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Pre-reg > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What is stage 1 hypertension

A

Clinic BP 140/90mmHg - 159/99mmHg

HBP 135/85mmHg - 149/94mmHg

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2
Q

What is stage 2 hypertension

A

Clinic BP - 160/100 mmHg or higher but less than 180/120 mmHg

HBP - 150/95 or higher

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3
Q

What is severe hypertension

A

Clinic systolic BP of 180 mmHg or higher or
Clinic diastolic BP of 120 mmHg or higher

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4
Q

What is given for hypertension in type 2 diabetes

A

ACE Inhibitor

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5
Q

What is given for hypertension in type 2 diabetes in Black Afro-Carribbean

A

ARB

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6
Q

What is given for hypertension in under 55 and not Black Afro-Carribbean

A

ACE Inhibitor

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7
Q

What is given for hypertension in over 55’s

A

Calcium Channel Blocker

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8
Q

What is given for hypertension in Black Afro-Caribbean of any age

A

Calcium Channel Blocker

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9
Q

What is the BP target for under 80s

A

Clinic BP <140/90

HBPM <135/85

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10
Q

What is the BP target for over 80s

A

Clinic BP <150/90

HBPM <145/85

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11
Q

When can low dose spironolactone be given in hypertension

A

Step 4: If potassium is <4.5

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12
Q

When can an alpha blocker or a beta blocker be given in hypertension

A

Step 4: If potassium is >4.5

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13
Q

What is the BP target for under 80s with type 1 diabetes

A

Clinic BP:

If ACR <70 : <140/90
If ACR >70 : <130/80

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14
Q

What is the BP target for over 80s with type 1 diabetes

A

Clinic BP: <150/90

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15
Q

What is the BP target for patients with CKD and a ACR <70

A

Clinic BP below 140/90mmHg

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16
Q

What is the BP target for patients with CKD and a ACR >70

A

Clinic BP below 130/80mmHg

17
Q

What is the BP target for pregnant women with chronic hypertension

A

<150/100mmHg

18
Q

What is the BP target for pregnancy women with chronic hypertension and if target organ damage/given birth

A

<140/90mmHg

19
Q

What is first line for hypertension in pregnancy

A

Labetalol

20
Q

What can be given for hypertension in pregnancy if first line is not suitable

A

Second line: Nifedipine MR

Third line: Methyldopa

21
Q

When does methyldopa need to be stopped

A

2 days after birth

22
Q

What can be given in an emergency setting for severe hypertension or severe pre-eclampsia or if they have or have previously had an eclamptic fit

A

Magnesium Sulfate

23
Q

What is first line for hypertension post birth/ breastfeeding in non black afro carribbeans

A

Enalapril

24
Q

What is first line for hypertension post birth/ breastfeeding in black afro carribbeans

A

Nifedipine or Amlodipine

If not controlled with single drug consider a combination. If this combination is not tolerate or ineffective consider either adding labetalol or atenolol to the combination or swapping.

25
Q

Which ACE Inhibitor needs to be taken 30 to 60 minutes before food

A

Perindopril

26
Q

Which ACE Inhibitor is taken twice daily

A

Captopril

27
Q

Can ACE Inhibitors be given in pregnancy

A

NO - AVOID

28
Q

What are the common adverse reactions / side effects with ACE Inhibitors

A

Persistent dry cough
Hyperkalaemia
Higher risk in renal impairment and diabetes mellitus
Angioedema
Dizziness and headaches
Hepato-biliary disorders - Cholestatic jaundice, hepatic failure, Stop if LFTs 3x normal or jaundice occurs

Other common adverse effects:
Abdominal discomfort, alopecia, arrhythmias, chest pain/angina, constipation, diarrhoea, drowsiness, dry mouth, dyspepsia, dyspnoea, n&v, rash, myalgia, rhinitis, taste disturbance and vertigo, hypOglycaemia

29
Q

What are the common interactions with ACE Inhibtors

A

HYPERKALAEMIA
Aliskeren, ARB, K sparing diuretics / aldosterone antagonists, ciclosporin, heparin, trimethoprim

NEPHROTOXICITY AND REDCUED eGFR
NSAIDs (afferent arteriole constriction)

HYPOTENSION
Diuretics (volume depletion = low BP)

RENAL IMPAIRMENT
Avoid concomitant ACE + ARB (diabetic neuropathy)

DIGOXIN
Concomitant use with captopril can increase plasma concentrations of digoxin

ALLOPURINOL
Possible increased risk of leucopenia and hypersensitivity reactions, especially in people with renal impairment

LITHIUM
Concomitant use can increase plasma levels of lithium. Regular monitoring of serum lithium

30
Q
A

Pre-reg (20 decks)

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