Hypertension Flashcards
How will hypertension commonly present?
Asymptomatic
Little observation of dizziness or headache
What diastolic pressure is indicative of hypertension?
Greater than 90
What systolic pressure is indicative of hypertension?
Greater than 140
Pulse pressure of what is a very good indicator of hypertension?
Greater than 65
What age group is most at risk for hypertension?
50 or older
Cause of primary hypertension?
No identifiable cause
What happens to peripheral resistance in hypertension?
Cardiac output?
Peripheral resistance increase
Cardiac output remains the same
Where does Carbonic anhydrase inhibitors act?
Proximal tubule
What do carbonic anhydrase inhibitors prevent from being reabsorbed?
Bicarbonate which means the simport doesn’t work to transport Na out and water won’t follow
Effect of long term diuretics on HR and CO?
Unchanged
Effect of long term diuretics on total peripheral resistance?
Decreased
Effect of long term diuretics on plasma volume?
Decreased on unchanged
Effect of long term diuretics on plasma renin activity?
Increased
What diuretics act in the loop of henle?
Loop Diuretics
Loop Diuretics inhibit what?
Na,K,Cl symport
Potassium drives what ions from the lumen into interstitial space?
Ca2+
Mg2+
Where do loop diuretics work?
Thick ascending limb
Clinical uses of Loop Diuretics? (2)
Edematous conditions
Acute pulmonary edema
When do you not want to use Loop diuretics?
Patients with sulfa allergies
Toxicities of loop diuretics?
Dehydration Hypokalemic metabolic alkalosis Ototoxicity Hyperuricemia Hypomagnesemia
In patients with normal renal function what type of diuretics do you want to use to treat hypertension?
Thiazides are more effective than loop diuretics in these patients
Which diuretics work in the distal convoluted tubules?
Thiazides
What symport does thiazide inhibit?
Sodium Chloride channel
Suffix that tells you a drug is a thiazide?
THIAZIDE
Thiazide drug you need to know?
Chlorthiazide
clinical uses of thiazides? (2)
Hypertension
Congestive heart failure
Contraindication for thiazide diuretics?
Sulfa allergies
Diuretics that act in the collecting tubule?
Na channel inhibitors
Reduced Na entry into cells in Amiloride collecting tube diuretics also reduces whaT?
K+ excretion
Toxicity of Amiloride collecting tube diuretics? (2)
Hyperkalemia
Hyperchloremic metabolic acidosis
Contraindications for Amiloride collecting tube diuretics? (2)
K+ supplements
ACE inhibitors
Clinical uses of Amiloride collecting tube diuretics?
CHF/hypertension
Reducing BP
What type of diuretic is Triamterene?
Collecting tube diuretic
Effect of Triamterne on BP?
No efficacy in lowering BP when used alone
Contraindications of Triamterne?
Kidney stones
K+ supplements
ACE inhibitors
Antagonist of Aldosterone?
Spironolactone
Action of Spironolactone? (2)
Block actions of aldosterone
Inhibition of 5a-reductase
Clinical uses of Spironolactone? (1)
Hypertension/CHF
Toxicities of Spironolactone? (5)
Hyperkalemia Hyperchloremic metabolic acidosis Gynecomastia Impotence Benign prostatic hyperplasia
Contraindications of Spironolactone?
K+ supplements
ACE inhibitors
Chronic renal insufficiency
Aldosterone antagonist that isn’t Spironolactone?
Eplerenone
How long does therapy with Eplerenone take?
4 weeks
What clinical problem do you use Eplerenone for?
Hypertension
Toxicities of Eplerenone? (2)
Hyperkalemia
Hypertriglyceridemia
Contraindications of Eplerenone? (4)
K+ supplements
CYP450 3A4 inhibitors
Diabetes associated with microalbuminuria
Chronic renal insufficiency
