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44 Cards in this Set
- Front
- Back
Complications of hypertension
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-Heart: LVH,CHF,MI,angina, sudden death
-Ophthalmic:retinal hemorrhage retinopathy, blindness -Renal:renal failure, nephropathy -Cerebrovascular: stroke |
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Blood pressure formula
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BP=stroke volume x heart rate x peripheral resistance
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Drugs that can induce hypertension
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-sympathomimetics
-steroids -alcohol/cocaine -cyclosporine/tacrolimus -erythropoietin -MAOI -NSAIDS -tricyclics |
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Treatment of hypertension: No compelling indication
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-stage 1: thiazide,maybe ACEI,ARB,BB,CCB
-stage 2: thiazide + ACEI/ARB/BB/CCB |
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Treatment of hypertension: compelling indication
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Compelling ind.:
HF, post MI, high coronary disease risk, diabetes, chronic kidney disease, recurrent stroke prevention |
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Treatment of hypertension:
In patient with HF |
diuretic/beta blocker/ ACEI/ARB/ aldosterone antagonist
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Treatment of hypertension:
In patient post MI |
beta blocker/ACEI/ aldosterone antagonist
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Treatment of hypertension:
High coronary disease risk |
diuretic/ beta blocker/ ACEI/ CCB
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Treatment of hypertension:
Diabetes |
diuretic/ BB/ACEI/ARB/CCB
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Treatment of hypertension:
Chronic kidney disease |
ACEI/ ARB
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Treatment of hypertension:
In post stroke pt. |
diuretic/ ACEIh
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Thiazide diuretics Adverse effects/counseling
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-increase in glucose/lipids
-muscle cramps can indicate hypokalemia -sensitivity to sun -steriods:antagonize by retaining salt -NSAIDs blunt response -thiazides dec. Li clearance |
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Thiazide monitoring
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-BP
-cholesterol -electolytes -uric acid -BUN, creatinine |
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Loop diuretics Adverse effects/counseling
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-sensitivity to sunlight
-increase in BG -Muscle cramps: hypokalemia -With AG: incr.risk of ototox. |
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Centrally acting alpha2 agonists
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-clonidine: Catapres
-Methyldopa: Aldomet -Guanfacine: Tenex -Guanabenz: Wytensin |
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Brand: Trandate, normodyne
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Generic: labetolol
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Brand: Corgard
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Generic: nadolol
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Brand: Sectral
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Generic: acebutolol
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Brand: Kerlone
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Generic: betaxolol
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Brand: Visken
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Generic: pindolol
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Brand: Apresoline
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Generic: hydralazine
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Brand: Loniten
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Generic: minoxidil
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Direct vasodilators
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-Minoxidil
-Hydralazine |
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Adverse effects(precautions) of minoxidil/hydralazine
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-reflex tachycardia due to vasodilation:watch HR
-Edema due to vasodilation -Hypotension/per.neuropathy -Caution in CAD,recent MI,CHF, sig.renal failure -Lupus (hydralazine) |
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Brand: Sular
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Generic: Nisoldipine
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Brand:Dynacirc
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generic: Isradipine
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Brand: Cardene SR
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generic: nicardipine
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Brand: Nifedipine
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generic: Procardia XL, Adalat CC
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Adverse effects of CCB
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-ankle edema
-gingival hyperplasia -flushing -headache -Verapamil (constipation) |
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Which ACEI causese neutropenia?
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-captopril and enalapril
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which ACEI causes rash?
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-all can, but especially captorpril
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Brand: Univasc
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generic: moexipril
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Brand: Aceon
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generic: perindopril
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Brand: Mavik
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generic: trandolapril
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Brand: Teveten
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generic: eprosartan
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Brand:Avapro
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generic: irbesartan
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Brand: Micardis
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generic: telmisarten
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Hypertensive Emergency
vs. urgency |
-Emergency: immediate reduction of BP is required because target organ damage is present.
-Urgency: no organ damage,immediate reduction in BP not required |
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Mean arterial pressure
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CO x SVR
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Treatment of hypertensive emergency
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-reduce MAP no more than 25% w/i minutes or hours
-Reach 160/100 within 2-6h -Further reduce BP over days |
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Signs and symptoms of organ damage in HTN emergency
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-papiledema,bleeding of eye
-chest pain,pulmonary edema -dyspnea -polyuria,proteinuria,hematuri -coma,seizure, confusion -S4 gallop,ischemia on ECG |
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drugs used for HTN emergency
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nitroprusside,nicardipine,NTG,
enalaprilat,hydralazine, diazoxide,labetalol, esmolol,phentolamine |
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Drugs used in HTN urgency
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-captopril
-clonidine -labetalol |
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Selective beta blockers
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-atenolol
-esmolol (injectable) -metoprolol -acebutolol -bisoprolol -nebivolol |