TBL - HTN Flashcards
What are complications of HTN?
End-organ damage:
In heart = MI, HF
in brain = Strokes
In eyes = retinopathy (blindness)
In kidneys = CKD
What drugs are 1st line for hypertension?
Thiazide diuretics
ACEIs
ARBs
CCBs
What drugs are 2nd line for HTN?
Loop diuretics
Beta blockers
MR antagonists
What are examples of thiazides diuretics?
Hydrochlorothiazide
Chlorthalidone
How do thiazides work?
Inhibit NCC on distal tubule
Inc. salt excretion = dec. total body sodium = dec. BP
What are AEs associated with thiazides?
Hypo:
- volemia
- tension
- magnesemia
- kalemia
- natremia
Hyper:
- uricemia
- calcemia
- glycemia
- lipidemia
Metabolic alkalosis
Skin rash
Photosensitivity
What are CIs associated with thiazides?
Advanced kidney failure
Sulfonamide allergy
What are situations with potentially favorable effects if taking thiazides?
Osteoporosis
Nephrolithiasis
High-normal K+
African American + elderly patients
Name an ACEI
Enalapril
What AEs are associated with Enalapril?
Hypotension
AKI
Hyperkalemia
Cough
Angioedema
What are situations with potentially favorable effects for enalapril patients?
Low normal K+
DM CKD CAD Prior stroke LV dysfunction
When is enalapril contraindicated?
Pregnancy
Name an ARB
Losartan
What AEs are associated with losartan?
Hypotension
AKI
Hyperkalemia
Less cough
Less angioedema
What situations are ARBs potentially favorable?
Low normal K+
DM CKD CAD Prior stroke LV dysfunction
When is losartan contraindicated?
Pregnancy
Name two CCBs
DHP =
Nifedipine
Non-DHP =
Verapamil
What are AEs associated with nifedipine?
Hypotension
Peripheral edema
Reflex tachycardia
What are AEs associated with verapamil?
Hypotension
Bradycardia
AV block
HF
Constipation
What situations would Nifedipine be potentially favorable?
Raynaud’s phenomenon
African american + elderly patients
What situations would Verapamil be potentially favorable?
SVTs
Tachycardia
Angina
African american and elderly patients
What are contraindications for verapamil?
AV block
HF
Name a loop diuretic
Furosemide
What situations would furosemide be potentially favorable?
Edema
Severe CKD
What AEs are associated with furosemide?
Hypo:
- volemia
- tension
- calcemia
- magnesemia
- kalemia
- natremia
Hyper:
- uricemia
- glycemia
- lipidemia
Metabolic alkalosis
Skin rash
Photosensitivity
Ototoxicity
Name 2 beta blocker examples
Metoprolol
(Beta1)
Propranolol
(Nonselective)
What are AEs associated with beta blockers?
Beta1 blockade =
- bradycardia
- AV block
- HF
- hypotension
- hyperkalemia
- hypoglycemia
Beta2 blockade =
- bronchoconstriction
- hyperkalemia
- hypoglycemia
What situations would beta blocker be potentially favorable?
SVTs
HF
CAD
Angina
When are beta blockers contraindicated?
Bradycardia
AV block
Acute HF
Name a MR antagonist
Spironolactone
What AEs are associated with spironolactone?
Hyperkalemia
Gynecomastia
ED
What situations is sprironolactone potentially favorable?
HF hirsutism
Acne (women)
What are contraindications for spironolactone?
Hyperkalemia
