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Phar 505 > Pathophysiology and Pharmacotherapy of Hypertension 2 > Flashcards

Pathophysiology and Pharmacotherapy of Hypertension 2 Flashcards

1
Q

When is a person diagnosed with hypertenstion

A

2-3 properly measured blood pressure reading that are over 130/80 mmHg

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2
Q

T/F: Blood pressure greater than or equal to 130/80 daytime (awake) is considered hypertension

A

True

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3
Q

T/F: Home blood pressure monitoring is considered the gold standard over ambulatory blood pressure monitoring

A

False: Worn device taken every 15 to 20 mins during the day and every 30 to 60 mins during sleep for 24-48 hours ambulatory blood pressure monitoring is considered gold standard

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4
Q

What is white coat hypertension, when is it clinically significant

A

Elevated office blood pressure but normal readings outside with either Ambulatory or home blood pressure monitoring, when SBPs and DBPs are higher than 20/10 mmHg compared to at home or Ambulatory

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5
Q

What is masked hypertension

A

Normal BP in office but Ambulatory and Home Blood pressure monitoring (ABPM/HBPM) are consistently above normal

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6
Q

When a patient has normal blood pressure what is the best option for them, when should they be reassessed

A

Promote healthy lifestyle habits, reassess in one year

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7
Q

When a patient has elevated BP what is the best option for them, when should they be reassessed

A

Lifestyle habit changes, reassess in 3 to 6 months

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8
Q

When a patient has stage 1 Hypertension Blood pressure levels when would they be advised lifestyle changes and BP medication

A

If the Patient has a clinical ASCVD risk or estimated CVD risk greater than 10%

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9
Q

T/F: When a patient has stage 2 Hypertension Blood pressure levels they are given lifestyle changes and BP medication and are reassessed every 3 to 6 months

A

False: When a patient has stage 2 Hypertension Blood pressure levels they are given lifestyle changes and BP medication and are reassessed every month until their goal is met, then they are reassessed every 3 to 6 months

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10
Q

T/F: It is important to individualize therapy to determine a BP goal for each individual patient due to intolerable adverse effects

A

True

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11
Q

What are the best proven nonpharmacological interventions for the prevention/treatment of hypertension

A

weight loss, Dash and Mediterranean diet, Decrease Na intake, increase exercise, decrease alcohol intake if excessive

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12
Q

What medication classes target the kidney to lower BP

A

Thiazides, ACEI, ARB, Aldosterone Antagonist, Renin Antagonist

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13
Q

What medication classes target the heart to lower BP

A

Beta Blockers, Non-DHP Caclium Channel Blockers

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14
Q

What medication classes and medications target the vasculature to lower BP

A

DHP Calcium Channel Blockers, Alpha Blockers, Nitrates, Minoxidil, Hydralazine

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15
Q

Which medications work on the central nervous system to lower BP

A

Clonidine and Methyldopa

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16
Q

What is the MOA of thiazide diuretics, what adverse reactions can they cause

A

Blockade of Sodium reabsorption at the distal tubule causing initial volume loss in the 1st week mostly/ electrolyte abnormalities, gout , dehydration, glucose intolerance

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17
Q

T/F: Thiazide diuretics can be given no matter the co-morbid condition

A

False: Thiazides can cause more harm and have reduced efficacy with co-morbid renal disease

18
Q

T/F:Hydrochlorothiazide is the preferred thiazide for lowering BP

A

False: Low-dose chlorthalidone is the preferred thiazide

19
Q

What is the MOA of ACE inhibitors, what adverse reactions can they cause

A

Block conversion of Angiotensin 1 to Angiotensin 2, reduce metabolism of bradykinin/ Hyperkalemia, cough, angioedema

20
Q

What is the MOA of Angiostensin Receptor blocker, what adverse reactions can they cause

A

block the actions of angiotensin 2/ Hyperkalemia

21
Q

What is the MOA of DHP Calcium Channel Blockers, what adverse reactions can they cause

A

Vasodialation of vascular smooth muscle via calcium antagonism/ Headache, light headness, flushing, dose dependent peripheral edema

22
Q

What are ways to combat dose dependent peripheral edema cause by DHP Calcium Channel blockers

A

Decrease the dose, Switch to another agent, and/or add RAAS-blocking agent (ACE/ARB)

23
Q

What is the MOA of non-DHP Calcium Channel Blockers, what are the adverse reactions they can cause

A

Reduction of cardiac output via decreases in heart rate via inhibition of calcium ions entering voltage sensitive areas of mycoardium during depolarization/bradycardia, heart failure exacerbation

24
Q

Whait is the MOA of Beta-Blockers, what are the adverse reactions they can cause

A

Blockade of B1-receptors redcues cardiac output via reductions in both HR and stroke volume/ bradycardia, lethargy, sexual dysfunction

25
Q

What are the first line medications for hypertension

A

Thiazides, ACEI, ARBS, DHP-Calcium Channel Blockers

26
Q

What are the 2nd line medications for hypertension

A

Renin Inhibitors, Beta-blockers

27
Q

What are the only add-on therapy medications for hypertension

A

Clonidine, Methyldopa, Hydralazine, Minoxidill

28
Q

What medications are thiazide/ thiazide-like diuretics

A

Hydrochlorothiazide, chlorthalidone, indapamide, metolazone

29
Q

What medications are ACE inhibitors

A

Lisinopril, enalapril, captopril, benazepril, ramipril

30
Q

What medications are angiotensin receptor blockers

A

Lorsartan, valsartan, irbesartan, candersartan

31
Q

What medications are DHP-calcium channel blockers

A

Amlodipine, Nifedipine, Felodipine, Nicardipine

32
Q

What medications are non DHP Calcium Channel Blockers

A

Diltazem and Verapamil

33
Q

What are the B1-selective beta-blockers

A

Atenolol, bisoprolol, metoprolol, nebivolol

34
Q

What are the nonselective beta-blockers

A

Carvedilol, labetalol, propanolol

35
Q

What is the best beta-blocker to give if a patient has HFrEf

A

carvedilol, metoprolol ER, Bisoprolol

36
Q

What is the best beta-blocker for asthma/ COPD

A

Atenolol or metoprolol

37
Q

What is the best beta-blocker for Type 2 DM

A

Carvedilol, metoprolol

38
Q

What is the best beta-blocker for migraines

A

Propanolol carvedilol

39
Q

What are the alpha blockers

A

Doxazosin, terazosin, prazosin

40
Q

T/F: Alpha-blockers are used as 3rd or 4th line therapy

A

False: The role was drastically limited after the ALLHAT trial and was seen as inferior to other drugs

Phar 505 (33 decks)

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