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NAPLEX STUDY > Hypertension/HF > Flashcards

Hypertension/HF Flashcards

1
Q

1st line for htn

non black

A

thiazide
dhp ccb
ace or arb

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2
Q

1st line for htn

A

thiazide or dhp ccb

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3
Q

1st line for htn

ckd stage 3 or albumineria

A

ace or arb

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4
Q

when 2 start 2 drugs in htn

A

if stage 2 htn AND BP?20/10 above goal

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5
Q

meds that can worsen htn

A

amphetamine and adhd
cocaine
decongestants(pseudofed)
erythropoiesis-stimulating agents (by increasing blood viscosity)
immunosupprents (e.g cyclosporine)
nsaids
steroids

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6
Q

Lisinopril/hctz brand name

A

Zestoretic

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7
Q

Losartan/ hctz

A

Hyzaar

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8
Q

olmesartan/ hctz

A

Benicar HCT

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9
Q

valsartan/hctz

A

Diovan HCT

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10
Q

benazepril/amlodipine

A

Lotrel

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11
Q

valsartan/amlodipine

A

exforge

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12
Q

Highlights for thiazides

A

contraindicated w. sulfa allergy
side effects: decrease K, Na, Mg
increase ca, ua, bg, ldl/tg
dosing: start at 12.5 mg daily
MDD: Chlorthalidone 25mg daily, hctz 50 mg daily

not effective if Crcl<30 ml/min

DDI: nsaids, lithium

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13
Q

DHP CCBS

A

vasodilatory effects
minimal cardiac effect

**amlodipine safest dhp ccb for bp control in pt w dhp

NIFEDIPINE ir NOT USED IN HTN

can cause gingival hyperplasia

cyp3a4 substrates (ex: clevidipine)

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14
Q

non dhp ccbs

A

bradycardia
constipation
do not use in heart failure

can cause gingival hyperplasia

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15
Q

clevidipine

A

dhp ccb in a lipid emulsion
provides 2kcal/mL
hyperTG
si w soybean, soy , or egg allergy
change bottle and tubing q12h due to risk of bacterial growth in lipid emulsions
IV

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16
Q

ACE ARB

A

CI: pregnancy
angioedema
bilateral renal artery stenosis
-356 hour of entresto

cough, Increase potassium, renail impairment
drugs: lithium

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17
Q

olmesartan SE

A

DIARRRHEA and weightloss

18
Q

beta blockers

A

not first line unless compeling indication
common side effects: decreased hr, fatigue, dizziness, depression

additive risk of bradycardia w. non dhp ccb, digoxin, amiodarone, clonidine

metoprolol notes:
metoprolol and labetalol must be taken w food or immediately after eating

10 mg iv metoprolol =25 mg PO metoprolol

19
Q

drugs that cause drug induced lupus DILE

A

methyldopa
hydralizine

20
Q

other drug classes

a2- agonists

A

decrease sympathetic outflow

clonidine (catapress)-
change patch q7days
can cause rebound htn if taken off abruptly
Clonidine (Kapvay not for htn)

21
Q

Hypertensive crisis
hypertensive urgency vs emergency

A

emergency: target organ damage
ex: stroke, MI, flash pulmonaryedema, damage to kidneys, encephalopathy

22
Q

treatment of hyperensive urgency

A

decrease bp gradually over 1-2 days
PO: captopril, labetalol, clonidine, hydralizine

23
Q

treatment of hypertensive emergency

A

kidneys/heart/brian failinng
decrese bp by 25% in the first hour. then gradual lowering
IV: clevedipine, nitroprusside (cyanide toxzicity),
ntg (mi)
nicardipine, labetalol (stroke)

24
Q

drugs that can cause worsen of HF

A

ddp4 inhibitors (alogliptin)

immunosupressants (tnf inhibitors like infklixamab)

non chb ccb

antiarrythmics (less risk w. amiodarone. Class 1)

tzd’s (pioglitazone)

itraconazole

anthracyclines

nsaids

25
Q

hfpef EF aka diastolic hf

A

IMPAIRD VENTRICULAR RELAXATION AND FILLING DURING DIASTOLE
>/50%

26
Q

hfmref EF

A

40-50%
mized systolic and diastolic dysfunction

27
Q

Hfref ef

A

aka systolic dysfunction
impaired ability to eject blood during systole

28
Q

which drugs have a motarlity benefit in HF

A

BB (carvedilol, bisoprolol, metoprolol)
ACE/ARBS/arni
ARA
sglt2

BIDIL( isosorbide nirate/ hydralazine) not 1st line

29
Q

which drugs can be used in hf but dont have mortality benefit

A

digoxin
loop diuretics

30
Q

loop diuretics in hf

A

dont decrease mortality
sulfa allergy- choose ethacrynic acid
ototoxicity

furosemide iv:po 1:2

20 mg iv=40 mg PO furosemide

31
Q

Target doses of ace in HF

A

most aCE is 40 mg FOR hf
*ENALAPRIL 20 MG bid

RAMIPRIL 10 mg

32
Q

target does of arbs in HF

A

losartan -50-150 mg daily
valsartan 150 mg bid

33
Q

ARAS RISKS

A

do not use if K>5 or Crcl<30

34
Q

BIDIL

A

isosorbide nirate/ hydralazine) not 1st line

only use in black pts.

35
Q

meds decreases hospitalizations in hf

A

ivabridine (should be in normal sinus rhythm, hr atlest 70 bpm and should be on a beta blocker target dose

digoxin- therepeutic range 0.5-0.9 in HF( higher levels increase rate of mortality
increases contractility
renally cleared
toxicity-n/v, decreased appetite, decreased hr, yellow green vision, arrythmias
antidoite: digifab

36
Q

electrolyte imbalances that increase risk for digoxin toxicity

A

hypokalemia
hypomagnesemia
hypercalcemia

37
Q

target doses in hf for BB

A

metoprolol xl: 200 mg/day
carvedilol 25 mg bid (in pts who weigh <85 kg

38
Q

zestril is brand name for

A

lisinopril

39
Q

Coozar is brand name for

A

losartan

40
Q

olmesartan is generic for

A

benicar

41
Q
A

NAPLEX STUDY (7 decks)

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