Pharm Test 2/ Normal Flashcards
What determines Mean Arterial pressure flow?
- peripheral resistance
- heart rate
- stroke volume
- body position
- muscle activity
- baroreceptors
- hormones
Factors that create primary hypertension?
- Genetics
- African American
- decreased sodium excretion
- obesity
- alcohol use
- smoking
- NSAID use
- excessive salt intake
High blood pressure contributes to 3 problems?
- ischemia
- heart failure
- kidney disease
This doubles your risk for heart disease?
SBP 20mmHg above normal
DBP 10mmHg above normal
Risk factors for hypertension are?
- metabolic syndrom
- hyperlipidemia
- obesity
- DM
- smoking
- inactivity
- microalbuminuria (GFR <60mL/min)
BMI is calculated by?
weight/height
Another name for metabolic syndrome is?
syndrome of X
Metabolic Syndrom consist of?
- insulin resistance syndrome
(hyperinsulenemia) - obesity (dyslipidemia sydrome)
Hyperinsulemia is seen as
- FPG > _____
- Glucose Tolerance >___
110
200
Factors that increase risk of CVD?
- abdominal obesity
- hypertension
- insulin resistance
- lipid disorder
Hypertension predisposes to what health problems?
stroke
CHF
Renal Failure
PVD
This is a triglycerides 150, HDL <35 in females <39 in males, BP >140/90 and urine albumin >20 or creatine/albumin >30.
Dyslipidemia Syndrome
Risk associated with abdominal obesity are?
- Waist-to-hip ratio > 0.90
- BMI >30
- Waist-to-girth in females >0.90 and males 0.85
Signs and symptoms experienced with secondary hypertension are?
HA Daytime somnelence fatigue tachycardia claudication cold feet sweating tinning of skin flank pain muscle weakness tremor
What to look for with 2ndary HTN?
- variable pressure with tachycardia
- sweating or tremors
- hyper dynamic apical pulse
- Murmurs anterior and posterior thorax
- abnormal pulsation in neck
- abdominal bruit
- abdominal and flank masses
- trunk obesity and purple striae
- weak femoral pulses
- absent pedal pulses
Things I see in neck of a 2ndary hypertensive patients?
- carotid bruise
- Jugular venous distention
- thyroid enlargement
Things I see in extremities of a 2ndary hypertensive patients
bruits
edema
Things I see in lungs of a 2ndary hypertensive patients
congestion
bronchospasm
Things I see in abdomen of a 2ndary hypertensive patients
aortic pulsation
bruits
enlarged kidney
Things I see in heart of a 2ndary hypertensive patients
pericardial heaves enlargement abnormal rate or rhythm murmurs S3 and S4
Causes of 2ndary hypertension include?
- Coarctation of aorta
- cushing syndrome
- pheochromocytoma
- primary aldosteronism
- chronic kidney disease
- Renovascular disease
- sleep apnea
- hyperthyroidism
- hyperparathyroidism
In coarctation of aorta you will see ____ femoral artery pulses?
delayed
Way to diagnose coarctation of aorta?
EKG
CXRAY
ECHO
DOPPLER
Cushing syndrome is seen as?
Long steroid use
trunk obesity
moon face
Prehypertension is a SBP and DBP of?
SBP 120 to 139
DBP 80-89
Prehypertension ____ treatment needed unless compelling indication.
no
Stage 1 hypertension is a SBP ___ and DBP ____
SBP 140- 159
DBP 90-99
Treatment for stage 1 hypertension with no compelling reasons is?
thiazide ACEI ARB BB CCB COMBINATION
Treatment for stage 1 hypertension with compelling reasons is?
DIURETICS ACEI ARBS BB CCB
Treatment for stage 2 hypertension with no compelling reasons is?
THIAZIDE ACE ARB BB CCB
Stage 2 hypertension is a SBP___ and DBP_____?
SBP >160
DBP >100
Treatment for stage 2 hypertension with compelling reasons?
DIURETICS ACEI ARBS BB CCB
The target organ of damage with hypertension is?
heart
brain
kidney
Peripheral alpha 1 receptors blockers affect BP how?
DBP more than SBP
Example of alpha 2 agonist are?
CLONIDE
METHYLDOPA
____ receptors reduce the sympathetic outflow in the brainstem?
alpha 2
What will you see with decreased sympathetic outflow in the brain?
lower PVR
lower renal vascular resistance
lower HR
lower BP
Renal blood flow and GFR are ____ by alpha 2 receptors?
unchanged
Example of direct vasodilators are?
hydralizine
minoxidil
_____ is not a concern with hydralizine and minoxidil?
orthostatic hypotension
this is a dilation of the arteries not the veins
_____ ____ ____ is associated with hydralizine and minoxidil. This means the body will compensate for the arterial change by increasing renin production, angiotensin 2, aldosterone and ultimately sodium levels and fluid retention.
Renal homeostatic mechanism
Use Hydralizine in combination with?
BB
CLONIDINE
METHYLDOPA
Minoxidil must have additional medications with it to prevent fluid overload.
BB
DIURETICS
This is an example of a renin inhibitor?
ALISKIREN
Aliskiren is not for ___ and ____ patients this puts them at risk for stroke?
DM
renal patients
Aliskiren blocks renin production by producing ____?
Plasma renin activity (PRA)
____ decrease risk of stroke and mortality
BB
____ and ____ have not been shown to decrease risk of stroke or mortality?
CCB
ALPHA blockers
Best medications to give to a pregnant mother with hypertension?
METHYLDOPA
LABETOLOL
NIFEDIPINE
Treatment for compelling heart failure?
Thiazide BB ACEI ARBS ALDO ANT
Treatment for Post MI?
Cardioselective BB
ACEI
ARBs
ALDO ANT
Treatment for CVD risk?
THIAZIDE
BB
ACEI
CCB
TREATMENT FOR DM?
THIAZIDE BB ACEI ARBS CCB
TREATMENT FOR CKD
ACEI
ARB
TREATMENT FOR STROKE
THIAZIDE
ACEI
TREATMENT FOR COPD
CCB
AFRICAN AMERICANS DO WELL WITH WHAT MEDICATIONS?
CCB + THIAZIDE
THIAZIDES-(MONOTREATMENT)