Hypertension Flashcards
What’s in Zestoretic?
What’s in Hyzaar?
What’s in Benicar HCT?
Lisinopril/HCTZ
Losartan/HCTZ
Olmesartan/HCTZ
What’s in Diovan HCT?
What’s in Lotrel?
What’s in Exforge?
Valsartan/HCTZ
Benazepril/Amlodipine
Valsartan/Amlodipine
What’s in Tenoretic?
What’s in Ziac?
What’s in Maxzide/maxzide-25/dyazide?
Atenolol/Chlorthalidone
Bisoprolol/HCTZ
Triamterene/HCTZ
What’s the thiazide diuretics MOA?
What are the thiazide diuretics side effects?
What are thiazide diuretics special notes?
inhibits sodium reabsorption in the distal convoluted tubules. increased excretion of sodium, chloride, water, and potassium.
Ci’d in hypersensitivity to sulfonamide-derived drugs. Watch for hypokalemia, magnesemia, natremia, hypercalcemia,uricemia, lipids, glycemia.
CrCl<30 not effective, take early to avoid nocturia, chlorothiazide is the only medication available IV. Can decrease lithium clearance and increase risk of lithium toxicity.
What are the common side effects of the dihydropine CCB’s?
What are the special notes and monitoring for the dCCB’s?
What are the special things to know about clevidipine?
Hypotension, Nifedipine IR: do not use for chronic hypertension or acute BP reduction. Side effects are peripheral edema, flushing, headache, palpitations/tachycardia, gingival hyperplasia.
monitor peripheral edema, amlodipine is safest in heart failure with reduced ejection fracture, nifedipine ER is a drug of choice in pregnancy. Amlodipine(Norvasc), Nifedpine ER(Adalat CC, Procardia XL), Nicardipine IV(Cardene IV).
CI’d in allergy to soybeans, soy products, eggs, hypotension, reflex tachycardia, hypertriglyceridemia, infections. lipid emulsion(2kcal/mL), milk-white, strict aseptic technique and use in 12 hours.
What to know about nonDHPCCB’s?
What are the CCB’s drug interactions?
What to know about the ACEinhibitors?
Verapamil(calan, verelan) and diltiazem(cardizem). May worsen HF symptoms, edema, constipation(verapamil more), gingival hyperplasia.
nonDHP’s are moderate inhibitors cyp3a4, so lower doses of simvastatin or lovastatin. Avoid grapefruit juice, watch for additive effects with beta blockers, digoxin, clonididne.
Benazepril(lotensin), Enalapril(vasotec), enalaprilat(vasotec IV), Quinapril(accupril), Lisinopril(zestril, prinivil), Rampril(altace). BBW of injury and death to developing fetus, discontinue in pregnancy. Watch for angioedema, hyperkalemia, cough, use within 36 hours CI’d when using neprilysin inhibitor, watch for renal impairment.
What to know about the sartan’s?
What are your heart failure beta blockers?
What are the beta blockers side effects?
Irbesartan(Avapro), Olmesartan(Benicar), Losartan(Cozaar), Valsartan(Diovan). No washout period with neprilysin. Olmesartan has sprue-like enteropathy. RAAS can lower lithium renal clearance and increase risk of lithium toxicity.
Carvedilol, Bisoprolol, Metoprolol.
Do NOT discontinue abruptly, taper dose(boxed warning), Caution in diabetes(can mask hypoglycemia symptoms and can make hyper or hypoglycemia worsE). Watch for fatigue, dizziness, depression, Lopressor or Toprol XL should be taken immediately with or following food. Metoprolol tartrate IV is not equivalent to PO(IV to po is 1:2.5)
What are the beta 1 selective blockers? AMEBBA
Which beta 1 selective blocker has nitric oxide dependent vasodilation?
What are your non selective beta blockers?
Atenolol(Tenormin), Esmolol(Brevibloc), Metoprolol succinate and tartrate(toprol XL and lopressor). Atenolol,Metoprolol, Esmolol, Bisoprolol, Betaxolol, Acebutolol.
Nebivolol(Bystolic).
Propanolol(inderal, innopran). Propanolol has high lipid solubility, more cns side effects, useful for migraine prophylaxis.
What are your non selective beta blockers and alpha 1 blockers?
What are the alpha 2 agonists?
What are the alpha 2 agonists side effects?
Carvedilol(coreg), Labetalol. Take carvedilolw ith food, dosing conversions are not 1:1. Labetalol is drug of choice in pregnancy.
Clonidine(catapres), guanfacine, and methyldopa.
Methyldopa CI’d with MAOI’s. Do not discontinue abruptly(rebound hypertension), must taper. Watch for dry mouth, somnolence, fatigue, dizziness, constipation, decreased HR and hypotension. Clonidine patch can cause skin rash, itching, erythema. Methyldopa can cause DILE. Remove clonidine patch weekly(remove before MRI), Methyldopa drug of choice in pregnancy.
What is the direct renin inhibitor and what to know about it?
What’s your direct vasodilators and what to know about them?
Aliskiren. BBW of injury and death to developing fetus, discontinue as soon as pregnancy is detected. Do not use with ACEI and ARB in pregnancy. Angioedema, hyperkalemia, renal impairment(avoid in renal artery stenosis).
Hydralazine. DILE warning, watch for headache, hypotension, reflex tachycardia, palpitations. Minoxidil- flui retention, tachycardia, hair growth, potent antihypertensive. OTC topical for hair growth.
