Brainscape's Knowledge GenomeTM

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


See full index

NAPLEX > Hypertension > Flashcards

Hypertension Flashcards

1
Q

Hypertension stages

A

Normal BP : 120 /80

Prehypertension : 120-139 / 80-89

Hypertension I : 140-159/ 90-99

Hypertension II: > 160/100

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

Risk factors for Hypertension

A 
Secondary hypertension
Family history
Obesity
Smoking
Sedintery Lifestyle
Diabetes
Dyslipidemia
Micro albumin uria / GFR < 60ml/min
Age > 55 men,.  > 65 women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hypertension types

A

Primary: cause unknown , above 90% cases, age 35 and above

Secondary: 2- 5 % cases, underlying disease, age 30 and above

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

Target organ damage in HTN

A 
Brain
Kidney (renovascular damage, kidney damage)
Heart
Brain
Peripheral arterial disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Blood pressure formula

A

Cardiac output x Total Peripheral Resistance (TPR)

Cardiac Output = stroke volume x heart rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Physiology of hypertension

A

Sympathetic Nervous system:
Baroreceptors (carotid & aortic arch) —> respond to change in BP. Symp system causes them to constrict–> contraction force increase, HR increase, causing hypertension

Renin- Angiotensin- Aldosterone System:
Renal hypotension –> kidney releases renin–> renin enzyme for angiotensin to make angiotensin I –> angiotensin I to Angiotensin II by ACE (in pulmonary endothlium) –> Angiotensin II potent vasoconstrictor & releases Aldosterone from Adrenal gland–> Aldosterone

Aldosterone function:
Reabsorption of Sodium and water thus Blood volume increase .
releases ADH and Vasopressin (Pituitary)
Myocardial hypertrophy & vascular hypertrophy
Facilitate release and inhibit uptake of nor Adrenaline

Mosaic theory: many factors
Genetics, endothelial dysfunction, bradykinin, nitric oxide, ANP

Fluid Volume regulation: increased fluid volume increase TPR

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

Secondary HTN causes

A 
Cushing Syndrome 
Pheochromocytoma
Drug induced
Chronic kidney disease
Renal Artery Stenosis
Primary Aldosteronism
Thyroid , parathyroid disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Drugs that induce secondary HTN

A 
Corticosteroids (chronic)
Estrogen and oral contraceptive
NSAIDs
Nasal decongestant
TCA
MAOs
Appetite suppressants
Cyclosporine
Erythropoietin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Lab findings in Secondary HTN

A

RFT:
BUN, creatinine elevation

Urinary test:
Vanilyll mandelic acid & metanephrine ( pheochromocytoma)

Hyperkalemia (primary Aldosteronism or Cushing Syndrome)

Renal arteriography, Ultrasound or renal venography

ECG

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

JNC Target BP for patients with diabetes or renal disease

A

130/80 mmHg

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

Thiazide Diuretics Classification with brand names

A 
Chlorothiazide (Diuril)
Hydrochlorothiazide (Microzid, hydroDiuril)
Polythiazide ( Renese)
Metyclothiazide
Chlorthalidone
Metolazone (Zaroxolyn, Mykrox)
Indapamide (Lozol)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Doses for thiazide Diuretic JNC 7

A

mg/day

Chlorthiazide  125 - 500 
Chlorthalidone 12.5 - 25
Hydrochlorothiazide 12.5 - 50
Polythiazide 2-4
Indapamide 1.25 - 2.5
Metolazone mykrox  0.5 - 1.0
Metolazone Zaroxolyn 2.5 - 5
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Mechanism thiazide Diuretics

A

Urinary excretion of Sodium & water & chloride reabsorption
Urinary excretion of potassium & little bit Bicarbonate
Increase effect of other antiHTN by reducing and preventing more blood volume

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

Interaction of thiazide Diuretics

A

NSAIDs

Reduce effect of diuretic

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

Side effects thiazide Diuretics

A 
Hypokalemia
Hypomagnesemia
Uric acid retention
Hyperglycemia
Hypercalcemia
Fatigue , headache, palpitations, rash, vertigo, transitory impotence
Hyperlipidemia
Dehydration
Hypovolemia in extreme cases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Loop Diuretics Classification

A

Bumetanide ( Bumex)
Furosemide (Lasix)
Torsemide (Demadex)
Ethacrynic Acid (Edecrin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Loop Diuretics mechanism

A

Act on ascending loop of Henle
Decrease Na reabsorption
Intense action but short acting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Interaction loop Diuretics

A

NSAIDs

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

Side effects loop Diuretics

A

Hypokalemia
Hypovolemia
Renal function monitoring BUN & creatinine
Transient Deafness (especially with Amino glycoside)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Doses Loop Diuretics

A

Bumetanide 0.5 - 2
Furosemide 20 - 80
Torsemide 2.5 - 10
Ethacrynic Acid 25 - 100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Potassium Sparing diuretics classification

A

Spironolactone (Aldactone)
Amiloride ( Midamor)
Triamterene (Dyrenium)
Eplerenone ( Inspra)

22
Q

Interaction K sparring

A

ACE inhibitors

Potassium Supplement

23
Q

Precautions sode effects

A

Acute renal failure hyperkalemia

Not in patients of recent kidney stones or hepatic disease

24
Q

Doses K sparring diuretic

A

Amiloride 5 - 10
Spironolactone 25 - 100
Triamterene 50 - 100 mg
Eplerenone 50 - 100

25
Q

B Blockers Classification

A 
Atenolol (Tenormin)
Acebutolol (Sectrat)
Betaxolol (kerlone)
Bisoprolol (Zebesta)
Carvedilol (Coreg)
Labetalol (Normodyn, Trandate)
Metoprolol (Lopressor)
Metoprolol ER (toprol xl)
Nadolol (cograd)
Penbutolol (levatol)
Pindolol 
Propranolol ( Inderal)
Timolol (Blocarden)
26
Q

B blockers side effects

A

Cardiac decompensation due to decrease heart rate
ECG monitor for bradyarrythemia
Asthma COPD
Withdrawal (dose should be started and ended with titration)
Impotence

Caution in patients with:

Diabetes (masks hypoglycemia)

Raynaud phenomenon

Neurology disorders : fatigue lethargy, poor memory, weakness, depression

27
Q

Propranolol

A

Inderal
B blocker non selective
40 - 160 mg
Rapid acting and long acting dosage form

28
Q

Metoprolol

A

Lopressor
Toprol XL (sustained release)
Selective b1 blockage
50 - 100 mg /day

29
Q

Timolol

A

Blocarden
Prevents death in Acute MI
Non selective blocker
20 - 40 mg

30
Q

Labetalol

A

Labetalol effective in hypertensive crisis
a b both

Labetalol 200 - 800

31
Q

Esmolol

A

Brevibloc
Ultrashort action
Used in surgery for htn and tachycardia
150 - 300 mcg/kg/min

32
Q

Peripheral a blockers

A

Prazosin (Minipress)
Terazosin( hytrin)
Dixazosin( Cardura)

33
Q

a blocker action

A

Indirect vasodilator
Block postsynaptic a adrenergic receptors
Causing vasodilation both arteries and veins
Low incidence of reflex tachycardia tham direct vasodilator
No adverse effects on lipid serum and other cardiac risks

34
Q

Precautions in a blockers

A

First dose risk

35
Q

Doses a blocker

A

Prazosin 2 - 20
Terazosin 1- 20
Dixazosin 1 - 16

36
Q

Centrally Active A agonist

A

Methyldopa (Aldomet)
Clonidine (catapress)
Reserpine
Guanfacine (Terex)

37
Q

Methyldopa side effects

A 
Orthostatic hypotension
Fluid accumulation
Rebound hypertension
Sedation
Fever flu like symptoms
Positive Coombs test. 1% develops reversable hemolytic anemia.
Dry mouth
Lactation in either gender
Impotence
Depression
38
Q

Clonidine

A

Catapres
Effective in patients with renal impairment
Stimulation of a2 rec centrally to decrease heart rate

Initial paradoxical i crease in BP followed by a prolonged decrease
Sedation and dry mouth
Worsen depression

Dose 0.1 to 0.8 mg

39
Q

Guanabenz & Guanfacine

A 
Centrally acting a² agonist
When initial therapy fails
Sedation dry mouth bradycardia dizziness
Caution in Coronary insufficiency MI  CVA hepatic renal patients
Dose 1 - 3 mg
40
Q

Postganglionic Neuron blockers

A

Best avoided. Unless there’s severe refractory hypertension unresponsive to all other therapy

Reserpine (0.05mg) in combo with diuretic

Central acting, depletes catecholamines stores in brain and periphery
Can cause severe depression that lingers for months after last dose
Peptic ulcer contra

41
Q

ACE inhibitors

A 
Benazapril (Lotensin)
Captopril ( Capoten)
Enalapril (Vasotec)
Fosinipril
Lisinopril (zestril)
Moexipril (Univasc)
Perindopril (Aceon)
Quinapril (Accupril)
Ramipril (Altace)
Trandola pril (Mavick)
42
Q

ACE mechanism

A

Disrupts Renin Angiotensin Aldosterone System by inhibition of ACE . Thus Angiotensin II is decreased. No aldosterone

43
Q

ACE inhb interactions

A

NSAIDs

Potassium Sparring diuretic ( hyperkalemia)

44
Q

Adverse effects

A 
Neutropenia (renal or autoimmune disease)
Proteinuria (renal disease)
Hyperkalemia
Renal insufficiency, renal stenosis
Dry cough
Dysgeusia (altered taste)
Rashes
Vertigo
Headache fatigue 
First dose hypotension
Minor GI disturbance
45
Q

Captopril

A

Capoten
12.5 to 25 mg 3 times daily
Increased to 25 to 100

46
Q

Enalapril

A

Vasotec
Prodrug
Enalaprilat (active)
5 mg daily increased upto 40 mg later

Enalaprilat drug readily available. Used to treat acute hypertension crisis

47
Q

Lisinopril

A

Zestril
Long acting analog of enalapril
5 to 10 mg. Later 10 to 40 mg

48
Q

ARBs

A 
Angiotensin II inhibitors
Azilsartan (Edarbi)
Candesartan (Atacand)
Eprosartan( Teveten)
Irbesartan (Avapro)
Losartan (Cozaar)
Olmesartan (Benicar)
Telmisartan( micardis)
Valsartan (Diovan)
49
Q

Ca channel blockers

A 
Amlodipine (Norvasc)
Clevidipine (cleviprex)
Diltiazem (cardizem)
Felodipine (plendil)
Isradipine (DynaCirc CR)
Nicardipine (Cardene SR)
Nifedipine (procardia XL)
Nisoldipine (Sular)
Verapamil (Calan)
50
Q

Action ca channel blockers

A

Ca channel blocker inhibit influx of Ca throw slow channel in vascular smooth muscle and cause relaxation

Best response in black, low renin hypertensive and elderly patients

51
Q

Ca channel blockers interaction

A

B blocker

52
Q

Adverse effects

A 
SA AV node disturbance contra
Digitalis toxicity contra
Nifedipine association with
Headache, flushing, peripheral edema. 
Sustained release dosage lowers these effects
Verapamil causes constipation

NAPLEX (6 decks)

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