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AmCare Exam 1 > Hypertension Medications > Flashcards

Hypertension Medications Flashcards

1
Q

Consequences of uncontrolled HTN

A 
Stroke
Heart failure
Erectile dysfunction
Vision loss
Heart attack
Kidney disease/failue
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2
Q

Steps for picking the right agents

A 
Safety
Tolerability
Effectiveness
Price 
Simplicity (once daily dosing)
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3
Q

Thiazides Drugs

A

HCTZ
Chlorthalidione
Indapamide

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4
Q

Thiazide Benefits

A 
- Great HTN BP lowering
Proven benefits in CV morbidity and mortality
Once daily
Cheap
Can be combine with other meds
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5
Q

Thiazides are not effective when?

A

CrCl is less than 30 mL/min

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6
Q

Thiazide ADR Profile

A 
Hypokalemia
Hyponatremia
Hypomagnesemia
Increased frequency of urination
Hyperuricemia (gout)
Volume depletion
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7
Q

Thiazide CI

A

Lower than normal K, Na, Mg
Sulfa allergy
Existing severe/uncontrolled gout

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8
Q

Calcium Channel Blockers

A

Non-DHP (verapamil and diltiazem)

DHP (amlodipine, felodipine, nifedipine)

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9
Q

NonDHP Use

A

Cardio-selective

Good for A fib

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10
Q

DHP Use

A

Peripherally selective
Better for essential HTN to reduce CV events
- Once daily and cheap

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11
Q

NonDHP ADRs

A

Bradycardia
Constipation
HA

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12
Q

DHP ADRs

A

Edema

HA

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13
Q

NonDHP CI

A

Low pulse
HF
AV block
Sick sinus syndrome

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14
Q

DHP CI

A

Existing edema

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15
Q

Calcium Channel Blocker CI

A

Clarithromycin

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16
Q

ACEi/ARB Benefits

A

QD to BID dosing
Cheap
CV morbidity and mortality benefit

17
Q

ACEi/ARB downside

A

Low renin activity (black population) leads to lower BP effects

18
Q

ACEi/ARB ADRs

A

Hyperkalemia
Angioedema
Cough
Transient increase in SCr

19
Q

Beta Blockers ADRs

A

Bradycardia
Dysrhythmias
Fatigue/lethargy

20
Q

Beta Blockers CI

A

AV block
Bradycardia
Severe asthma/COPD (edema)

21
Q

Changeable HTN Risk Factors & Non-changable

A 
Weight
High sodium
Alcohol
Lack of physical activities
Smoking
Stress
Non-changable: Aging, Race Family History Gener
22
Q

JNC 8 Guidelines for Less than 60

A

Goal: less than 140/90

23
Q

JNC8 Guidelines for greater than 60

A

Goal: less than 150/90

24
Q

JNC8 Guidelines for CKD

A

Goal: less than 140/90

First-line: ACEi/ARB

25
Q

JNC8 Guidelines for DM

A

Goal: less than 140/90

First-line: ACEi/ARB

26
Q

JNC8 Initial Treatment for Non-black population +/- DM

A

Thiazide
CCB
ACEi/ARB

27
Q

JNC8 Initial Treatment for black population +/- DM

A

Thiazide CCB

28
Q

ASH/ISH Guidelines Pre-HTN

A

SBP 120-139 mmHg

DBP 80-89 mmHg

29
Q

ASH/ISH Guidelines Stage 1

A

SBP 140-159 mmHg

DBP 90-99 mmHg

30
Q

ASH/ISH Guidelines Stage 2

A

SBP greater than 160 mmHg

DBP greater than 100 mmHg

31
Q

ASH/ISH Guidelines Essential HTN less than 80

A

Goal: less than 140/90

Including DM, CKD, CAD

32
Q

ASH/ISH Guidelines Essential HTN greater than 80

A

Goal: less than 150/90

Excluding DM and CKD

33
Q

ASH/ISH Guidelines First line Option for White/non-black less than 60

A

Initial: ACEi/ARB

34
Q

ASH/ISH Guidelines First line Option for White/non-black greater than 60

A

Initial: CCB or thiazide then ACEi/ARB

35
Q

ASH/ISH Guidelines First line Option for blacks all ages

A

Initial: CCB or thiazide

36
Q

***Secondary CAD BP Recommendations

A

AHA/ACCF and ACP/ACC

Recommend starting with a beta blocker + ACEi/ARB

37
Q

***Secondary DM Recommendation

A

ADA recommends taking one or more medications at night

38
Q

***Secondary CKD Recommendation

A

KDIGO recommends
 BP with or without DM but with INCREASED urine albumin excretion >30 mg/24 hr): less than 130/80 (ACEi/ARB)
 BP with or without DM with NORMAL urine albumin excretion >30 mg/24 hr): less than 140/90

39
Q

Increase or Add-On Therapy?

A

Either but it is 5X more effective to add another agent than to just increase a dose

AmCare Exam 1 (4 decks)

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