Hypertension Flashcards

1
Q

Erythropoietin

A

replacement that increases RBC production. We give this to patients with severe anemia.

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2
Q

Amphetamines, cocaine, binge drinking, corticosteroidsoids, Estrogen, Decongestants, MOA inhibitors increase or decrease your bp?

A

increase

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3
Q

Difference between risk group A, B, C

A

1: No risk factors 2: has at least one risk factor; not including DM 3: Target organ damage/clinical cardiovascular disease and/or DM

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4
Q

if patient has stage 1 bp (140-159/90-99), what treatment options are there for risk group A, B, C?

A

1: lifestyle changes for 1 year to see if that helps 2: lifestyle changes for 6 months to see if that helps 3: drug therapy

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5
Q

If patient has stage 2 or 3 bp (160+/100+), what treatment options are there for risk group A, B, C?

A

1: Drug therapy 2: Drug therapy 3: Drug therapy

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6
Q

Clinical manifestations of HTN

A

Tinnitus, HA, Morning HA, Dizziness

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7
Q

Papilledema

A

Target organ damage

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8
Q

Type of antihypertensive med for Black people

A

Thiazide-type diuretic or CCB or ACE I or ARB

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9
Q

HTN Diet, What do you decrease, increase & limit?

A

Decrease in fat, sodium, sugar. Increase in Calcium, Potassium, Magnesium Limit Alcohol

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10
Q

DASH Diet: Grains & grain products consist of?

A

Carbs & fiber

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11
Q

DASH Diet: Vegetable & Fruits consist of?

A

Potassium, magnesium & fiber

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12
Q

DASH Diet: Low-Fat/Fat free milk products consist of?

A

Calcium, protein, potassium & magnesium

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13
Q

DASH Diet: Meats, poultry & Fish products consist of?

A

Protein & magnesium

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14
Q

DASH Diet: Nuts, seeds & beans products consist of?

A

Magnesium, potassium, protein & fiber

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15
Q

If male >65 yr old patient is trying to control his HTN, how many drinks should he have? <65? Women at any age?

A

1 drink a day; 2 drinks a day; 1 drink a day

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16
Q

Side effect of ALL antihypertensive meds?

A

hypotension. Don’t stand still for extended periods of time. Get OOB slowly

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17
Q

5 main antihypertensive drugs

A

Thiazide Diuretics, BB, ACE inhibitors, CCB, Angiotensin II receptor blockers (ARB)

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18
Q

Pharmacological management of HTN?

A

start with one antihypertensive at a low dose, If that doesn’t work increase dose or add a 2nd, if that doesn’t work then increase dose if that’s not effective then add another med.

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19
Q

Why are ACE inhibitors the med of choice for diabetics?

A

because they delay the progression to end-stage renal disease

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20
Q

ACE inhibitors end in?

A

pril

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21
Q

Vasotec (enalapril), Zestril (lisinopril), Accupril (quinapril), Quinapril (accupril), Altace (ramipril) are what type of antihypertensive

A

Ace inhibitors

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22
Q

Ace inhibitor side effects

A

a chronic dry couch which require stopping of drug, taste alterations, dizziness, skin rashes, Angioedema, sleep problems, tachycardia, hyperkalemia ( SO WATCH K+ LEVELS!)

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23
Q

ARBS do what to arteries?

A

dilates them

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24
Q

What medication decreases the effectiveness of Ace inhibitors?

A

NSAIDS

25
Q

What people may experience angioedema with Ace inhibitors?

A

Smokers & African Americans

26
Q

Ace inhibitors decrease BP and they are also used for…

A

post MI, Left ventricular hypertrophy, HF, renal disease, asymptomatic, atherosclerosis, protenuia/ESRF, DM, Raynauds

27
Q

How do ARBs effect preload & afterload??

A

it decreases them

28
Q

ARB’s end in?

A

sartan

29
Q

Losartan (Cozaar), Candesartan (Atacand), Irbesartan (Avapro), Valsartan (Diovan) are what type of antihypertensive?

A

ARB

30
Q

What other medication is often used with ARBs?

A

often used with a diuretic or they come as combination pills with HCTZ in them.

31
Q

ARBs are used to decrease BP and are also used….

A

post MI, left ventricular hypertrophis, HF, renal disease, proteinuria/ESRF, DM

32
Q

What do you need to watch for with patients taking ARBS?

A

have kidney function tests done regularly & electrolytes

33
Q

Atenolol (Tenormin), Metoprolol (Lopressor, Toprol), Propranolol (Inderal), Nadolol (Corgard), Acebutolol (Sectral) are what type of antihypertensive?

A

BB

34
Q

BB decrease BP and are also used…….

A

MI, Afib, tachy dysrhythmias, angina, HF, tachycardia, anxiety, hyperthyroidism, migraines (Timolol & Propranolol)

35
Q

BB what should you teach patient about BB

A

it can exacerbate Raynauds, check pulse, use carefully with COPD & DM, don’t use in young

36
Q

Beta 1 cells consist of

A

cardiac cells

37
Q

Beta 2 cells consist of

A

smooth muscle in bronchi and blood vessels & convert glycogen to glucose in the liver & muscles

38
Q

nonselective beta cells do what

A

block both beta 1 & beta 2 cells

39
Q

When beta 1 & beta 2 are blocked, what will happen? Lungs? Blood Glucose levels?

A

Broncoconstriction and decreased glucose levels

40
Q

Nonselective bb should be used cautiously with whom?

A

Asthma/Diabetics

41
Q

Nadolol (Corgard) & Propranolol (Inderal) are what type of antihypertensive?

A

Nonselective BB

42
Q

“BETA BLOCKER” side effects

A

Bradycardia, Exacerbates HF, Tired, Appetite loss, Bad dreams, Low state depression, Only occasionally able to preform, Contractility decreased, Knowledge deficit, Exacerbates asthma, Really nauseated

43
Q

what should you warn a patient about with BB?

A

lethargy, impotence, fatigue

44
Q

CCB side effects “A-G”

A

Abundant N&V, Bradycardia, Constipation, Dizziness, Edema, Falling sperm count, Gingival overgrowth. (Dihydropyridine CCB can worsen nephropathy)

45
Q

CCB is used for

A

systemic & pulmonary HTN, angina, arrhythmias, left ventricular hypertrophy, peripheral artery disease, asymptomatic atherosclerosis angina, cerebral vasospasm

46
Q

Dihydropyridine CCB end in? and what do they do?

A

“-dipine”. They decrease vascular resistance & arterial pressure.

47
Q

Amlodipine (Norvasc), Nicardipine (Cardene), Nifedipine (Procardia) are which kinds of antihypertensive?? and what are they used fo r?

A

Dihydropyridine CCB; only used for angina & HTN

48
Q

Which Dihydropyridine CCB is only used for HTN?

A

Felodipine (Plendil)

49
Q

Nondihydropyridine CCB’s are used only for?

A

Angina

50
Q

Diltiazem (Cardizem) & Verapamil (Calan, Isoptin) are what kind of antihypertensive and what are they used for?

A

Nondihydropyridine and they are used only for angina

51
Q

Nondihydropyridine do what?

A

They decrease the force of the heart contraction and reduce the oxygen demand and decrease vasospasm

52
Q

What should you teach a patient with CCB?

A

report dizziness, grapefruit juice increases blood drug levels and pharmacologic effects, Erythromycin may increase antihypertensive effect

53
Q

Thiazide Diuretics are used to decrease BP and are used with…

A

elderly with isolated systolic increase in BP, CHF

54
Q

Thiazaide Diuretics increase renal secretion of what?

A

Na, K+, & Mg

55
Q

Thiazide treatment can cause what?

A

gout

56
Q

With gout, you should avoid what and increase what?

A

avoid foods high in purines (Red meat, alcohol, fish, beans) and increase fruits and veggies. Eat radishes before any gouty meal, eat raw cucumber, vit c, drink lots of water

57
Q

Chlorothiazide (Diuril), Hydroclorothiazide (Esidrix, HCTZ) Metolazone (Zaroxolyn) are what type of antihypertensive?

A

Thiazide diuretic

58
Q

Thiazide side effects

A

hypokalemia, increased LDL, decreased HDL, gout, hyperlipidemia, hypercalcemia, hyponatremia

59
Q

What should you watch for with a patient on a thiazide diuretic?

A

check cholesterol, increase K+ consumption, med can decrease insulin secretion & decrease insulin sensitivity