Hypertension Pharmacotherapy Flashcards
Diastolic hypertension with or without systolic hypertension
Monotherapy (1st line): TZD, b-blockers, ACEi, or DHP CCBs
Combo choices (2nd line): ACEi/CCB, ARB/CCB, ACEi or ARB/TZD
Isolated systolic hypertension without other compelling conditions
TZD, ARBs, or DHP CCBs
2nd line is the combo of the above options
HTN treatment in patients with DM with microalbumineria, renal disease, or additional risk factors
ACEi or ARBs
HTN treatment in patients with uncomplicated DM
ACEi, ARBs, DHP CCBs, or TZDs
HTN treatment in patients with coronary artery disease (CAD)
ACEi or ARBs
beta-blockers or CCBs if stable angina
HTN treatment in patients with recent MI
beta-blockers and ACEi (can use ARBs if pt. has ACEi intolerance)
HTN treatment in patients with HF
first line: ACEi, b-blockers, MRA
second line: Hydralazine/ISDN if ACEi or ARB is not well tolerated
TZD and DHP CCBs can be used for adjunct
HTN treatment in patients with LVH
ACEi, ARB, DHP CCB, or TZD
HTN treatment in patients with past stroke/TIA?
ACEi and TZD combo
HTN treatment in patients with non-diabetic CKD (with proteinuria)
ACEi
diuretics for adjunct therapy
What are some monitoring tips for diuretics in older adults?
Monitor electrolytes (hypokalemia and hyponatremia)
Orthostatic hypotension
Worsening urinary urgency/incontinence
What are some monitoring tips for ACEi/ARBs in older adults?
Generally well tolerated
Monitor K+ (can cause hyperkalemia)
What are some monitoring tips for CCBs in older adults?
May cause peripheral edema, especially at higher doses
Avoid non-DHP CCBs in HF
non-DHP CCBs have benefit in rate control for atrial fibrilation management
non-DHP CCBs can be constipating
What are some monitoring tips for beta-blockers in older adults?
Not reccomended in adults 60+ for HTN alone
May cause fatigue and decreased exercise intolerance
