Hypertenson Flashcards
Lisinopril
- category
- trade name
- use
- usual dose
- mechanism
- contraindications/adverse effects
(From Drugs needed to know on Med Review Sheet)
Category
- anti-hypertensive
- ACE inhibitor
Trade name
- Prinivil
- Zestril
Use
-treatment of HTN
Usual dose
-5-40 mg qd
Mechanism
- By inhibiting ACE, they
- Block formation of Angiotensin II (powerfulvasoconstrictor)
- ↓ Aldosterone (↓ Na+ retention)
- Also ↑ Bradykinin (→ vasodilation)
Contraindications
-2-3rd trimester of pregnancy
Adverse effects o Dry cough o Hypotension o Rash o Angioedema o May cause hyperkalemia -Monitor especially if on K supplements or K sparing diuretic o May cause acute renal failure in patients with bilateral renal artery stenosis or severe dehydration
Amlodipine -category -trade name -use -usual dose -mechanism -contraindications/adverse effects (From med review sheet)
category
- Anti-HTN
- Calcium antagonist (CCB)
- Dihydropyridine class
trade name
-Norvasc
use
-treat HTN
usual dose
-2.5-10 mg qd
mechanism
- contractility -
- peripheral vasodilation +++
contraindications
- Hypersensitivity to amlodipine or any of the components
- Pregnancy risk factor C
adverse effects
-may cause tachycardia
Atenolol
- category
- trade name
- use
- usual dose
- mechanism
- contraindications/adverse effects
(from med review sheet)
category
- anti-HTN
- Beta-blocker
- cardioselective class
trade name
-Tenormin
use
-treat HTN by decreasing HR
usual dose
-25-100 mg qd
mechanism
- Cardioselective effects are dose related, so have some beta 2 blocking effects at higher doses.
- Block beta-1 receptors
contraindications
- patients with:
- bradycardia
- heart block
- sinus node disease due to decreased heart rate
- cautioned in patients with uncontrolled heart failure
adverse effects
- May cause:
- fatigue, insomnia, -depression, -nightmares
- Bradycardia and ED
- aggravate peripheral vascular disease
- mask signs of hypoglycemia = important for those with DM
- mildly decrease HDL and mildly increase TG
Diuretics
-different classes
- thaizide
- potassium sparing
- loop diuretics
ACE inhibitors (ACEI)
- function
- common drug
- this class of drugs end in?
Function inhibit ACE by: -block formation of angiotensin II -decrease aldosterone -increase bradykinin
Common drug
-Lisinopril
end in:
-“pril”
Angiotensin-II receptor blockers (ARB)
- function
- common drug
- this class of drugs end in?
function
- block angiotensin II receptor they:
- cause vasodilation
- decreased aldosterone
common drug
-losartan
end in:
“sartan”
Calcium antagonists (CCB)
- function
- different classes
function -dependent on class
Classes
- CCD class effects
- Dihydropyridine class (ends with “dipine”
- Non-Dihydropyridine class
Beta-Blockers (BB)
-function
-this class of drugs end in?
function -dependent on class
ends in:
-“olol”
What lifestyle changes are useful to help reduce hypertension?
- Heart healthy diet
- Med or DASH (fruits, veg, whole grain, low fat dairy, poultry, fish, beans, nuts, non-tropical oils, avoid red meat);
- Limit sugary drinks and sweets
- Limit sat fat and trans fat to 5-6% of calories
- Limit sodium intake to 2400 mg daily (for adults with HTN further reduction to 1500 mg/d recommended) - Exercise regularly (mod-vig aerobic activity for 40 minutes 3-4 times per week)
- Healthy weight (BMI 18.5-24.9)
- Avoid tobacco
What is the blood pressure goal of a person who is age 60 or older and when should you initiate pharmacologic treatment?
Goal: /= 150/90
What is the blood pressure goal of a person who is younger than 60 or who is >/= 18 y.o with chronic kidney disease or with diabetes and when should you initiate pharmacologic treatment?
Goal: /= 140/90
Thiazide diuretics should be cautiously avoided in patients with __?
gout or a history of significant hyponatremia
Beta blockers should be generally avoided in patients with __?
asthma, reactive airways disease, or second or third degree heart block.
ACEIs and ARBs are contraindicated in____?
pregnant women or those likely to become pregnant
ACESIs should not be used in individuals with__?
a history of angioedema.
