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NAPLEX > Hypertension > Flashcards

Hypertension Flashcards

1
Q

Drugs that Increase BP

A
  • Amphetamine/ADHD Drugs
  • Cocaine
  • Decongestants
  • ESA
  • Immunosuppressants
  • NSAIDs
  • Systemic Steroids
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2
Q

Zestoretic

A

Lisinopril + HCTZ

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3
Q

Hyzaar

A

Losartan + HCTZ

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4
Q

Benicar HCT

A

Olmesartan + HCTZ

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5
Q

Diovan HCT

A

Valsartan + HCTZ

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6
Q

Lotrel

A

Benazepril + Amlodipine

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7
Q

Exforge

A

Valsartan + Amlodipine

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8
Q

Tenoretic

A

Atenolol + Chlorthalidone

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9
Q

Ziac

A

Bisoprolol + HCTZ

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10
Q

Maxide/Dyazide

A

Triamterene + HCTZ

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11
Q

IV HTN Medications

A
  • Chlorothiazide
  • Clevidipine
  • Diltiazem
  • Enalaprilat
  • Esmolol
  • Hydralazine
  • Labetalol
  • Metoprolol
  • Nicardipine
  • Nitroglycerin
  • Propranolol
  • Verapamil
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12
Q

Natural Products for Lowering BP/CV Risk

A
  • Fish Oils
  • Coenzyme Q10
  • L-arginine
  • Garlic
  • *Not recommended per HTN guidelines**
  • Lifestyle management preferred (DASH diet, Na < 1500 mg/d)
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13
Q

Preggo + HTN

A
  • RAASi - warning for fetal tox. D/C as soon as you know patient is preggo
  • Treat when SBP >= 160 OR DBP >= 105 (more lax goals)
  • 1st line: labetalol or nifedipine ER (Adalat CC)
  • Alt: methyldopa
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14
Q

Thiazide Diuretic MoA/Info

A
  • MoA: inhibits Na reabsorption in DISTAL convoluted tube (increases Na/Cl/H20/K excretion)
  • CI: sulfonamide allergy
  • Low electrolytes EXCEPT calcium (HYPERcalcemia)
  • Avoid CrCl < 30
  • Increases UA/LDL/TG/BG
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15
Q

CCBs MoA/Info

A
  • MoA: inhibits Ca+ from entering smooth muscle => peripheral arterial vasodilation
  • DHP CCB end in “-pine,” otherwise Non-DHP CCB
  • Can cause peripheral edema, flushing, tachycardia/palpitations
  • Drug of choice in Raynaud’s syndrome
  • NEVER use non-DHP CCBs in HF
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16
Q

Clevidipine

A
  • Lipid emulsion CCB, IV
  • CI: allergy to soybeans or eggs
  • Infection and hyperTG risk
  • STRICT aseptic technique => only 12 hours after puncture
  • 2 kcal/mL
17
Q

CCB DDI

A
  • AVOID grapefruit juice and major CYP3A4i

- Must lower doses of simvastatin and lovastatin if used together

18
Q

RAASi

A
  • Don’t double up any RAASi
  • Angioedema risk - higher risk in black patients
  • ALL have hyperkalemia risk
  • ACEi/ARBs decrease lithium clearance/increases its toxicity
19
Q

ACEi Info

A
  • ACEi (stop Ang I => Ang II), blocks bradykinin (dry cough)
  • Captopril - TID; Enalapril - BID
  • Warning: bilateral renal stenosis
  • Don’t use w/in 36 hours of Entresto
20
Q

ARBs

A
  • Blocks AngII from binging to receptor (stops vasoconstriction)
  • Less cough, angioedema, and no washout with Entresto
  • Olmesartan: “sprue-like enteropathy”
21
Q

K-Sparing Diuretics

A
  • Aldosterone receptor antagonists: Spironolactone or eplerenone are preferred add-ons for resistant HTN
  • Commonly used in HF
  • Eplerenone is selective and doesn’t display endocrine SE (gynecomastia, impotence)
22
Q

K-sparing Diuretic Info

A
  • Hyperkalemia warning (Triamterene esp.)
  • Addison’s disease for spironolactone
  • Increases SCr
  • Also decrease lithium clearance
23
Q

B-Blockers

A
  • Only first-line for comorbidities like post-MI or HF (bisoprolol, carvedilol preferred)
  • DON’T D/C abruptly (rebound tachycardia)
  • CI: severe bradycardia
  • Can mask signs of low blood sugar or worsen Asthma/COPD (non-selective)
24
Q

B1 Selective BB

A

AMEBBA

  • Atenolol (Tenormin)
  • Metoprolol (Lopressor, Toprol XL)
  • Esmolol (Brevibloc)
  • Bisoprolol
  • Betaxolol
  • Acebutolol (w/ ISA)
25
Q

B1 and B2 Blockers

A

Non-selective

  • Nadolol
  • Pindolol (w/ ISA)
  • Propranolol
  • Timolol
26
Q

Other BB

A

B1 w/ Nitric Oxide Vasodilation
-Nebivolol - Bystolic

Non-selective with Alpha-1 Blocker

  • Carvedilol (Coreg)
  • Labetalol
27
Q

Centrally Acting Alpha2 Agonist

A
  • Clonidine - oral, patch (remove before MRI, Qweekly) - Kapvay for ADHD
  • Guanfacine
  • Methyldopa - DILE risk
  • *DON’T D/C suddenly**
  • Antichol. SE
28
Q

Direct Vasodilator

A
  • Hydralazine: DILE (vasodilation SE)
  • Minoxidil: SIGNIFICANT edema (OTC - Rogaine, hair growth)
  • SE: Flushing, HA, tachycardia, etc.
29
Q

Alpha Blockers

A
  • Doxazosin
  • Prazosin
  • Terazosin
  • NOT recommended for HTN, should be used for BPH AND HTN (not HTN alone)
30
Q

HTN Emergency

A
  • BP >= 180/120 AND acute organ damage
  • IV meds!
  • No more than 25% reduction in BP in 1st hours (then aim for 160/100 over next 2-6 hours)

NAPLEX (59 decks)

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