Hypertension Flashcards
What are causes of hypertension?
Obesity Lack of physical activity Too much sodium in diet Older Age Family history of hypertension Chronic kidney disease Too much alcohol consumption Insufficient intake of potassium, magnesium, & calcium
Who determined the categories for HPTN?
JNC-7
What do HPTN drugs do?
Support lifestyle modifications
What drugs are prescribed for Stage 1 HPTN without compelling indications?
Thiazide-type diuretic for most.
May consider ACEI, ARB, beta-blocker, CCB, or combination
What drugs are prescribed for Stage 2 HPTN without compelling indications?
2 drug combo for most.
Usually a thiazide and ACE-I or beta-blocker, or CCB
What drugs are prescribed for hypertension without compelling indications?
Drugs for compelling indications.
Other antihypertensive drugs as needed.
- Diuretics
- ACE-I
- ARB
- beta-blockers
- CCB
What HPTN drugs are preferred in pregnancy?
Methyldopa
Beta Blocker
Vasodilators
What HPTN drugs should be avoided in pregnancy?
ACE Inhibitors
Angiotension Receptor Blockers
What is a possible contraindication to prescribing diuretics?
Dyslipidemia
*Diabetes
What are compelling contraindications of diuretics?
Gout
Allergy to sulfa-based diuretics
What are possible contraindications to prescribing beta-blockers?
Asthma
COPD
Dyslipidemia
Severe Peripheral Vascular Disease
What are compelling contraindications of beta blockers?
Bronchospastic disease
Second or third-degree heart block
What are possible contraindications of calcium channel blockers?
None
What are compelling contraindications of calcium channel blockers?
Second or third-degree heart block
Heart failure
Where do you want to use caution with hypertensive medication combinations?
Elderly patients
Combinations mask if one agent would have been sufficient.
What are adverse drug reactions of reserpine?
Central nervous system sedation, depression, nightmares. Extrapyramidal effects (e.g. tremor)
What is the mechanism of action of reserpine?
Neurotransmitter reuptake blockade of norepinephrine, dopamine, serotonin.
BIG blood pressure decreases.
What is the effect of reserpine?
Irreversible!
What is reserpine used for?
Psychiatric disorders.
Used worldwide.
What are the adverse drug reactions of guanethidine?
Hypotension- postural and post-exercise.
What is the mechanism of action for guanethidine?
Norepinephrine release inhibition - gradual depletion of norepinephrine in nerve endings.
True or false: guanethidine has few drug-drug interactions?
False! Many drug interactions.
Not marketed in the US
