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Cardiology > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What are the SBP/DBP parameters for Normal BP, Elevated BP, Stage 1 hypertension, and Stage 2 hypertension in adults per the 2017 ACC/AHA guidelines?

A

Normal SBP: < 120 mmHg &
Normal DBP: < 80 mmHg

Elevated SBP: 120 - 129 mmHg &
Elevated DBP: < 80 mmHg

Stage 1 HTN SBP: 130 - 139 mmHg OR
Stage 1 HTN DBP: 80 - 89 mmHg

Stage 2 HTN SBP: >/= 140 mmHg OR
Stage 2 HTN DBP: >/= 90 mmHg

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2
Q

Per JNC8, at which SBP/DBP level/s with which comorbidities or at which age should antihypertensives be started?

A

Start pharmacology if SBP/DBP exceeds:

140/90 mmHg with:
- < 60 years old
- DM
- CKD

150/90 mmHG with:
- >/= 60 years old

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3
Q

Which antihypertensives are recommended by the ACC/AHA and which are recommended by the JNC8 and for which categories?

A

ACC/AHA -

All patients:
- TZD (thiazides diuretics)
- CCB (calcium channel blockers)
- ACE (ace inhibitors)
- ARB (angiotensin receptor blockers)

JNC8 -

Black patients:
- TZD
- CCB

Nonblack patients:
- TZD
- CCB
- ACE
- ARB

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4
Q

What medication is NOT recommended by ACC/AHA or JNC8 for HTN and which two antihypertensives should NOT be given together?

A

BB’s (beta blockers) are NOT recommended for HTN

ACE’s (ace inhibitors) and ARB’s (angiotensin receptor blockers) should NOT be given together

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5
Q

What are the drugs and doses of TZD primary antihypertensive agents?

A

HCTZ (hydrochlorothiazide): 12.5mg - 50 mg

Chlorthalidone 12.5mg - 25mg (more potent than HCTZ)

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6
Q

What are the drugs and doses of CCB primary antihypertensive agents?

A

DHP’s (dihydropyridine - more potent vasodilators than non-DHP):
- Amlodipine 5mg - 10mg
- Nifedipine ER 30mg - 90mg

Non-DHP’s:
- Diltiazem 180mg - 360mg
- Verapimil 80mg - 120mg

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7
Q

What are the drugs and doses of ACE inhibitor primary antihypertensive agents?
What is a common side effect of these drugs?
What group of antihypertensives should not be given with ACE inhibitors?

A

ACE:
- Lisinopril 10mg - 40mg
- Benazapril 10mg - 40mg
- Ramipril 5mg - 10 mg

Common S/E: Cough

Ace inhibitors should NOT be given with ARB’s

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8
Q

What are the drugs and doses of TZD primary antihypertensive agents? What group of antihypertensives should NOT be given with ARB’s?

A

ARB’s:
- Candesartan 8mg - 32mg
- Valsartan 80mg - 320mg
- Losartan 50mg - 100mg
- Olmesartan 20mg - 40mg

ARB’s should NOT be given with ACE inhibitors

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9
Q

Which antihypertensives are recommended for patients with heart failure? Which antihypertensive should NOT be given to patients with heart failure?

A

Recommended with heart failure:
- ACE inhibitors —OR— ARB’s
&
- Beta blockers
&
- Sprionalactone

CCB’s should NOT be given with heart failure!!!

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10
Q

Which antihypertensives are recommended for patients with CAD (coronary artery disease)?

A

CAD:
- ACE inhibitors —OR—
- Beta blockers —OR—
- TZD’s —OR—
- CCB’s

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11
Q

Which antihypertensives are recommended for patients post-MI (myocardial infarction)?

A

Post-MI:
- ACE inhibitors —OR— ARB’s
&
- Beta blockers

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12
Q

Which antihypertensives are recommended for patients with DM?

A

DM:
- ACE inhibitors —OR— ARB’s
—OR—
- CCB’s
—OR—
- TZD’s

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13
Q

Which antihypertensives are recommended for patients with CKD?

A

CKD:
- ACE inhibitors —OR— ARB’s

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14
Q

Which antihypertensives are recommended for stroke prevention?

A

Stroke prevention:
- ACE inhibitors —OR— TZD’s

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15
Q

Which antihypertensives are recommended for pregnant patients?

A

First line with pregnancy:
- Labetolol (BB) —OR—
- Nifedipine (CCB) —OR—
- Methyldopa (centrally-acting agent)

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16
Q

What are the drugs and doses included in loop diuretic secondary antihypertensive agents?

A

Loop diuretics:
- Furosemide 20mg - 80mg
- Torsemide 10mg - 40mg

17
Q

What are the drugs and doses included in aldosterone receptor blockers (diuretic) secondary antihypertensive agents? What is a special feature of this group?

A

Aldosterone receptor blockers:
- Spironalactone 25mg - 50mg

It is K+ (potassium)-sparing

18
Q

What are the drugs and doses included in K+-sparing diuretic secondary antihypertensive agents?

A

K+-sparing diuretics:
- Amloride 5mg - 10mg
- Triamterene 100mg

19
Q

What are the drugs and doses included in beta blocker secondary antihypertensive agents?
With which conditions may BB’s be safer?

A

BB’s:
- Metoprolol 50mg - 100mg
- Propanolol 40mg - 120mg
- Labetolol 100mg - 300mg
- Carvedilol 6.25mg - 25mg

May be safer with:
- COPD
- asthma
- DM
- PVD

20
Q

What are the drugs and doses included in centrally-acting secondary antihypertensive agents?

A

Centrally-acting agents:
- Clonidine 0.1mg - 0.2mg
- Mehtyldopa 250mg - 500mg

21
Q

What are the drugs and doses included in vasodilator secondary antihypertensive agents?

A

Vasodilators:
- Hydralazine 25mg - 100mg
- Minoxidil 5mg - 10mg

22
Q

What are the drugs and doses included in alpha blocker secondary antihypertensive agents?

A

Alpha blockers:
- Terazosin 1mg - 5mg
- Doxazosin 1mg - 4mg HS

23
Q

Name medications that may increase BP.

A

NSAID’s:
- they hold Na+ which pulls water (increases fluid volume)

Cyclosporine

EPO

TCA’s

SNRI’s & NDRI’s

24
Q

Which labs and at which intervals should be checked when prescribing primary antihypertensive agents?

A

Labs:
- CCB: none
- ACE/ARB: K+, BUN, Cr
- TZD: K+

Intervals:
- At initiation
- At 2 weeks

25
Q

When should you expect the maximum drop in BP for patients on antihypertensive agents?

A

4 weeks

26
Q

Which primary antihypertensive agents are recommended for patients with heart failure?

A
  • ACE or ARB
    +
  • Beta blocker
    +
  • Spironolactone

***NO CCB with heart failure!!!!

27
Q

Which primary antihypertensive agents are recommended for patients with coronary artery disease?

A

ACE —OR—
BB —OR—
TZD —OR—
CCB

28
Q

Which primary antihypertensive agents are recommended for patients post-MI?

A

ACE —OR— ARB
+
BB

29
Q

Which primary antihypertensive agents are recommended for patients with DM?

A

ACE —OR— ARB

   —OR—

CCB

   —OR—

TZD

30
Q

Which primary antihypertensive agents are recommended for patients with chronic kidney disease?

A

ACE —OR— ARB

31
Q

Which primary antihypertensive agents are recommended for stroke prevention?

A

ACE

—OR—

TZD

32
Q

Which primary antihypertensive agents are recommended for pregnant patients?

A

First line with pregnancy:

  • Labetolol (BB)
    —OR—
  • Nifedipine (CCB)
    —OR—
  • Methyldopa (centrally-acting agent)

Cardiology (8 decks)

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