Hypertension Flashcards
What HTN diagnosing criteria must be met in order to label an individual’s as having HTN
3 abnormal BP readings unless >180/110 or evidence of TOD
What is some important patient teaching with HTN
Sodium restriction DASH diet Weight reduction Moderate ETOH Smoking cessation Aerobic exercise
At what range of BP should an individual without diabetes or CKD be before initiating medication?
140/90 or greater
An individual that’s greater than 60 must have a BP above what range to be started on medication?
150/90
If a patient has diabetes or CKD, no matter the age, what range should you have in order to start a BP medication?
140/90
JNC-8 recommend what as first line choices for Caucasian individual with HTN are what?
- ACE/ARB
- HCTZ
- CCB
Can add on up to 3 while reinforcing diet and exercise
For a AA individual with HTN what are your top choices for HTN
HCTZ
CCB
If patient has HTN and CKD or DM should be prescribed what medication?
ACEI or ARB
If a patient had HTN and known HF or CAD which medication is important to have in the regimen?
BB
What group of patients should NOT get HCTZ?
Renal patients - they can’t excrete the medication
What are SE of ACEI?
Angioedema- life threatening stop medication and Never give ACEI or ARB again!
Cough- from bradykinin build up, switch to ARB
Pregnancy category X
Which two BP meds should never be given together?
ACEI/ARB
Calcium channel blockers are 2 classes of medications. What are the two classes?
Dihydropyridines- amlodipine
Nondihydropyridines- diltiazem, varapamil
Dihydropyridines like amlodipine are more potent at this effect then the other class of CCB…
Vasodilators. They don’t slow rate and can be given with BB
Non dyhydropyridines like diltiazem should never be given with BB. This is because they do what
Have an effect on cardiac conduction and can slow rate during arrhythmias.
Some relative contraindications of BB are what?
Asthma/COPD
Bradycardia
2-3 degree Heart block
DM/PVD
Alpha 1 blockers like Doxazosin are good for men. This is because why?
It helps with both HTN and BPH
What 2 medications for BP can be used during pregnancy?
Methyldopa (#1 used)
Hydralazine
BB
What BP medication is good for extra-Long coverage especially in slow metabolizers?
Clonidine
What are some causes of HTN emergency?
Hypertensive encephalopathy ICH Basal ganglia Acute aortic dissection Acute pulmonary edema Unstable angina Hypertensive nephropathy Eclampsia Drug use
Why should you check a BP in both arms?
It will be different in: Aortic dissections Subclavian steal syndrome PVD Coarctation of the aorta
What is the difference between Hypertensive urgency and hypertensive emergency?
Organ damage in emergency
How much do you want to lower the person with hypertensive emergency blood pressure in the first hour?
10-15%
A SBP goal of 160-180 is ideal
What are the drugs of choice for treatment of Acute pulmonary edema induced hypertensive emergency?
Fenaldopam OR
Nitroprusside w/ loop diuretics and NTG
Labetolol is used for what 4 causes of hypertensive crisis?
Acute MI
Hypertensive encephalopathy
Aortic dissection
Eclampsia
What are the drugs of choice for treatment of Cocaine induced hypertensive emergency?
Verapamil, diltiazem or nicardipine with a benzo
