Hypertension Flashcards by RICHARD TREAT

ARB Side effects

edema and hyperkalemia (messing with filtration)

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Alpha blockers indications

Works for BPH because it relaxes the muscles which allows you to pee (NOT for BP anymore)

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Alpha blockers Contraindication

orthostatic

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Calcium Channel Blockers have two main types

Dihydropyridines and Nondihydropyridines

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Alpha-1 blockers examples

doxazosin, terazosin, prazosin

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Initial treatment for patients without co-factors

Thiazide diuretic
CCB
ACEi
ARB

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Centrally-acting medications (clonidine) and direct vasodilators (minoxidil and hydralazine)
are only used for

resistant HTN after spironolactone

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ARB Contraindication

Pregnancy, hyperkalemia because you’re messing with the body’s filtration

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lisinopril is the DOC for

hepatic dysfunction

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First line is always

diuretic

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ACE inhibitors and ARBs: Promotes regression of left

ventricular hypertrophy

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What causes hypertension and heart damage? Increase in __ and ___

sympathetic nervous system and renin-angiotensin- aldosterone system activity (RAAS)

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Direct acting vasodilators should be combined with ___ and ____ -> due to reflex tachycardia and fluid retention

BBs and diuretics

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CCB Contraindication

heart block (because CCB effects the impulses in the heart)

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If you have DM you might not want to take BB because

its excreted renally

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Calcium Channel Blockers: Dihydropyridines end in

“ine”

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CCB indications

Old people with high SBP

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ACEis are good for diabetics because

they protect the kidney

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B1 vs B2: Loss of selectivity as

dose increases

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Diuretics Side effects

hyper and hypo everything (because you’re messing with the filtration of things)

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ACEi Contraindication

Because it’s a big gun, don’t use for pregnancy, and because it effects angiotensin don’t use if they have hyperkalemia

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Beta blockers Side effects

Think about the contraindications- It can cause bronchospasm, slow the heart TOO much, slow your lipido, also randomly can cause hyperlipidemia

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Aliskiren is not good for

pregnancy

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Alpha blockers Side effects

orthostatic (same as contraindication)

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Calcium Channel Blockers: benefit of Nondihydropyridines

delayed drug release for several hours after dosing; benefit when dosing in the evening

ACE inhibitors and ARBs: ___ neutral

Lipid

Initial treatment for black people with out DM

Thiazide diuretic or CCB

Direct acting vasodilators examples

minoxidil and hydralazine

Verapamil and diltiazem increase levels of d___, s____, l___

digoxin, simvastatin and lovastatin

What causes hypertension and heart damage? Changes in n___ peptides, g__ factors, inflammatory c____

natriuretic peptides, growth factors and inflammatory cytokines

BB can mask

hypoglycemia

Direct acting vasodilators are always

combined with something else

Centrally-acting medications examples

clonidine

between Propranolol and atenolol, which crosses the BBB more

propranolol

Beta- Blockers: first pass metabolism

Propranolol and metoprolol

Verapamil is what type of drug

CCB

ACE inhibitors and ARBs: Less effective in

Less effective in African American than Caucasian

____ and ____ improve mortality of CHF in African Americans

Hydralazine + nitrates

Sartans are aka

ARBs

Beta- Blockers: renal excretion

Atenolol and nadolol

sartans are

Angiotensin Receptor Blockers (ARBs)

Drug-Drug Interactions: ___ decrease effectiveness of anti-HTN medications

NSAIDs

Direct acting vasodilators should be combined with BBs and diuretics -> due to

reflex tachycardia and fluid retention

ACE inhibitors and ARBs: Prevents progression of diabetic

proteinuria

ACEi Side effects

Can cause a cough (april is when you get allergies), edema and hyperkalemia because it messes with angiotensin

What causes hypertension and heart damage? Increased vascular s____ and e____ dysfunction modifications in hemodynamic effects

Increased vascular stiffness and endothelial dysfunction modifications in hemodynamic effects

Cross blood brain barrier -> tremors

beta blockers

Beta- Blockers: More effective in

younger patients

Alpha-1 blockers (doxazosin, terazosin, prazosin) are reserved for

Patients with BPH (NOT used for HTN)

fosinopril

no dosage adjustment; undergoes compensatory eliminiation

HTN in Pregnancy: Preferred due to fewer side effects

Labetalol

two of the ADRs for Aliskiren

cough and decreased hemoglobin

Diuretics Contraindication

Gout; renal insufficiency | because its urine so renal is a factor, and gout has to do with uricemia

which class is a prodrug

ACE inhibitor

What should you eat when taking Aliskiren

not fatty food because it decreases absorption

Aliskiren is a ___ ____ i____

Direct Renin Inhibitor

methydopa can be used during

pregnancy

ACEi indications

This, along with beta blockers, is the other big gun. Use it for HF, previous MI, DM nephropathy/proteinuira

Aliskiren compared to ACEi and ARBs

just as effective

What causes hypertension and heart damage? decrease in the release of

vasodilators

Prils are aka

ACE inhibitors

B1 vs B2: better cardioselectivity

HTN in Pregnancy: Absolute contraindications

ACEI, ARBs, Aliskiren

Drug-Drug Interactions: Diuretics: Hypokalemia can cause ____ toxicity

digoxin

Hydralazine + nitrates improve

mortality of CHF in African Americans

direct vasodilators examples

minoxidil and hydralazine

ACE inhibitors and ARBs: Slows progression of

ESRD/HD

Calcium Channel Blockers: Nondihydropyridines end in

zem and pil

ACE inhibitors and ARBs: Equally effective in

young and geriatric population

Drug-Drug Interactions: Diuretics: Hyponatremia may increase ___ levels

lithium

Diuretics indications

Aunt Yai HAS it HF Age Systolic HTN

CCB Side effects

gingival hyperplasia

ARBs stands for

Angiotensin II receptor blockers

diltiazem is what type of drug

CCB

Calcium Channel Blockers: Dihydropyridines are more potent peripheral vasodilators than nonDHPs-> more:

flushing, peripheral edema, reflex tacchycardia, h/a, dizziness

Beta blockers indications

These ones are for the really serious things! | Previous MI, angina, HF, tachyarrhythmias, migraines

Calcium Channel Blockers: Dihydropyridines are more __ ___ ___ than nonDHPs

potent peripheral vasodilators

Treatment for stage 2 HTN (SBP over 20 and DBP over 10)

2 agents from 2 different classes

ARB indications

It's good for a cough caused be ACEi and CHF

Beta blockers Contraindication

Its a blocker, so don't take it for things where there's already a blocking problem: heart block, asthma, COPD

B1 is Beneficial in c___ and a___

COPD and asthma