SG3: CVS1 Flashcards
1
Q
Hypertension-associated complications
A
Atherosclerotic vascular disease
- Coronary artery disease
- Myocardial infarction
- Acute coronary syndromes
- Chronic stable angina
- Carotid artery disease
- Ischemic stroke
- TIA
- Peripheral arterial disease
- Abdominal aortic aneurysm
Other forms of CV disease
- Left ventricular dysfunction (systolic heart failure)
- Chronic kidney disease
- Retinopathy
2
Q
What antihypertensives are recommended in pregnancy?
A
Methyldopa
- Widely considered the first-line agent for treatment of hypertension during pregnancy.
- Pregnancy B
- Precautions: Adverse effects include somnolence and dry mouth; caution in liver disease; hemolytic anemia and liver disease may occur; reduce dose in renal disease
3
Q
What drugs are recommended to prevent seizures in severe preeclampsia or eclampsia?
A
Magnesium sulfate
- Pregnancy D
- PRECAUTIONS:
- May cause loss of reflexes, diplopia, flushing, or slurring of speech;
- higher levels may cause muscular paralysis, ventilatory failure, and circulatory collapse; magnesium may alter cardiac conduction, leading to heart block in digitalized patients; in overdose, calcium gluconate IV can be administered as antidote for clinically significant hypermagnesemia
4
Q
What is an hypertensive crisis?
A
- severe elevation in blood pressure (BP), generally considered to be a diastolic pressure >120 mmHg.
- divided into 2 general categories: hypertensive emergencies and hypertensive urgencies.
- hypertensive emergency: severe hypertension with signs of damage to target organs
- hypertensive urgency: Very high blood pressure (eg, diastolic > 120 - 130 mm Hg) without target-organ damage
5
Q
Parenteral Drugs Commonly Used in the Treatment of Hypertensive Emergencies
A
- Nitroprusside
- Enalaprilat
- Esmolol
- Fenoldopam
- Hydralazine
- Lebetalol
- Nicardipine
- Nitroglycerin
- Phentolamine
6
Q
Management of patients with AF
A
- involves three objectives: slowing the ventricular rate, prevention of thromboembolism and correction of the rhythm disturbance.
- The first treatment goal is to slow the ventricular response rate, which allows better ventricular filling with blood. Anticoagulation can help achieve the second goal if it is indicated.
- Cardioversion to normal sinus rhythm can be delayed unless the patient is hemodynamically compromised due to the AF.
7
Q
What drugs are recommended to control the ventricular rate?
A
- First line drugs for rate control are the β-blockers (eg metoprolol, esmolol), verapamil and diltiazem.
- In the acute setting, IV formulations can be used.
8
Q
Which drugs can be used to achieve cardioversion?
A
- Many class I and III antiarrhythmic agents have been evaluated for efficacy in conversion of AF or atrial flutter to normal sinus rhythm.
- Flecainide, propafenone, dofetilide and amiodarone are widely recommended agents.