Hypertension Flashcards
JR, a 52 year old Mexican male, has hypertension and he is currently taking Lotrel. His BP today is 151/91 mmHg. Which of the following medication recommendations would be in accordance with JNC 8? (Select ALL that apply.)
Answer
A Change Lotrel to Exforge HCT B Change Lotrel to Tekturna C Add on hydrochlorothiazide D Add on valsartan E Change Lotrel to Azor
A
Change Lotrel to Exforge HCT
C
Add on hydrochlorothiazide
Patient is not at goal…
-He is currently on Lotrel (Amlodipine/benazepril) and thus requires a third agent.
- Exforge HCT (Amlodipine, valsartan and HCT) Is appropriate
- Tekturna is aliskiren, this is just wrong
- Add on HCT to current regimen is appropriate
- Valsartan not appropriate because already on a RAAS drug
- Change Lotrel to Azor (Amlodipine/olmesartan) is basically the same as Lotrel so this is wrong
BF is a 71 year old African-American female with hypertension. Her last BP reading was 165/101 mmHg and she is willing to be started on medication. According to JNC 8, which of the following statements are correct for treating hypertension in BF? (Select ALL that apply.)
Answer
A
BF should be started on either an ACE inhibitor, ARB, CCB and/or thiazide-type diuretic.
B
BF should be started on either a CCB or thiazide-type diuretic.
C
BF should be treated to a goal BP of < 150/90 mmHg.
D
BF should be treated to a goal BP of < 140/90 mmHg.
E
It is strongly recommended to start BF on two medications initially.
B
BF should be started on either a CCB or thiazide-type diuretic.
C
BF should be treated to a goal BP of < 150/90 mmHg.
BF should be treated to a goal BP of < 150/90 mmHg using thiazide-type diuretics or CCB, alone or in combination. While initiating two medications can be considered in patients with SBP > 160 mmHg, it is not strongly recommended (more of a clinical decision) and this patient is only 15/11 mmHg above her goal.
TR, a 59 year-old white male, has been diagnosed with hypertension. He also has diabetes. His blood pressure runs between 170-174/97-99 mmHg. Choose an appropriate initial treatment regimen for this patient according to JNC 8? (Select ALL that apply.)
Answer
A Losartan and hydrochlorothiazide B Amlodipine and benazepril C Lisinopril and irbesartan D Amlodipine and aliskiren E Amlodipine and hydrochlorothiazide
A Losartan and hydrochlorothiazide B Amlodipine and benazepril E Amlodipine and hydrochlorothiazide
A patient gave the pharmacist a prescription for Cozaar she needed filled. Her other medication is Yaz contraceptive pills. The pharmacy is in a supermarket and the pharmacist notices the patient has Morton Salt Balance in her shopping cart, which contains potassium chloride. Which of the following are correct counseling statements for this patient? (Select ALL that apply.)
Answer
A
Her new medication is safe in pregnancy.
B
Yaz can increase potassium.
C
Her new medication can cause a dry, hacking cough.
D
Her new medication, and the salt substitute, can increase her potassium.
E
Her new medication can decrease the effectiveness of Yaz.
B
Yaz can increase potassium.
D
Her new medication, and the salt substitute, can increase her potassium.
A patient has been started on hydrochlorothiazide. Which of the following statements are correct? (Select ALL that apply.)
Answer
A Blood glucose can increase B LDL can decrease C Uric acid can increase D Sodium can increase E Magnesium can decrease
A Blood glucose can increase C Uric acid can increase E Magnesium can decrease
YP has hypertension. He states he feels fine and cannot believe he has to take medication but because his physician told him to, he began to take lisinopril 10 mg daily. He developed an irritating, dry cough and was switched to irbesartan. He took the irbesartan for awhile then stopped using it. Which of the following factors can contribute to poor medication adherence in patients with hypertension? (Select ALL that apply.)
Answer
A
Lack of understanding of the need to take medication
B
Inability to afford the medications
C
Side effects from the medications
D
Hypertension is asymptomatic; therefore, the patient does not experience any symptom relief
E
The patient does not believe in taking medications
A
Lack of understanding of the need to take medication
B
Inability to afford the medications
C
Side effects from the medications
D
Hypertension is asymptomatic; therefore, the patient does not experience any symptom relief
E
The patient does not believe in taking medications
What is the mechanism of action of clonidine?
Answer
A
Acts as an alpha-1 agonist, resulting in a decrease in norepinephrine release
B
Acts as an alpha-1 antagonist, resulting in an increase in norepinephrine release
C
Acts as an alpha-2 agonist, resulting in a decrease in norepinephrine release
D
Acts as an alpha-2 antagonist, resulting in a decrease in norepinephrine release
E
Acts as an alpha-1 and alpha-2 antagonist, resulting in an increase in norepinephrine release
C
Acts as an alpha-2 agonist, resulting in a decrease in norepinephrine release
By acting as an alpha-2 receptor agonist, norepinephrine outflow is reduced. This is called reducing sympathetic outflow.
Diltiazem and verapamil affect the hepatic metabolism of other drugs. This is due to the following reason:
Answer
A They are CYP 450 3A4 inducers. B They are CYP 450 3A4 inhibitors. C They are CYP 450 2D6 inducers. D They are CYP 450 2C9 inducers. E They are CYP 450 2C19 inhibitors.
B
They are CYP 450 3A4 inhibitors.
A patient gave the pharmacist a prescription for Accupril 40 mg PO daily. Which of the following is an appropriate generic substitution for Accupril?
Answer
A Fosinopril B Ramipril C Benazepril D Trandolapril E Quinapril
E
Quinapril
A patient has diabetes, microalbuminuria and a BP of 151/93 mmHg. The patient has no other co-morbid conditions. Which drug would be the first-line antihypertensive for this patient?
Answer
A Losartan B Atenolol C Hydrochlorothiazide D Hydralazine E Amlodipine
A
Losartan
ACE inhibitors and angiotensin receptor blockers should be used first-line in patients with diabetes and microalbuminuria.
