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KC Cardio Module-1 > Hypertensive Pharm > Flashcards

Hypertensive Pharm Flashcards

1
Q

Lisinopril

A

(Vestril, Prinivil)

ACE inhibitor

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2
Q

Quinipril

A

Accupril

ACE-inhibitor

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3
Q

Ramapril

A

Altace

ACE-inhibitor

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4
Q

Benzapril

A

Lotensin

ACE-inhibitor

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5
Q

Enalapril

A

Vasotec

ACE-inhibitor

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6
Q

Aliskiren

A

(Tekturna)

Direct Renin Inhibitor

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7
Q

Candesartan

A

(Atacand)

ARB

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8
Q

Losartan

A

(Cozaar)

ARB

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9
Q

Valsartan

A

(Diovan)

ARB

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10
Q

Telmisartan

A

(Micardis)

ARB

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11
Q

Olmesartan

A

(Benicar)

ARB

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12
Q

Irbesartan

A

(Avapro)

ARB

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13
Q

Hydrochlorothiazide

A

(Hydrodiuril)

Thiazide diuretic

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14
Q

Clorthalidone

A

(Diuril)

Thiazide diuretic

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15
Q

Indapamide

A

(Lozol)

Thiazide diuretic

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16
Q

Metolazone

A

(Zaroxylyn)

Thiazide diuretic

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17
Q

Furosemide

A

(Lasix)

Loop diuretic

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18
Q

Torosemide

A

(Demadex)

Loop diuretic

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19
Q

Bumetanide

A

(Bumex)

Loop diuretic

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20
Q

Spironolactone

A

(Aldactone)
Aldosterone antagonist
Also potassium sparing

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21
Q

Eplerenone

A

(Inspra)

Aldosterone antagonist

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22
Q

Triamterene

A

(Dyazide or Maxide when combined with HCTZ)

Potassium sparing

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23
Q

Nifedipine

A

(Procardia, Adalat)

Dihydropyridine CCBs

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24
Q

Felodipine

A

(Plendil)

Dihydropyridine CCBs

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25
Q

Amlodipine

A

(Norvasc)

Dihydropyridine CCBs

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26
Q

Verapamil

A

(Calan)

Non-Dihydropyridine CCBs

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27
Q

Diltiazem

A

(Cardizem, Tiazac)

Non-dihydropyridine CCBs

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28
Q

Atenolol

A

(Tenormin)

Cardiospecific Beta Blockers

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29
Q

Bisprolol

A

(Zebeta)

Cardiospecific Beta Blockers

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30
Q

Metoprolol tartate

A

(Lopressor)

Cardiospecific Beta Blockers

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31
Q

Naldol

A

(Corgard)

Non-Selective Beta Blockers

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32
Q

Propanolol

A

(Inderal)

Non-Selective Beta Blockers

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33
Q

Minoxidil

A

Peripheral Vasodilators

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34
Q

Hydralazine

A

(Apresoline)

Peripheral Vasodilators

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35
Q

Methyldopa

A

Central Alpha-2 Agonists

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36
Q

Clonidine

A

(Catapres)

Central Alpha-2 Agonists

37
Q

Prazosin

A

(Minipress)

Alpha Blockers

38
Q

Doxazosin

A

(Cardura)

Alpha Blockers

39
Q

Terazosin

A

(Hytrin)

Alpha Blockers

40
Q

Carvedilol

A

(Coreg)

Mixed Alpha/Beta Blockers

41
Q

Labetalol

A

(Trandate)

Mixed Alpha/Beta Blockers

42
Q

Metoprolol succinate

A

(Toprol)

Cardiospecific Beta Blockers

43
Q

Nicardipine hydrochloride

44
Q

Nitroglycerin

45
Q

Labetalol hydrochloride

46
Q

Hydralazine hydrochloride

47
Q

Esmolol hydrochloride

48
Q

Sodium nitroprusside

49
Q

Pregnancy potential?

A

no ACE/ARB

50
Q

gout, hyponatremia, SSRI, or urinary incontinence

A

CCB, ACE/ARB

51
Q

no gout, hyponatremia, SSRI, or urinary incontinence

A

thiazide, CCB, ACE/ARB

52
Q

Consider these popuations when choosing a drug:

A
  • pregnant

- older than 80 y.o.

53
Q

Thiazide diuretics:

A
  • hydrochlorothiazide (hydrodiuril)
  • chlorthalidone (diuril)
  • indapamide (lozol)
  • metolazone (zaroxolyn)
54
Q

DRI’s:

A

aliskiren (tekturna)

55
Q

Loop Diuretics:

A
  • Bumetanide (bumex)
  • Torsemide (demadex)
  • furosemide (lasix)
56
Q

Potassium Sparing:

A

Spironolactone (aldactone)

Triamterene: dyazide and maxide w/ HCTZ

57
Q

Alodsterone Antagonists:

A

Spironolactone (aldactone)

eplerenone (inspra)

58
Q

ACE’s: (4)

A

lisinopril (vestril, prinivil)
ramipril (altace)
quinnipril (accupril)
benzapril (lotensin)

59
Q

ARB’s: (6)

A 
candesartan (atacand)
telmisartan (micardis)
irbesartan (avapro)
olmesartan (benicar)
valsartan (diovan)
losartan (cozaar)
60
Q

CCB’s: (3)

A

amlodipine (norvasc)
felodipine (plendil)
nifedipine (procardia, adalat)

61
Q

non-CCB’s: (2)

A

verapimil (calan)

diltiazem (cardizem; tiazac)

62
Q

Beta blockers: cardiospecific (3) and nonselective (2)

A 
cardiospecific (3):
- metoprolol succinate (toprol XL)
- metoprolol tartate (Lopressor)
- Bisoprolol (zebeta)
nonselective (2):
- naldol (Corgard)
- propanolol (inderal)
63
Q

Mixed alpha and beta blockers: (2)

A

Labetalol (trandate)

Carvedilol (coreg)

64
Q

Alpha-1 blockers: (3)

A

terazosin (hytrin)
prazosin (minipress)
doxazosin (cardura)

65
Q

Central alpha-2 agonists: (3)

A

clonidine (catapress)
methyldopa (aldomet)
guanfacine (tenex)

66
Q

Peripheral vasodilators: (2)

A

hydralazine (aspresoline)

minoxidil

67
Q

HTN in pregnancy preferred drugs:

A

labetalol, methyldopa, diltiazem

68
Q

Chronic HTN in pregnancy:

A

> 140/90 before 20 weeks gestation, pre-pregnancy, or 12 weeks post-pregnancy

69
Q

Gestational HTN/Pregnancy-induced HTN:

A

> 140/90 after 20 weeks gestation w/o proteinuria, which resolves 12 weeks post-pregnancy

70
Q

Preeclampsia in pregnancy:

A

> 140/90 after 20 weeks gestation w/ proteinuria

  • MC: nulliparious women, multiple fetuses, fam hx, or h/o HTN or renal dz
  • definitive tx: delivery
  • restrict activity, bed rest, and close monitoring
71
Q

Initial steps in Hypertensive ER:

A
  • loss of BP autoregulation

- abrupt rise in systemic vasculature resistance

72
Q

sodium nitroprusside use:

A

Most HT emergencies; caution w/ high ICP’s, azotemia, or in CKD

73
Q

nicardipine hydrochloride use:

A

Most HT emergencies, except acute HF; caution w/ coronary ischemia
- MC to drop BP in pt. w/ a cerebral bleed

74
Q

esmolol hydrochloride use:

A

aortic dissection; perioperative; cardiac cause; not acute HF

75
Q

nitroglycerin use:

A

Coronary ischemia or HF; venous vasodilator and great for fluid overload

76
Q

hydralazine hydrochloride use:

A

ecclampsia; MC w/ pregnancy; not a drip so not good for titration meds

77
Q

labetalol hydrochloride use:

A
  • Most HT emergencies, except acute HF

- BB w/ alpha-blockade

78
Q

Treatment guidelines in hypertensive emergency:

A

reduce MAP no more than 10-20% over minutes to 1 hour w/ IV meds; reduce 5-15% over 23 hrs in ICU under close monitoring of IV meds; over next days to weeks w/ oral meds for BP lowering

79
Q

Just placing these HTN emergent pts in a quiet room to rest caused:

A

BP to fall 20/10 in or more in 1/3rd of patients

80
Q

Hypertensive emergent w/u:

A
  • serum chemistries to detect AKI
  • UA to detect hematuria, proteinuria, RBC or RBC casts
  • CBC/peripheral blood smear if new onset
  • cardiac enzymes x 3
  • imaging: CXR; non-contrast CT
  • tox screen, preg screen, and endocrine testing
81
Q

Hypertensive emergent PE:

A
  • eyes: hemorrhages, exudates, papilledema
  • CV: CP, JVD, preipheral edema, crackles on auscultation, dyspnea, acute severe back pain
  • CNS: agitated, delirius, visual deficits, focal signs, sz; n/v if increased ICP
  • abdominal: masses or bruits
82
Q

Hypertensive emergency: ACS complication and tx

A
  • ACS, includes MI: Tx if SBP>160 or DBP>100 (reduce by 20-30%)
  • nitroglycerin and beta-blockers
  • C/I: thrombolytics if BP >185/100
83
Q

Hypertensive emergency: AHF complication and tx

A

*goal SBP <140mmHg
(1) loop diuretic IV often administered 1st if pt. volume overloaded
(2) nitroglycerin or nitroprusside to reduce afterload (vasodilators)
(never beta blocker-depresses cardiac contractility or hydralazine- increases cardiac work by vasodilating)

84
Q

Hypertensive emergency: sympathetic overactivity

A
  • cocaine toxicity, amphetamines
  • pheo
  • severe autonomic dysfx: cord injury; GBS
  • Beta-blocker alone is C/I
85
Q

ischemic stroke pt. recieving IV or intraarterial fibrinolysis w/ tpa tx goal:

A

BP goal <185 or <110

86
Q

acute ischemic stroke tx goal:

A

tx only if SBP >220 or DBP >120

- preferred drugs: labetalol or nicardipine

87
Q

acute aortic dissection tx goal:

A

rapidly lower SBP to 100-120 within 20 minutes

  • preferred tx: narcotic analgesics (morphine sulfate); BB (esmolol, labetalol); vasodilators (nitroprusside)
  • avoid BB w/ cardiac tamponade or aortic regurgitation
88
Q

SAH or ICH tx goal:

A

further bleeding risk vs. risk for ischemia

  • ~160mmHg
  • preferred nicardipine, esmolol, or labetalol

KC Cardio Module-1 (7 decks)

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