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Y4R7 - Medicine III 🩺 > L6: Systemic HTN (Pt 3) > Flashcards

L6: Systemic HTN (Pt 3) Flashcards

1
Q

Dx of HTN

A
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2
Q

Methods of BP Measurment

A
  1. Clinic.
  2. Home setting (self monitoring) (inaccurate).
  3. ABP monitoring (in white coat HTN).
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3
Q

Methods of BP Measurment

  • Clinic
A
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4
Q

Methods of BP Measurment

  • ABPM
A
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5
Q

Methods of BP Measurment

  • Out of Office Blood Pressure Measurement
A
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6
Q

Methods of BP Measurment

  • White Coat & Masked HTN
A
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7
Q

Risk in White coat hypertension

A
  • These subjects are at intermediate cardiovascular risk between normotensives and sustained hypertensives
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8
Q

Dx of White coat hypertension

A

repeated office and out-of-office BP measurements

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9
Q

TTT of White coat hypertension

A

NO treatment if there is no cardlovascular risk or (HMOD)
- But need lifestyle modification

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10
Q

Dx of Masked HTN

A

Repeated office and out-of-office BP measurements

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11
Q

TTT of Masked HTN

A

May require drug treatment aiming to normalize outof - office BP.

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12
Q

TTT of HTN

A
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13
Q

TTT of HTN

  • Goals
A
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14
Q

TTT of HTN

  • Non-Pharm
A
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15
Q

TTT of HTN

  • Modification & Subsequent Effect
A
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16
Q

TTT of HTN

  • Pharm
A
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17
Q

Pharmacological TTT of HTN

  • Ideal Drug
A
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18
Q

Pharmacological TTT of HTN

  • Diuretics
A
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19
Q

Diuretics in HTN

  • examples
A

Hydrochlorothiazide

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20
Q

Diuretics in HTN

  • MOA
A
  • Act by decreasing blood olume and cardiac output
  • Decrease peripheral resistance during chronic therapy
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21
Q

Diuretics in HTN

  • DOC in …..
A

elderly hypertensives

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22
Q

Diuretics in HTN

  • SE
A
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23
Q

Diuretics in HTN

  • Notes
A
  • Not safe in renal and hepatic insufficiency
  • Thiazide Is most commonly used in the treatment of hypertension.
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24
Q

Beta Blockers in HTN

A
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25
Q

Beta Blockers in HTN

  • Examples
A
  • Atenolol, Metoprolol, nebivolol
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26
Q

Beta Blockers in HTN

  • MOA
A
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27
Q

Beta Blockers in HTN

  • DOC in ….
A
  • patients with co-existent coronary heart disease
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28
Q

Beta Blockers in HTN

  • SE
A
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29
Q

Beta Blockers in HTN

  • Not Safe in …..
A

patients with co-existing asthma and diabetes

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30
Q

CCBs in HTN

31
Q

CCBs in HTN

  • Examples
A

Amlodipine

32
Q

CCBs in HTN

  • MOA
33
Q

CCBs in HTN

  • DOC in ….
A
  • elderly hypertensives
  • Those with co-existing asthma
34
Q

CCBs in HTN

  • SE
A

Flushing, headache, Pedal edema

35
Q

CCBs in HTN

  • CI
A

HOCM, SVT, unstable Angina

36
Q

ACEIs in HTN

37
Q

ACEIs in HTN

  • Examples
A

Ramipril, Lisinopril, Enalapril

38
Q

ACEIs in HTN

  • MOA
A

Inhibit ACE and formation of angiotensin ll and block its effects

39
Q

ACEIs in HTN

  • DOC in …….
A
  • co-existent diabetes mellitus
  • Heart failure
  • Those with co-existing asthma
40
Q

ACEIs in HTN

  • SE
42
Q

ARBs in HTN

43
Q

ARBs in HTN

  • Examples
44
Q

ARBs in HTN

  • MOA
A

Block the angiotensin il receptor and inhibit effects of angiotensin II

45
Q

ARBs in HTN

  • DOC in ……
A

with co-existing diabetes mellitus

46
Q

ARBs in HTN

  • SE
A

safer than ACEI, hypotension, Hyperkalemia, Angioedema

47
Q

Alpha Blockers in HTN

48
Q

Alpha Blockers in HTN

  • Examples
49
Q

Alpha Blockers in HTN

  • MOA
A
  • Block a-1 receptors and cause vasodilation
  • Reduce peripheral resistance and venous relurn
  • Exert beneficial effects on lipids and insulin sensitivity
50
Q

Alpha Blockers in HTN

  • DOC in ……
A

Co-Existing BPH

51
Q

Alpha Blockers in HTN

  • SE
A

Postural hypotension

52
Q

Central Alpha-2 Agonists in HTN

A

Methyldopa (Aldomet) / Clonidine (oral and patch) / Guanfacine

53
Q

Blood vessel dilators (vasodilators) in HTN

54
Q

What to use & What to avoid in

  • HTN + HF
A
  • ACE inhibitors, Diuretics
  • Ca channel blockers
55
Q

What to use & What to avoid in

  • HTN + IHD
A
  • B blocker or Ca channel blocker.
  • Hydralazine
56
Q

What to use & What to avoid in

  • HTN + DM
A
  • ACE inhibitors, Ca channel blockers
  • B blockers (masking of warning signs of hypoglycemic coma)
57
Q

What to use & What to avoid in

  • Ederly >60
A

Calcium channel blockers, Diuretics

58
Q

What to use & What to avoid in

  • BPH
A

Alpha-Blockers

59
Q

What to use & What to avoid in

  • HTN + Renal Impairment
A
  • BB, CCB, Diuretics (Lasix), a methyl dopa & ACE inhibitors but with monitoring of creatinine level
  • ACE inhibitors in bilateral renal stenosis
60
Q

What to use & What to avoid in

  • HTN + Asthma or COPD
A
  • Calcium channel blockers
  • B blockers
61
Q

What to use & What to avoid in

  • HTN + Pregnancy
A
  • a methyl dopa, Ca channel blocker, Hydralazine or Labetalol
  • ACE inhibitors, B blockers, Diuretics.
62
Q

What to use & What to avoid in

  • HTN + Hyperthyroidism
63
Q

What to use & What to avoid in

  • HTN + PVD
A
  • Ca channel blockers, a blocker
  • B blockers.
64
Q

Drugs For HTN in Pregnancy

A
  • Nifedipine, labetalol, hydralazine,
  • beta-blockers, methyldopa, prazosin
65
Q

Drugs For HTN in IHD

A
  • Beta-blockers, ACE inhibitors,
  • Calcium channel blockers
66
Q

Drugs For HTN in

  • CHF
A
  • ACE inhibitors
  • beta-blockers
67
Q

Algorithm for TTT of HTN

68
Q

Algorithm for TTT of HTN

  • First Step
A

Lifestyle Modification

69
Q

Algorithm for TTT of HTN

  • Not at goal BP after LS Mod.
70
Q

Algorithm for TTT of HTN

  • Not at Goal BP after first Trial of Drugs
71
Q

Initial TTT of HTN

72
Q

Step 2 TTT of HTN

73
Q

Step 3 TTT of HTN

Y4R7 - Medicine III 🩺 (26 decks)

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