Hypertension

Question 1

Management of patient w <120<80 blood preasure

Answer 1

Yearly follow up

Question 2

Management of patient w <130<80 blood preasure

Answer 2

LSM

6 month follow up

Question 3

Management of stage I HTN

Answer 3

those with <140<90mmHg should have:
LSM +3month follow up. And if they have ANY risk factor for CAD Monotherapy:
1month follow up

Question 4

Management of stage II HTN >=140/90

and >150/90

Answer 4

begin with 1 primary antihypertensive

2med +1month follow up

Question 5

hypertensive Emergency Dx

Answer 5

end organ dame and dbp>120

Question 6

hypertensive urgency Dx

Answer 6

sBP >180, dBP >110 +
no evidence of end-organ damage

*toronto notes 2021

Question 7

AntiHTN pick for HF and CAD

Answer 7

BB + ACEi

metoprolol, carvedilol, nebivolol

Question 8

outpatient AntiHTN pick for Stroke

Answer 8

ACEi+ Tiazide

Question 9

AntiHTN pick for Chronic Kideny Disease

Answer 9

ACE or ARB.

Except if stage 4

Question 10

AntiHTN pick for DBT

Answer 10

ACE

if microalbuminuria?

Question 11

AntiHTN pick for African American patients

Answer 11

thiazide-type diuretic or CCB

not ACE

Question 12

AntiHTN pick if only HTN

Answer 12

pick any of them. just 1

Question 13

dihydropyridines CCB (dCCB) SE + perks + contraindication

Answer 13

peripheral edema.
Anti-anginal
Do not use in HF

Question 14

ACE

ARB SE + perks

Answer 14

↑creatinin. ↑K
teratogenic
only ACE: dry cough, angioedema.

switch to ARBs after ACE angioedema

indicated in all. Specially in aforementioned ones.

Question 15

Thiazides SE + perks

Answer 15

hctzd
↓K= hypokalemia
↓Urinary Calcium

Prevention of calcium Kidney stones

Question 16

βB SE + perks

Answer 16

↓HR. OLD obstructive long disease exacerbation

good at HF with reduced EF and at CAD

Question 17

who are the Aldosterone antagonist?

Answer 17

spironolactone

eplerenone

Question 18

Aldosterone antagonist (spironolactone like)SE + perks

Answer 18

↑K gynecomastia

Good for hyperaldestoronism
or CHF class 3

Question 19

Dilators…?

Answer 19

hydralazine

ISON isosorbide dinatrare

Question 20

hydralazine SE + perks

Answer 20

reflez tachycardia cuz dilates arteries
drug induced lupus

good for CKD V

Question 21

ISON isosorbide dinatrare SE + perks

Answer 21

do not combine w other nitrates cuz dilates veins.
nor Phosphodiasterase 5 inhibt (sildenafil)

he is Antianginal

Question 22

Dilators perks

Answer 22

work well for CHF, CAD

Question 23

alpha antagonist SE + indications

Answer 23

orthostatic hypotension

methyldopa- HTN pregnancy
Clonidine- HTN urgency, adhd, tourette. Symptomatic control of opioid withdrawal.

Question 24

Central actin medicationsL¿

Answer 24

clonidine

Question 25

clonidine SE

Answer 25

rebound HTN. which could be avoided w TD patch.

This is a very LAST resource drug

Question 26

nondihydropyridineCCB

Answer 26

verapamil and diltiazem

Question 27

nondihydropyridineCCB perks

Answer 27

good for rate control, AFib. BUT dont’t replace βB when it comes to HF and Coronary artery disease

Question 28

Hypertensive Emergency Management

Answer 28

OnlineMedEd:
ICU. 15% reduction in MAP with infusion, in the 1st 6h

TN and AMBOSS:
Reduce BP by max. 25% within the first hour (usually nitroprusside
and labetalol)

strategy is to gradually and progressively reduce BP in 24-48 h

Question 29

Goal of Management in Hypertensive Emergency in case of ischemic stroke

Answer 29

do not rapidly reduce BP, maintain BP >150/100 for 5 d

Question 30

hypertensive urgency management

Answer 30

• Outpatient treatment is recommended.
• Move patient to a quiet room for 30 minutes.
• Reinstitute or increase the dosage of existing oral antihypertensive therapy.

-consider a rapid-acting oral antihypertensive agent prior to discharge

Question 31

what rapid-acting oral antihypertensive agent prior to discharge can you use in HTN urgency?

Answer 31

Clonidine
Captopril
Labetalol
Prazosin