Hypertension (25.9.2013) Flashcards
Drug of choice for hypertensive emergency
sodium nitroprusside
When does sodium nitroprusside therapy lead to cyanide toxicity
infusion for 48-72 hrs
renal insufficiency
Features of thiocyanate toxicity
paresthesias,tinnitus,blurred vision,delirium or seizures
Nitroglycerin should be avoided in pts with
Inferior wall MI
DOC for hypertensive emergencies in pregnancies
Labetolol
situations in which labetolol is beneficial
Conditions of adrenergic excess
Clonidine withdrawal
pheochromocytoma
Post coronary bypass grafting
Half life of labetolol
5-8 hours
role of parenteral esmolol in Hypertension
aortic dissection,used along with nitroprusside
Parenteral agent used in postoperative hypertension
Nicardipine
role of fenoldopam
High risk hypertensive surgical patients
Drug used in hypertensive urgencies as oral loading
clonidine
toxicity of nitroprusside in liver failure
cyanide toxicity
Dosage of nitroglycerin
5-250ug/min
Goal in hypertensive emergency
20-25% reduction of MAP or reduction in DBP to 100 or 110mm HG
When should treatment of hypertension in pregnancy begin
when DBP is >100 mm Hg
For whom does BP classification apply
adults overs 18 yrs of age,not on antihypertensives,not acutely ill
acute withdrawal syndrome in hypertension is associated with use of which drugs
Centrally acting adrenergic agents particularly clonidine
betablockers
secondary causes of hypercholesterolemia
hypothyroidism
nephrotic syndrome
Indications for fasting cholesterol
total cholesterol > 200mg/dl or HDL < 40mg/dl
When should screening for hypercholesterolemia begin
age more than 20yrs
Low HDL cholesterol
Less than 40mg/dl
primary target of therapy for pts with low HDL cholesterol
LDL cholesterol
relation between estrogen and blood lipids
increases triglycerides and HDL
The lipid lowering effect of statins appear within
1 week
Role of omega 3 fatty acids in dyslipidemia
reduce triglycerides in combo with statins
Most effective pharmacologic agents for raising HDL levels
niacin
Effect of standing on blood pressure
fall in systolic pressure and rise in diastolic pressure
Lying and standing BP should be obtained periodically in all hypertensives over the age of
50
Anti hypertensive agent effective in slowing down cognitive impairment
CCB(sys-EURO trial)
effect of menopause on BP
BP rises
Effect of HRT on BP
Modest..It should not preclude its use in normotensive or hypertensive pts
Contraceptive induced hypertension is equivalent to
progestogenic component
BP in first trimester
falls
fetal loss and acceleration of maternal renal disease occurs if creatinine is more than
1.4mg/dl
SBP should be lowered to _________ mm Hg in aortic dissection
100
Bladder volume above ___________ ml cause hypertension
300 ml
agent of choice in management of hypertensive emergency in ischemia pts
nitroglycerin
drug used to control intraoperative tachycardia
esmolol
OSA should be suspected in hypertensive patient with BMI more than
27kg/m2
Hypertensive choroidopathy is seen in
young hypertensives due to eclampsia or pheochromocytoma
Findings of hypertensive choroidopathy
Elschnig spots
Siegrist streaks
Eye and hypertension
retinopathy
choroidopathy
optic neuropathy
quantitatively the largest risk factor for cardiovascular diseases
hypertension
isolated systolic hypertension
SBP> 140 mm
DBP< 90 mm
