photosensitivity
Administration of thiazides?
- Take early in the morning to avoid nocturia
What is the only thiazed available as IV?
Chlorothiazide
What thiazide is considered the most effective at lowering BP due to longer DOA and increased potency?
Chlorothalidone
MOA of DHP CCBs?
More selective for vascular smooth muscle causing peripheral arterial vasodilation
ADRs of DHP CCBs?
- Peripheral edema
- HA
- Palpitations
- Flushing
- Reflex tachycardia
- Gingivial hyperplasia
- Hypotension
Amlodipine
Norvasc
Nicardipine
Cardene IV
Nifedipine
Procardia XL, Adalat CC
Clevidipine
Cleviprex
IV DHP CCBs
Nicardipine, Clevidipine
DHP CCB drug of choice in pregnancy? HFrEF?
Nifedipine ER (Procardia XL)
Amlodipine
CI of clevidipine?
Allergy to soy and eggs
ADRs specific to clevidipine?
- Hypotension
- Reflex tachycardia
- Infections
- Hypertriglyceridemia
How many kcal are in clevidipine?
2kcal/mL