Hypertension

Question 1

What HTN diagnosing criteria must be met in order to label an individual’s as having HTN

Answer 1

3 abnormal BP readings unless >180/110 or evidence of TOD

Question 2

What is some important patient teaching with HTN

Answer 2

Sodium restriction
DASH diet
Weight reduction 
Moderate ETOH
Smoking cessation
Aerobic exercise

Question 3

At what range of BP should an individual without diabetes or CKD be before initiating medication?

Answer 3

140/90 or greater

Question 4

An individual that’s greater than 60 must have a BP above what range to be started on medication?

Answer 4

150/90

Question 5

If a patient has diabetes or CKD, no matter the age, what range should you have in order to start a BP medication?

Answer 5

140/90

Question 6

JNC-8 recommend what as first line choices for Caucasian individual with HTN are what?

Answer 6

1. ACE/ARB
2. HCTZ
3. CCB

Can add on up to 3 while reinforcing diet and exercise

Question 7

For a AA individual with HTN what are your top choices for HTN

Answer 7

HCTZ

CCB

Question 8

If patient has HTN and CKD or DM should be prescribed what medication?

Answer 8

ACEI or ARB

Question 9

If a patient had HTN and known HF or CAD which medication is important to have in the regimen?

Answer 9

BB

Question 10

What group of patients should NOT get HCTZ?

Answer 10

Renal patients - they can’t excrete the medication

Question 11

What are SE of ACEI?

Answer 11

Angioedema- life threatening stop medication and Never give ACEI or ARB again!

Cough- from bradykinin build up, switch to ARB

Pregnancy category X

Question 12

Which two BP meds should never be given together?

Answer 12

ACEI/ARB

Question 13

Calcium channel blockers are 2 classes of medications. What are the two classes?

Answer 13

Dihydropyridines- amlodipine

Nondihydropyridines- diltiazem, varapamil

Question 14

Dihydropyridines like amlodipine are more potent at this effect then the other class of CCB…

Answer 14

Vasodilators. They don’t slow rate and can be given with BB

Question 15

Non dyhydropyridines like diltiazem should never be given with BB. This is because they do what

Answer 15

Have an effect on cardiac conduction and can slow rate during arrhythmias.

Question 16

Some relative contraindications of BB are what?

Answer 16

Asthma/COPD
Bradycardia
2-3 degree Heart block
DM/PVD

Question 17

Alpha 1 blockers like Doxazosin are good for men. This is because why?

Answer 17

It helps with both HTN and BPH

Question 18

What 2 medications for BP can be used during pregnancy?

Answer 18

Methyldopa (#1 used)
Hydralazine
BB

Question 19

What BP medication is good for extra-Long coverage especially in slow metabolizers?

Answer 19

Clonidine

Question 20

What are some causes of HTN emergency?

Answer 20

Hypertensive encephalopathy
ICH
Basal ganglia
Acute aortic dissection
Acute pulmonary edema
Unstable angina
Hypertensive nephropathy
Eclampsia
Drug use

Question 21

Why should you check a BP in both arms?

Answer 21

It will be different in: 
Aortic dissections
Subclavian steal syndrome
PVD
Coarctation of the aorta

Question 22

What is the difference between Hypertensive urgency and hypertensive emergency?

Answer 22

Organ damage in emergency

Question 23

How much do you want to lower the person with hypertensive emergency blood pressure in the first hour?

Answer 23

10-15%

A SBP goal of 160-180 is ideal

Question 24

What are the drugs of choice for treatment of Acute pulmonary edema induced hypertensive emergency?

Answer 24

Fenaldopam OR

Nitroprusside w/ loop diuretics and NTG

Question 25

Labetolol is used for what 4 causes of hypertensive crisis?

Answer 25

Acute MI

Hypertensive encephalopathy

Aortic dissection

Eclampsia

Question 26

What are the drugs of choice for treatment of Cocaine induced hypertensive emergency?

Answer 26

Verapamil, diltiazem or nicardipine with a benzo