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NAPLEX > Hypertension > Flashcards

Hypertension Flashcards

1
Q

Define secondary HTN

A

caused by renal disease (CKD) adrenal disease (exces aldosterone secretion), OSA, or drugs. There is increased activity of the sympathetic nervous system (SNS) and the RAAS, leading to increased levels of neurohormones (NE, ANG 2, aldosterone) that can increase BP

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2
Q

BP equation

A

SVR x CO

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3
Q

CO equation

A

Stroke volume x HR

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4
Q

normal BP

A

> 120/<80

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5
Q

elevated BP

A

120-129/<80

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6
Q

Stage 1 HTN

A

SBP 130-139 or DBP 80-89

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7
Q

Stage 2 HTN

A

SBP > 140 or DBP > 90

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8
Q

Drugs that can inc. BP (7)

A 
ADHD drugs
cocaine
Decongestants
ESA
Immunosuppressants
NSAIDs
Systemic steroids
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9
Q

BP goals

A

<130/80 for all patients

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10
Q

initial drug selection for non-black (4)

A

thiazide
ccv
acei
arb

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11
Q

initial drug selection for black (2)

A

thiazide

ccb

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12
Q

initial drug selection for CKD

A

acei

arb

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13
Q

initial drug selection for DM with albuminuria

A

acei

arb

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14
Q

BP meds CI in pregnancy

A

ACEi
ARB
DRI: aliskiren

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15
Q

Drugs of choice for HTN in pregnancy (3)

A

labetalol
nifedipine
ER methyldopa

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16
Q

When to treat HTN in pregnancy

A

if SBP > 160 or DBP > 105

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17
Q

Thiazide diuretic MOA

A

inhibit Na reabsorption in the DCT causing increased excretion of Na, Cl, H20, and K

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18
Q

Major allergy CI with thiazides

A

sulfonamide hypersensitivty

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19
Q

At what CrCl are thiazides not effective

A

CrCl < 30

20
Q

List DHP CCB

A

amlodipine
nifedipine
nicardipine

21
Q

List Non-DHP CCB

A

diltiazem

verapamil

22
Q

DHP CCB MOA

A

inhibit Ca ions from entering vascular smooth muscle and myocardial cells; this causes peripheral arterial vasodilation (which dec. SVR and BP) and coronary artery vasodilation.

23
Q

Common SE in DHP CCB (4)

A

reflex tachycardia
HA
flushing
peripheral edema

24
Q

DHP CCB to use in pregnancy

A

nifedipine ER

25
Q

Clevidipine is a lipid emulsion and provides how many kcal/mL

A

2 kcal/mL

26
Q

which CCB is preferred for HTN

A

DHP

27
Q

Non-DHP CCB indication

A

control HR in certain arrhythmias
sometimes HTN
sometimes angina

28
Q

Non-DHP CCB MOA

A

inhibit Ca ions from entering vascular smooth muscle and are myocardial cells, but they are more selective for the myocardium

29
Q

ACEi MOA

A

block the conversion of antiotensin 1 to 2 resulting in decreased vasoconstriction and dec. aldosterone secretion and block the degration of brady kinin

30
Q

ARB MOA

A

block Ang 2 from binding to the angiotensin 2 type-1 receptor on vascular smooth muscle preventing vasoconstriction

31
Q

Caution with entresto and ACEi

A

36 washout period required

32
Q

List K-sparing diuretics (4)

A

traimterene-Na channel inhibitor
amiloride-Na channel inhibitor
spironolactone-aldosterone antagonist
eplerenone-aldosterone antagonist

33
Q

preferred add on treatment for patients with resistant HTN

A

spironolactone

epleronone

34
Q

resistant HTN

A

uncontrolled BP despite max tolerated dose of CCB + thiazide +ACEi/ARB

35
Q

difference b/w spironolactone and epleronone

A 
spironolactone
-non-selective
-also blocks androgen
epleronone
-selective
-no endocrine SE
36
Q

K-sparing diuretic MOA

A

compete with aldosterone at receptor sites in the DCT and CD, increasing Na and H2O excretion and conserving K

37
Q

Major SE of spironolactone

A

gynecomastia
breast tenderness
impotence

38
Q

BB MOA

A

competitively blocking beta-1 and/or beta-2 adrenergic receptors resulting indecreases in HR nad myocardial contracility

39
Q

major BB that are beta-1 selective (3)

A

atenolol
esmolol
metoprolol

40
Q

caution with BB in DM

A

can worsen hyperglycemia or hypoglycemia and mask hypoglycemic symtpoms

41
Q

alpha-2 agonist MOA

A

decrease BP by stimulating alpha-2 receptors in the brain and reducing sympathetic outflow of norepinephrine, which decreases SVR and HR

42
Q

List Alpha-2 agonist

A

clonidine
guanfacine
methyldopa

43
Q

caution with d/c a-2 agonists aburptly

A

rebound hypertension

44
Q

List vaodilators (2)

A

hydralzine

minoxidil

45
Q

define HTN crisis

A

BP > 180/120
2 types
-HTN emergency: acute target organ damage (encephalopathy, stroke, AKI, ACS)
-HTN urgency: no acute organ damage

NAPLEX (65 decks)

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