Week 8 Flashcards
What are the highest carriers of rabies
Bats
Describe the progression of Rabies
1) incubation (1-3 months)
2) prodromal phase (2-10 days, fever, malaise, paresthesia)
3) Acute neurological phase, encephalitic, hydrophobia, adgitation, flaccid paralysis)
Post-exposure for rabies
1) Immune globulin (immediately neutralize rabies virus in wound, weight-based, one-time dose, infiltrate as much as possible around wound, inject IM at a site distant from wound)
2) Vaccine (4-injection series, days 0,3,7,14, and 28 if immunosuppressed).
What percent of adults have HTN
50% in the USA
Lowering SBP by 10 mm Hg decreases risk of CVD by how much
20-30%
What medications to start with for stage 1 HTN
- Thiazide diuretic, Ca channel blocker, or ACE inhibitor/ARB
- Use 2 drugs if stage 2 HTN and BP of 20/10 above target
What part of the BP equation do loop target
They lower stroke volume, which directly comes from them lowering the blood volume.
Where does lasix work in the body
the ascending loop of henle
Site of action for HCTZ
distal convoluted tubule
ACEs and ARBs can cause what nutrient abnormality
Hyperkalemia
If patients are on loop diuretics long term, what supplementation is necessary
Potassium (loop diuretics decrease potasium)
Aldosterone antagonists cause what kind of common side effect
gynecomastia
Aldosterone antagonists: Spironolactone and eplieronone
Thiazide diuretics can cause which side effect
photosensitivity
Which HTN meds cause hyperuricemia
diuretics, especially loop (Lasix) and thiazide (HCTZ)
Most commonly used CA inhibitor
Acetazolamide
Which classes of antihypertensives is most likey to decrease serum potassium levels
Thiazide diuretics like cholorathiadone
How do you treat a patient on HCTZ that has low potassium?
Switch to triamterene/ HCTZ
What are the calcium channel blockers
Amlodipine, nifedipine, diltiazem (cardizem), and verapamil
What are the 2 categories of Ca channel blocers (CCBs)
- Dihydropyridines (-dipine)
- Non-dihydroperidines
Main effect of dihydropyridines
Relax smooth muscle, which causes vasodialation, which lowers BP by decreasing afterload
Adverse effects of DHPs
- Peripheral Edema
- CAD exacerbation (have to give nifedibine as the extended release for these to decrease impact, do not give immediate release)
Non-DHP adverse reactions
diltiazem, verapamil
- Bradycardia, hypotension, CHF exascerebation, gingeval hyperplasia
What are the beta blockers
Atenolol, metoprolol (succinate and tartate), propranol
What are the A1- blockers
prazosin
What are the a2 agonists
clonidine
What are the beta blockers with the a1 blocking effect
carvedilol
Preferred agents for htn in pregnancy
Labetalol and nifedipine most common, then methyldopa, hydralazine
Contraindicated in pregnancy
ACEs
ARBs
Aldosterone antagonists
What are the primary htn meds for black/AA pts
Thiazide diuretics and Ca channel blockers (HCTZ and amlodipine and nifedipine, diltizem and verapamil)
Which drug helps with postural hypotension
midodrine (PO)
Pure alpha 1 agonist.
