Hypertension Flashcards
normal BP
<80
pre hypertension
120-139/80-89
stage I HTN
140-159/90-99
stage II HTN
> 160/>100
which drugs can cause secondary HTN
corticosteroids, anorexiants/decongestants, thyroid hormone excess, OCPs, NSAIDs/COX-2, occasionally TCA’s and venlafaxine, excessive licorice
goal BP- no diabetes, no kidney diseases
<140/90
goal BP- diabetes or kidney disease
<130/80
first choice patient with stage I HTN without compelling indications
Thiazide
first choice for patient with stage II HTN without compelling indications
2 drug combo: ACEI, ARB, BB, or CCB
first choice HTN tx pt has heart failure
ACEI plus BB
first choice HTN tx pt has CAD
ACEI plus BB
first choice HTN tx pt has diabetes
ACEI or ARB
first choice HTN tx pt has CKD
ACEI or ARB
first choice HTN tx pt has recurrent stroke
ACEI plus thiazide
first choice HTN tx pt has isolated systolic HTN
thiazide
what does excessive body sodium do in the body
increases vascular resistance (increases vessel rigidity, fluid retention, and epi and norepi release
this diuretic has a potent diuretic effect but low hypertensive effect
furosemide
this class inhibits luminal NaCl transport in the distal tubule of the kidney
thiazide
short term effects: sodium and water excretion (decreases plasma volume)
HCTZ
long term effects: decrease peripheral vascular resistance
HCTZ
this class loses efficacy as renal function declines, not generally used if creat clearance is <30 mL/min
thiazide diuretics
can use this class for HTN, CHF, nephrogenic diabetes insipidus, and to prevent kidney stones due to hypercalciuria
thiazide diuretics
Adverse effects: HYPOkalemia, hyperuricemia, hypomagnesemia, impaired carb tolerance, and HYPERglycemia
thiazide
this class changes urine ionic content: increases the loss of Na, K, and water
thiazide
adverse effects: hyperlipidemia, hyponatremia (our goal), allergies, weakness, fatigue, parasthesias, impotence, photosensitivity
thiazide
this drug is usually combined with loop diuretics for patients with HF who are refractory to loop diuretics alone (given 30 min before lasix)
metolazone
this drug requires close monitoring, can cause volume depletion and hypokalemia
metolazone
this class acts on the ascending LOH at the chloride pump (can potentially cause a 25-30% reduction in Na content of urine)
loops
this class is the most potent diuretic. can be used on pts with renal insufficiency that have failed thiazide
loops
this class can increase renal blood flow. Can relieve pulmonary congestion, decrease LV filling pressures before diuresis occurs
loops
class causes changes in urine ionic content: increases loss of Na, K ,water, and calcium
loops
this class is used for edema (heart failure), hypercalcemia, hyperkalemia, and acute renal failure
loops
adverse effects include: hyperuricemia, hyperglycemia, hypovolemia, hypotension, potassium and magnesium depletion, allergic reactions, and ototoxicity
loops
this drug is a synthetic steroid antagonist of aldosterone. It inhibits Na resorption and K secretion in collecting tubules
spironolactone
this drug is effective as an antiHTN, but limited use due to hyperkalemia
spironolactone
Can be used to treat primary and secondary aldosteronism. Also, it can blunt the potassium wasting tendencies of other diuretics
spironolactone
Adverse effects include gynocomastia, menstrual irregularities, hyperkalemia, and hyperchloremic metabolic acidosis
spironolactone
this drug directly inhibits sodium flux through the ion channels of the collecting tubule
triamterene
therapeutic uses: blunt K wasting tendencies of other diuretics, HTN. It is a weak diuretic alone, and is usually combined with thiazides
triamterene
adverse effects include hyperkalemia, hyperchloremic metabolic acidosis, and kidney stones
triamterene
all diuretics interact with this class of drug
NSAIDs