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PHRM 844 > Hypertension > Flashcards

Hypertension Flashcards

1
Q

normal BP followup time

A

1 year

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2
Q

elevated BP followup time and tx

A

3-6 months, non pharm

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3
Q

stage 1 tx and followup

A

ASC >10% or comorbid = nonpharm + 1 agent - 1 month
ASCVD <10% = nonpharm - 3-6 months

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4
Q

stage 2 tx and followup

A

nonpharm and 2+ agents - 1 month

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5
Q

HTN pts at goal followup time?

A

3-6 months

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6
Q

tx initiation BP for ASCVD >10% or CVD

A

130/80

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7
Q

tx initiation for diabetes

A

130/80

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8
Q

tx initiation for secondary stroke

A

140/90

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9
Q

SPRINT trial pts and outcome

A

no diabtetes/stroke
tighter BP goal decreased CV events 25%

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10
Q

ACCORD trial pts and outcome

A

diabetes and CVD
no death benefit with tighter goal
decrease stroke risk 41%

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11
Q

stable ischemic heart disease agents

A

ACE/ARB or beta blocker
if angina: dihydropyridine CCB

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12
Q

heart failure reduced ejection fraction agent

A

avoid non-DHP CCBS

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13
Q

heart failure preserved ejection fraction agent

A

ACE/ARB, diuretic, beta blocker

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14
Q

CKD agent

A

ACE/ARB if albuminuria >300

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15
Q

renal transplant agent

A

DHP CCB

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16
Q

secondary stroke prevention agent

A

ACE/ARB and/or thiazide only if BP >140/90

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17
Q

diabetes agents

A

any first line
ACE/ARB if proteinuria

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18
Q

atrial fib agents

A

ARB

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19
Q

black patients without CKD or HF agents

A

thiazide or CCB

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20
Q

pregnancy agents

A

methyldopa
nifedipine
labetalol

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21
Q

thiazide diuretics drugs

A

HCTZ, chlorthalidone, indapamide, metalozone

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22
Q

thiazides are more effective for pts with a CrCl > what

A

> 30 mL/min

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23
Q

hydrochlorothiazide max dose and dosing

A

25 mg daily

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24
Q

chlorthalidone max dose and dosing

A

100 mg daily

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25
thiazide diuretics effect on potassium
hypokalemia
26
thiazide diuretics adverse effects
hypokalemia, hypomagnesemia, hypercalcemia, hyperuricemia, hyperglycemia, sexual dysfunction, increase in triglycerides/cholesterol
27
thiazide diuretics contraindications
sulfa allergy, anuria
28
loop diuretics drugs
furosemide, torsemide, bumetanide, ethacrynic acid
29
loop diuretics more effective with CrCl < what
30
30
furosemide max dose and dosing
80 mg once or twice daily
31
loop diuretics effect on potassium
hypokalemia
32
loop diuretics adverse effects
hypokalemia, hypomagnesmia, hypoclacemia, hyperuricemia, ototoxicity
33
loop diuretics contraindications
sulfa allergy
34
aldosterone antagonists drugs
spironolactone, eplerenone
35
ALLHAT trial
thiazide should be first line
36
PATHWAY 2 trial
spironolactone with resistant HTN
37
do not initiate spironolactone with what potassium level?
greater than 5
38
spironolactone max dose and dosing
100 mg and daily/BID
39
consider holding dose if potassium ____
>5.5
40
spironolactone adverse effects
hyperkalemia, hyponatremia, gynecomastia
41
contraindications to aldosterone antagonists
use with potassium-sparing diuretics
42
potassium sparing diuretics drugs
triamterene, amiloride
43
potassium sparing diuretics use
concominant with thiazides
44
potassium sparing diuretics caution
GOUT, if uncontrolled its bad cause hyperuricemia
45
ACE inhibitors side effects
cough, angioedema, hyperkalemia, acute renal failure
46
ACE inhibitors contraindications
angioedema on ACE concominant use of alirisken pregnancy/breastfeeding
47
ARB adverse effects
angioedema, hyperkalemia, acute renal failure
48
ARB contraindications
angioedema on ARB concominant use with alirisken pregnancy/breastfeeding
49
consider holding ACE/ARB if potassium ____
greater than 5.5
50
alirisken
no cough dont use with ACE/ARB
51
alirisken adverse effects
hyperkalemia, diarrhea, dizziness, orthostatic hypotension
52
dihydropyridine calcium channel blockers
amlodipine, nifedipine
53
DHP uses
Reynauds syndrome, elderly with isolated systolic
54
amlodipine max dose
10 mg
55
nifedipine max dose
120 mg
56
lisinopril max dose
40 mg
57
DHP adverse effects
reflex tachycardia, peripheral edema
58
DHP interactions
grapefruit, CYP3A4
59
non DHP uses
afib, angina who cant do beta blocker
60
non DHP does what to heart rate
decreases
61
non DHP drugs
diltiazem and verapamil
62
non DHP adverse effects
bradycardia, AV block, constipation (verapamil esp)
63
non DHP drug interactions
concominant use of beta blockers grapefruit juice CYP 3A4
64
labs required for CCB monitoring
none
65
peripheral edema is ___
dose dependent
66
what release is preferred in CCBs
extended release
67
CCB drug for heart failure
amlodipine
68
beta blockers use
HF or CAD
69
avoid abrupt cessation of what drugs?
beta blockers and alpha 2 agonists
70
metoprolol tartrate max dose and frequency
450 mg BID
71
metoprolol succinate max dose and frequency
400 mg daily
72
cardioselective beta blockers
metoprolol, atenolol, bisoprolol, bextaxolol, nebivolol
73
non selective beta blockers
propranolol
74
avoid which drugs in asthma / COPD?
non selective beta blockers (propranolol)
75
ISA beta blockers
acebutolol, penbutolol, pindolol
76
avoid what drugs in heart failure
ISA beta blockers
77
mixed alpha/beta beta blockers
carvedilol, labetalol
78
carvedilol max dose and frequency
50 mg BID
79
beta blockers adverse effects
masked hypoglycemia, bradycardia, exercise intolerance, depression, fatigue
80
beta blocker contrainidcations
heart block, decompensated HF, post-MI, severe bradycardia
81
direct arterial vasodilators
minoxidil and hydralazine
82
minoxidil and hydralazine special conditions use
severe CKD / hemodialysis
83
minoxidil and hydralazine must have concominant therapy with what
beta blocker and diuretic
84
frequncy of hydralazine
2-4 times daily
85
frequency of minoxidil
1-3 times daily
86
hydralazine/minoxidil side effects
tachycardia, chest pain lupus like sydrome/rash with hydralazine hair growth with minoxidil
87
minoxidil boxed warning
pericarditis, pericardial effusion
88
alpha 1 blockers drugs
prazosin, doxazosin, terazosin
89
alpha blockers use
HTN with BPH
90
central alpha 2 agonist drugs
clonidine, methyldopa, guanfacine
91
alpha 2 agonist side effects
CNS depression, dizzy, reflex tachycardia
92
must wean off of which med?
clonidine, wean off beta blocker first then 3-4 days to quit clonidine
93
monitoring paramaters for ACE/ARB
BUN/Scr, potassium
94
monitoring parameters for CCBs
heart rate
95
monitoring parameters for aldosterone antagonists
BUN/SCr, potassium
96
monitoring parameters for other diuretics
BUN/Scr, electrolytes, uric acid
97
beta blockers monitoring parameters
HR
98
steps of resistant HTN
1. 3 drug regimen (ace/arb, ccb, diuretic) max dose 2. chlorthalidone 3. spironolactone 4. beta blocker if HR >70, clonidine if <70 5. hydralazine 6. minoxidil
99

PHRM 844 (16 decks)

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