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IDT Winter > Therapeutics of Hypertension > Flashcards

Therapeutics of Hypertension Flashcards

1
Q

what is a common cause of secondary hypert

A

sleep apnea

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2
Q

which race/ethnicity is hypert higher in?

A

non-hispanic black adults

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3
Q

T/F starting at 115/75, risk of CVD doubles ever 20/10 increase

A

true

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4
Q

what is weight losses impact on SBP?

A

-5

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5
Q

what is a heart-healthy diets impact on SBP?

A

-11

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6
Q

what is sodium reductions impact on SBP?

A

-5-6

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7
Q

what is potassium supplementations impact on SBP?

A

-4-5

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8
Q

what is exercise’s impact on SBP?

A

-5-8

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9
Q

how would drinking no more than 2 for men and 1 for women standard drinks per day impact SBP?

A

-4

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10
Q

what does the ASCVD risk assessment tell us?
identify/interpret the score criteria

A

10 year risk of a cardiovascular complication
less than 5%: low risk
5-7.45%: borderline
7.5-20%: intermediate
over 20%: high risk

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11
Q

according to the ADA, people with diabetes and hypertension should aim to target their blood pressure to be?

A

less than 130/80

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12
Q

according to ACC/AHA guidelines, anyone with a comorbidity or over the age of 65 should aim to have a blood pressure of?

A

less than 130/80

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13
Q

if pt has a BP of <130/80, what is the guideline?

A

no change, reassess in 1 year

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14
Q

if pt has BP of 120-129/80, what is the guideline?

A

nonpharm therapy, reassess in 3-6 months

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15
Q

if pt has BP of 130-139/80-89, what is the guideline?

A

if ASCVD less than 10%, nonpharm therapy and reassess in 3-6 months
if more than 10%, nonpharm therapy plus BP med and reassess in 1 month

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16
Q

if pt has BP of 140/90, what is the guideline?

A

nonpharm therapy and BP med and reassess in 1 month

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17
Q

what are the first line treatment for HTN?

A

thiazide diuretics, CCBs, and ACE-I/ARBs

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18
Q

based on the reviewed study, which drug showed the best results for reducing SBP?

A

chlorthalidone

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19
Q

based on the reviewed study, which drug showed the best results for reducing DBP?

A

Amlodipine

20
Q

based on the reviewed study, how did chlorthalidone, amlodipine, and lisinopril compare towards preventing a cardiac event?

A

they all had the same effect on outcome

21
Q

based on the reviewed study, what was the concluding drug of choice to treat HTN?

A

thiazide-diuretics

22
Q

what are the SEs of thiazide diuretics?

A

hyponatremia, hypomagnesemia, hypokalemia, hyperuricemia, hypercalcemia

23
Q

what should we monitor with pts taking thiazide diuretics?

A

BP, electrolytes, renal function

24
Q

if a pt has hypertension and CKD, which HPT drug would be most beneficial?

A

ACE-Is

25
Q

if a pt has hypertension and left ventricular dysfunction, which HPT would be most beneficial?

A

ACE-Is

26
Q

what are the SEs of ACE-Is?

A

hypotension, hyperkalemia, angioedema, increased serum creatinine, dry cough

27
Q

when are ACE-Is contraindicated as treatment for HPT?

A

pregnancy or bilateral renal artery stenosis

28
Q

what should we monitor for with pts using ACE-Is?

A

BP, renal function, and potassium

29
Q

why can ACE-Is potentially cause angioedema?

A

ACE-Is block degradation of bradykinin which increases as a result

30
Q

which ACE-Is are used once daily? (rest are 2+ more daily)

A

Fosinopril
Lisinopril
Perindopril

31
Q

The place in therapy and clinical benefits of ARBs is similar to ACE-Is. what is a SE ARBs don’t cause that ACE-Is can?

A

cough

32
Q

what are SEs from Non-DHP CCBs?

A

bradycardia
worsening HF (more with verapamil)
hypotension
constipation (more with verapamil)

33
Q

what are drug-drug interactions of Non-DHP CCBs?

A

may increase concentration of other Cyp3A4 substrates such as simvastatin and lovastatin

34
Q

Cardizem SR is given how often?

A

BID

35
Q

Cardizem CD is given how often?

A

QD

36
Q

Verapamil IR is given how often?

A

TID

37
Q

Verapamil SR/ER is given how often?

A

QD

38
Q

what place in therapy do we use aldosterone receptor antagonists?

A

add-on therapy for hypertension
heart failure

39
Q

SEs of aldosterone receptor antagonists?

A

hyperkalemia
gynecomastia (spironolactone)
dizziness

40
Q

what adverse effect can hydralazine cause?

A

drug-induced lupus-like syndrome

41
Q

first line therapy for HPT is typically thiazide, CCB, ACE-I, or ARB. However, for pts with heart issues, what therapy is recommended?

A

Beta-blocker with an ACE-I or ARB

42
Q

how do you classify resistant hypert?

A

BP above goal using 3 diff drug classes including a diuretic

43
Q

which drugs can be given IV in hypertension emergencies?

A

nicardipine, sodium nitroprusside, nitroglycerine, hydralazine, esmolol, labetalol, enalapril, and phentolamine

44
Q

which drug is the treatment of choice for chronic HPT in pregnancy?
what are alternative treatments?

A

methyldopa
labetalol, CCBs, BBs (excluding atenolol)

45
Q

when do we treat children with HPT?

A

SBP and/or DBP greater than the 95th percentile for sex, age, and height on at least 3 occasions

IDT Winter (19 decks)

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