Hypertension Flashcards
lab monitoring with HTN
creatinine UA TSH glucose K, Na, Ca lipid panel CBC (anemia)
causes of secondary hypertension
renal (renal artery stenosis, polycystic kidneys, CKD)
endocrine (hyperthyroidism, hyperaldosteronism, pheochromocytoma)
others (OSA, coarctation of aorta)
BP in arms higher than BP in legs
coarctation of the aorta
DBP >120 w/ clinical findings of organ damage (N/V, CVA/TIA, subarachnoid hemorrhage, MI, PE, ARF, retinopathy)
hypertensive emergency
diet recommended for prehypertension, HTN, weight loss
DASH diet
diet high in K, Mg, Ca w/ decreased red meat/processed foods, increased grains, legumes, fish, protein
DASH diet
important to monitor __ level with diuretics
potassium
medication class changes the way the kidneys handle sodium; increases urine output
thiazide diuretics
anti-htn medication - avoid if sulfa allergy
thiazide diuretics
medication class inhibits Na-K-Cl pump of the kidney in the loop of Henle
loop diuretics
medication class
furosemide (Lasix)
bumetanide (Bumex)
loop diuretics
medication class antagonizes the action of aldosterone; increases elimination of water in the kidneys and preserves potassium
aldosterone receptor antagonist diuretics
medication class indicated for htn, HF, hirsutism, precocious puberty
aldosterone receptor antagonist diuretics
medication class avoid combining with potassium-sparing diuretics, ACE-I, or potassium supplements
aldosterone receptor antagonist diuretics
medication class of spironolactone eplerenone (inspra)
aldosterone receptor antagonist diuretics
medication class avoid stopping abruptly - may cause severe rebound hypertension
beta blockers
medication class - MOA
decreases vasomotor activity, CO, inhibits renin and norepinephrine release
beta blockers
medication class - contraindications
asthma, COPD, 2nd/3rd degree heart block, sinus bradycardia
beta blockers
uses of medication class htn MI migraine glaucoma resting tachycardia angina pectoris post-MI
beta blockers
medication class - MOA
blocks voltage-gated calcium channels in cardiac smooth muscle and BVs resulting in systemic vasodilation
CCB
medication class - side effects headache ankle edema heart block/bradycardia reflex tachycardia
CCB
medication class - contraindications
2nd/3rd degree heart block
bradycardia
CHF
CCB
medication class nifedipine amlodipine verapamil diltiazem
CCB
medication class - MOA
blocks conversion of angiotensin I to II
ACE + ARB
medication class drug of choice with DM and/or CKD
ACE/ARB
medication class (htn)
category C in 1st trimester
category D in 2-3rd trimester
ACE/ARB
effects of ACE/ARB on fetus
fetal kidney malformations and fetal hypotension
medication class - contraindications
mod-severe CKD
renal artery stenosis
hyperkalemia
ACE/ARB
medication class
losartan
candesartan
olmesartan
ARB
medication class potent vasodilator; given at bedtime with slow titrations
alpha-1 blocker/agonist
or
alpha-adrenergic blocker
medication class - s/e
orthostatic hypotension
dizziness
reflex tachycardia
alpha-1 blocker/agonist
or
alpha-adrenergic blocker
medication class
terazosin
tamsulosin
alpha-1 blocker/agonist
or
alpha-adrenergic blocker
medication class indicated if both htn and BPH
alpha-1 blocker/agonist
or
alpha-adrenergic blocker
hypertension tx plan in HF patient
ACE or ARB 1st
may add BB, diuretic
hypertension tx plan in DM patient
ACE or ARB 1st
if AA can start w/ CCB or thiazide
hypertension tx plan in CKD patient
ACE or ARB 1st
can add CCB or thiazide
hypertension tx plan in CVA patient
ACE or ARB 1st
can add CCB or thiazide as 2nd line
s/s include copper/silver wire arterioles, AV nicking
hypertensive retinopathy
tx for elderly patients with isolated systolic htn
thiazide diuretic or CCB
which medication should women with htn + osteoporosis/osteopenia receive
thiazide diuretic (slow down calcium loss)