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148 Cards in this Set
- Front
- Back
What is the most common cardiovascular disease? This affects what % of Americans? |
* Hypertension is the most common cardiovascular disease. * It affects 29.1% of Americans (NHANES 2011-12) |
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Hypertension: What is associated with an increase in morbidity and mortality? |
* Elevated blood pressure (>120/80) is associated with an increase in morbidity and mortality |
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Hypertension: What does elevated blood pressure eventually do? |
* Eventually, elevated blood pressure damages internal organs |
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Hypertension: A patient with hypertension is more likely to have what other 3 conditions? |
* Kidney disease * Heart disease * Cardiovascular problems |
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Hypertension: Hypertension is divided into categories based on what? What are the 3 categories? |
* Based on the cause or progression of the disease, hypertension is divided into categories: -- Primary (idiopathic, essential) -- Secondary -- Malignant |
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Hypertension: What is Primary (idiopathic, essential) Hypertension caused by? What % of patients is affected? |
* Primary (idiopathic, essential): from an unknown cause -- 85-90% of patients |
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Hypertension:
What is Secondary Hypertension caused by? What % of patients is affected? |
* Secondary: identified/associated w/ a disease process of endocrine or renal system
-- 10% of patients |
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Hypertension: What is Malignant Hypertension caused by? What % of patients is affected? |
* Malignant: high or rapidly rising blood pressure -- about 5% of patients with primary or secondary hypertension |
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Hypertension: New guidelines were defined by the 2014 JNC 8. What was not addressed and what was defined? |
* Definitions of hypertension and prehypertension were not addressed, but thresholds for pharmacologic treatment were defined |
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Hypertension: The recommended selection was among what 4 spacific medication classes? |
* Recommended selection among 4 specific medication class (ACEI or ARB, CCB or Diuretics) |
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Treatment of Hypertension - JNC 8: Strong evidence supports treating patients 60 years and older up to what BP? |
* Strong evidential support - Age 60 years and older, treat to BP goal of less than 150/90 mmHg |
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Treatment of Hypertension - JNC 8: Strong evidence supports treating patients 30-59 years with hypertension up to what BP? |
* Strong evidential support - Age 30-59 years with hypertension, treat to diastolic goal of <90 mmHg |
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Treatment of Hypertension - JNC 8: What is there not enough evidence to support treating? |
* Not enough evidence to support treating: -- to a specific systolic goal in patients <60 years of age -- patients younger than 30 years of age to a diastolic goal |
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Treatment of Hypertension - JNC 8: In the General population, patients > 60 years should be treated to what BP? |
* SBP <150 mmHg / DBP <90 mmHg |
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Treatment of Hypertension - JNC 8: In the General population, patients < 60 years should be treated to what BP? |
* SBP <140 mmHg / DBP <90 mmHg |
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Treatment of Hypertension - JNC 8: In the Diabetic or CKD (chronic kidney disease), patients all ages should be treated to what BP? |
* SBP <140 mmHg / DBP <90 mmHg |
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Treatment of Hypertension: What should be used as BP becomes greater than goal? |
* Use a step-care approach as BP become greater than goal |
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Treatment of Hypertension:
What 5 lifestyle modifications are recommended in treatment of hypertension? |
* Lifestyle modifications:
-- Weight reduction -- Physical activity -- A diet rich in fruits and vegetables -- Reduced contents of saturated and total fats -- Sodium restriction |
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Treatment of Hypertension: What diets support the lifestyle modifications recommended in treatment of hypertension? |
* DASH diet, USDA Food Pattern or AHA diet |
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Treatment of Hypertension: Lifestyle modifications should be initiated at what hypertension staging? |
* This should be initiated regardless of hypertensive staging |
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Treatment of Hypertension - Initial Drug Choices: What is the most common treatment for hypertension? How is it often used to help increase control while reducing side effects? |
* Thiazide diuretics most common treatment * Often a 2 drug regiment is used to help increase control while reducing side effects
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Treatment of Hypertension - Initial Drug Choices: What 6 compelling indications help influence the agents that are selected for treatment? |
* Compelling indications such as: -- Heart failure -- Post-MI -- High cardiovascular risk -- Diabetes -- Chronic kidney disease -- Recurrent stroke prevention
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Treatment of Hypertension -
Initial Drug Choices: In heart failure, which is the order of best treatment in improving outcomes? a) ACEI > CCB > thiazide b) CCB > thiazide > ACEI c) thiazide > ACIE > CCB |
* c) In heart failure thiazide > ACEI > CCB in improving outcomes
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Treatment of Hypertension:
What are the big four antihypertensive groups? What group is no longer included? |
* The Big Four antihypertensive groups are:
-- Diuretics -- CCBs -- ACIEs -- ARBs * Beta-adrenergic blocking agents are no longer included. |
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Treatment of Hypertension: According to JNC 8, what diuretics are included as recommendations for treatment of hypertension? |
*Per JNC, only the thiazide diuretics, chlorthalidone and indapamide are included |
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Treatment of Hypertension: According to JNC8, what are no longer included in the diuretic recommendations?
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* Loop and potassium sparing diuretics are not included in the recommendation |
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What is among the most common agents for treatment of hypertension? |
* Thiazide Diuretics |
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Thiazide Diuretics: What is the most commonly used thyazide? |
* hydrochlorothiazide (HCTZ) is the most commonly used thiazide |
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Thiazide Diuretics: How are many patients with hypertension treated? |
* Many patients with hypertension are treated soley with hydrochlorothiazide (HCTZ) |
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Thiazide Diuretics - MOA: What is the MOA of thiazide Diuretics? |
* Mechanism of Action (MOA) - exact MOA unknown |
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Thiazide Diuretics - MOA:
What does thiazide initially inhibit and where? |
* Thiazide initially inhibits sodium reabsorption from the distal convoluted tubule of the kidneys
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Thiazide Diuretics - MOA: What passively accompanies the sodium and what does it produce? |
* Water and chloride ions passively accompany the sodium, producing diuresis (increased urine production) |
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Thiazide Diuretics - Adverse Reactions: What may be needed from taking tiazide diuretics? |
* Potassium supplementation may be needed due to loss of K+ from diuretics |
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Thiazide Diuretics - Adverse Reactions:
What 3 drugs can increase risk of arrhythmia? |
* Hypokalemia
* Digoxin * Epinephrine |
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Thiazide Diuretics - Adverse Reactions: When should epinephrine be limited to the cardiac dose |
* Limit to cardiac dose if digoxin toxicity present & thiazide is taken |
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Thiazide Diuretics - Adverse Reactions: What are 5 other side effects to using thiazide diuretics? |
* Other side effects include: -- Hyperglycemia -- Hyperlipidemia -- Hypercalcemia -- Anorexia -- Xerostomia
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Thiazide Diuretics - Adverse Reactions: What is of special concern if the patient has gout? |
* Hyperuricemia is of special concern if the patient has gout |
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Thiazide Diuretics: What can reduce the antihypertensive effect of thiazide diuretics? |
* Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce the antihypertensive effect of thiazide diuretics |
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Thiazide Diuretics:
Because it takes a few days to develop, use of NSAIDs to reduce the antihypertensive effect is ok for what? |
* It takes a few days to develop so use of NSAIDs ok for acute, short term use
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Loop Diuretics: What is the most common loop diuretic? |
* Furosemide (Lasix) is the most common loop diuretic |
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Loop Diuretics - MOA:
What does loop diuretics act on? |
* Acts on the ascending limb of the loop of henley and has some effect on the distal tubels
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Loop Diuretics:
What does loop inhibit reabsorption of? What is there concurrent loss of? |
* Inhibits reabsorption of sodium with concurrent loss of fluids and potassium
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Loop Diuretics: What is usually prescribed to take with florsemide? |
* Usually potassium is prescribed to take with the flurosemide to replace lost potassium |
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Loop Diuretics: Besides furosemide, what are also included as loop diuretics? |
* Other loop diuretics include bumetanide and torsemide |
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Loop Diuretics: What are loop diuretics more potent than and at a higher risk of? |
* More potent than thiazides, higher risk of adverse effects |
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Loop Diuretics - Adverse effects: What are loop diuretics' adverse effects similar to? |
* Adverse effects are similar to those from thiazide diuretics |
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Loop Diuretics: What are loop diuretics used in treatment of? |
* Used in treatment of hypertensive patients with heart failure |
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Loop Diuretics: What do loop diuretics cause? |
* Rapid diuresis |
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Loop Diuretics: What is the efficacy of loop diuretics decreased by? |
* Decreased efficacy when NSAIDs are used |
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Potassium-Sparing Diuretics:
What type of diuretic action do potassium-sparing diuretics have? |
* Weak diuretics action
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Potassium-Sparing Diuretics: What two drugs are potassium-sparing diuretics? |
Spironolactone and Triamterene |
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Potassium-Sparing Diuretics:
What is spironolactone MOA? What does it result in and what is reabsorbed? |
* Spironolactone: aldostrone antagonist
-- results in sodium excretion through diuresis and loss of fluid volume -- Potassium is reabsorbed |
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Potassium-Sparing Diuretics:
What is triamterene MOA? What does it inhibit? |
* Interferes with sodium-potassium exchange by inhibiting sodium-potassium adenosine triphosphate (ATPase)
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Potassium-Sparing Diuretics: What is used to reduce potassium loss? |
*Combo of triamterene/hctz used to reduce potassium loss |
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Calcium Channel Blockers: What is the MOA of CCBs? |
* MOA - inhibits movement of extracellular calcium ions into cells |
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Calcium Channel Blockers: How do CCBs affect smooth muscle? |
* Relaxes vascular smooth muscle and dilates coronary and peripheral arteries and arterioles, reducing afterload |
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Calcium Channel Blockers: What uncommon with CCBs? |
* Orthostatic hypotension is uncommon |
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Calcium Channel Blockers: How do CCBs affect cardiac muscle? |
* May reduce heart rate, decrease myocardial contractillity (negative inotropic effect), and slow AV nodal conduction |
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Calcium Channel Blockers: What are CCBs used to treat? |
* Used to treat hypertension and other cardiac conditions such as arrhythmia and angina |
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Calcium Channel Blockers - Adverse Reactions: What are the CNS side effects of CCBs? |
* CNS: can produce excessive hypotension, which can cause dizziness, lightheadedness, and headache |
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Calcium Channel Blockers - Adverse Reactions: What are the GI side effects of CCBs? |
* GI: nausea, vomiting, and constipation |
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Calcium Channel Blockers - Adverse Reactions: What are the Cardiovascular side effects of CCBs? |
* Cardiovascular: bradycardia and edema |
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Calcium Channel Blockers - Adverse Reactions: What are the Nasal side effects of CCBs? |
* Nasal: Nasal congestion and rhinitis (may interfere with nitrous oxide) |
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Calcium Channel Blockers - Oral Effects: What are the oral effects of CCBs? |
* Xerostomia, dysgeusia, gingival enlargement |
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Calcium Channel Blockers - Oral Effects:
What may be a significant oral effect of CCBs? |
* Gingival enlargement may be significant and extend onto crown surfaces
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Calcium Channel Blockers - Oral Effects: On discontinuation of the CCBs, what usually happens to gingival enlargement? |
* On discontinuation of the CCBs, the gingival enlargement usually reverts to normal tissue and does not reappear. |
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Calcium Channel Blockers - Oral Effects: What does changing to another CCB NOT do? |
* Changing to another CCB does not appear to resolve gingival enlargement (class effect) |
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Calcium Channel Blockers - Oral Effects: What may be required if gingival enlargement does not revert to normal? |
* A gingivalectomy or gingivoplasty may be required |
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Calcium Channel Blockers - Examples: What are the two main classes of CCBs? |
Non-dihydropyridine CCBs and Dihydropyridine CCBs |
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Calcium Channel Blockers - Examples: What two drugs are in the Non-dihydropyridine CCBs class? |
* Diltiazem and verapamil |
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Calcium Channel Blockers - Examples: What is the suffix of the 6 drugs in the Dihydropyridine CCBs class? |
* Dihydropyridine CCBs end in -dipine
(amlodipine, felodipine, isradipine, nicardipine, nifedipine, nisoldipine) |
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Beta-Adrenergic Blocking Agents: Is Beta-adrenergic stimulation considered "fight or flight" or "rest and digest"? |
* Beta-adrenergic blocking agents are "fight or flight" |
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Beta-Adrenergic Blocking Agents: What is Beta1-receptor stimulation associated with? |
* Beta1-receptor stimulation is associated with increased heart rate, cardiac contractility, and AV conduction |
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Beta-Adrenergic Blocking Agents: What does Beta2-receptor stimulation cause? |
* Beta2-receptor stimulation causes bronchodilation in pulmonary tissues and vasodilation of skeletal muscles |
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Beta-Adrenergic Blocking Agents: What do nonselective Beta-adrenergic blockers block? |
* Nonselective Beta-adrenergic blocking drugs such as propranolol block both beta1- and beta2-receptors |
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Beta-Adrenergic Blocking Agents:
In usual doses, what do selective beta-adrenergic blocking drugs block? |
* In usual doses select beta-adrenergic blocking drugs such as metoprolol block beta1-receptors more than beta2-receptors
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Beta-Adrenergic Blocking Agents: What beta-adrenergic blockers are preferred for asthmatic patients and why? |
* selective beta-adrenergic blocking drugs are preferred in asthatic patients (don't block beta2), less likely to interact with epi |
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Beta-Adrenergic Blocking Agents: At large doses, what dissappears from selective beta-adrenergic blocking drugs? |
* At larger doses, the selectivity disappears |
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Beta-Adrenergic Blocking Agents: How do Beta-Adrenergic Blockers lower blood pressure? |
* Beta-adrenergic blockers lower blood pressure by decreasing cardiac output |
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Beta-Adrenergic Blocking Agents:
In addition to lowering blood pressure, what else do beta-adrenergic blockers do? |
* Reduce plasma volume and venous return
* Decrease sympathetic outflow from CNS and reduces peripheral resistance |
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Beta-Adrenergic Blocking Agents - Side Effects: What are the 3 side effects by reduction? |
* bradychardia, mental depression, and decreased sexual ability |
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Beta-Adrenergic Blocking Agents - Side Effects: What do CNS side effects include? |
* CNS effects: confusion, hallucinations, dizziness, and fatigue have been reported |
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Beta-Adrenergic Blocking Agents - Side Effects: What do GI tract effect include? |
* GI tract effects: diarrhea, nausea/vomiting, may produce mild xerostomia |
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Beta-Adrenergic Blocking Agents - Side Effects: What may beta-adrenergic blocking agents exacerbate? |
* May exacerbate asthma, angina or peripheral vascular disease |
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Beta-Adrenergic Blocking Agents - Side Effects: When should patients taking beta-adrenergic blocking agents be limited to cardiac dose of epi? And what is that dose? |
* Patients that use non-selective beta-blockers should be limited to cardiac dose of epi if there is cardiovascular disease or higher blood pressure (unless careful blood pressure monitoring is done) * 0.04 mg |
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Beta-Adrenergic Blocking Agents - Side Effects: When can usual doses of epi be given to patients with cardiovascular disease or higher blood pressure? |
* When taking selective beta1-blockers -- BUT... remember they lose selectivity at higher doses |
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Beta-Adrenergic Blocking Agents - Side Effects:
When cardiovascular disease or higher blood pressure patients on non-selective beta-blockers are given the cardiac dose of epi, what may happen with the vasopressor? |
* May have a two- to fourfold increase in vasopressor response resulting in hypertension
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Beta-Adrenergic Blocking Agents - Side Effects: When cardiovascular disease or higher blood pressure patients on non-selective beta-blockers are given the cardiac dose of epi, what leads to a hypertensive response? |
* Non select beta blockers prevent the vasodilation which leaves the alpha vasoconstriction from the epi unopposed, leading to a hypertensive response |
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Beta-Adrenergic Blocking Agents - Side Effects: When cardiovascular disease or higher blood pressure patients on non-selective beta-blockers are given the cardiac dose of epi, which patients are at risk of having a stroke? |
May not be harmful in majority of patients ( can cause headache), but those with vascular abnormalities present in the brain may have a stroke |
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Beta-Adrenergic Blocking Agents: What are 4 generic beta1-selective blockers? |
* Metaprozolol (Lopressor/Toprol XL) * Atenolol (Tenormin) * Mizoprolol (Zebeta) * Nebivolol (bystolic) |
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Beta-Adrenergic Blocking Agents: What are 4 generic non-selective beta-blockers? |
* Propranolol (Inderal LA) * Nadolol (Corgard) * Sotolol * Timolol (Blocadren) |
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Beta-Adrenergic Blocking Agents: What are 3 beta-blockers with intrinsic sympathomomimetic activities? |
* Acebutolol (Sectral) Penbutolol (Levatol) Pindolol (Visken) |
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Beta-Adrenergic Blocking Agents:
What are 2 generic beta-blockers with alpha-blocking activity? |
* Carvedilol (Coreg)
* Labetalol |
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Antiotensin-Related Agents: What are two types of drugs whos mechanism involves antiotensin?
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* ACEIs and ARBS |
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Antiotensin-Related Agents:
What is an ACE? |
* ACE - An enzyme that converts angiotensin I to II, which results in vasoconstriction as part of normal regulation of blood pressure system
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Antiotensin-Related Agents:
What do ACEIs prevent? |
* ACEIs prevent the convenrsion of angiotensin I to angiotension II
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Antiotensin-Related Agents: What do many ACEIs end in? |
* Many ACESIs end in -pril e.g. lisingpril |
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Antiotensin-Related Agents:
What do ARBs attach to and what do they block the effect of? |
* Arbs attach to the angiotensin II receptor and block the effect of angiotensin II.
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Antiotensin-Related Agents:
What is the common suffix for ARBs? |
* The common suffix for ARBs is -sartan
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Antiotensin-Related Agents: What is the prototype for ARBs? |
* Losartan (Cozaar) is the prototype for ARBs |
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Antiotensin-Related Agents: Are angiotensin-related agents safe during pregnancy? |
* No. Angiotensin-related agents are teratogenic and should be avoided in pregnancy |
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Angiotensin-Converting Enzyme Inhibitors (ACEIs) - Adverse Reactions: What are the cardiovascular adverse reactions?
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* Cardiovascular: hypotension has produced lightheadedness, and fainting. Tachycardia and chest pain have been noted. |
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Angiotensin-Converting Enzyme Inhibitors (ACEIs) - Adverse Reactions: What are the CNS adverse reactions? |
* CNS: may include dizziness, insomnia, fatigue, and headache |
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Angiotensin-Converting Enzyme Inhibitors (ACEIs) - Adverse Reactions: What are the GI adverse reactions? |
* GI: nausea, vomiting and diarrhea can occur |
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Angiotensin-Converting Enzyme Inhibitors (ACEIs) - Adverse Reactions: What is the most notable adverse reaction? |
* A dry, hacking cough can occur |
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Angiotensin-Converting Enzyme Inhibitors (ACEIs): Are ACEIs safe during pregnancy? |
* No, they are teratogenic and should be avoided in pregnancy |
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Angiotensin-Converting Enzyme Inhibitors (ACEIs): What is the suffix for ASEIs drugs? |
* ACEIs drugs end in -pril
e.g. benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Zestril, Prinivil), moexipril (Univasc), iperindopril (Aceon), quinaqril (Accupril), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik) |
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Angiotensin Receptor Blockers (ARBs): Because ARBs are more specific than ACEIs, what may be expected? |
* ARBs are more specific than ACEIs and may be expected to have fewer adverse reactions |
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Angiotensin Receptor Blockers (ARBs) - Adverse Reactions: What are the CNS adverse reactions? |
* CNS: can include dizziness, fatigue, insomnia, and headache |
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Angiotensin Receptor Blockers (ARBs) - Adverse Reactions: What are the GI adverse reactions? |
* GI: losartan can produce diarrhea |
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Angiotensin Receptor Blockers (ARBs) - Adverse Reactions: What are the Pain adverse reactions? |
* Pain: both muscle cramps, leg and back pain have been reported with losartan |
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Angiotensin Receptor Blockers (ARBs) - Adverse Reactions: What adverse reaction rarely occurs? |
* Angioedema can occur, rarely |
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Angiotensin Receptor Blockers (ARBs):
Are ARBs safe for pregnancy? |
* No, they are taratogenic and should be avoided in pregnancy
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Angiotensin Receptor Blockers (ARBs): What is the suffix for ARBs drugs?
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* ARBs drugs end in -sartan
e.g. candesartan (Atacand), eprosartan (Tevetan), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan) |
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Renin Inhibitors: What are renin inhibitors? |
* A new class of drugs approved by the U.S. Food and Drug Administration for treatment of hypertension |
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Renin Inhibitors: What is aliskiren (Tekturna)? |
* The first of a new class of drugs, the renin inhibitors |
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Renin Inhibitors:
How do renin inhibitors work? |
* Work by binding to renin (Direct renin inhibitor) which then reduces the level of angiotensin I, angiotensin II, and aldostrone
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Renin Inhibitors: Are renin inhibitors safe for pregnancy? |
No, teratogenic and are contraindicated in pregnancy |
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Renin Inhibitors: In which patients should renin inhibitors NOT be used in conjunction with ACEIs and ARBS? |
* Do not use in conjunction with ACEIs or ARBs in diabetics or in patients whos GFR <60mL/min/1.73m2 |
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Renin Inhibitors:
In which patients should renin inhibitors be used with caution? |
* Use with caution in patients:
-- who have a history of angioedema -- with worsening renal function -- with low renal blood flow |
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alpha1-Adrenergic Blocking Agents for Hypertension: What do adrenergic blockers include? |
* the adrenergic blockers include the alpha-blockers and the beta-blockers previously described -- alpha1 and alpha2 |
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alpha1-Adrenergic Blocking Agents for Hypertension: Alpha1-blocking agents produce what? |
* Alpha1-blocking agents produce peripheral vasodilation in the arteriols and venules that decreases peripheral vascular resistance |
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alpha1-Adrenergic Blocking Agents for Hypertension: What do they have a minimal effect on? |
* Minimal effect on cardiac output or renal blood flow |
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alpha1-Adrenergic Blocking Agents for Hypertension: alpha1-Adrenergic blockers result in a reduction in what? |
* Result in a reduction in urethral resistance and pressure, bladder outlet resistance, and urinary symptoms |
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alpha1-Adrenergic Blocking Agents for Hypertension: What are alpha1-adrenergic blockers used in management of? |
* Used in management of older men who have an enlarged prostate gland |
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alpha1-Adrenergic Blocking Agents - Adverse Reactions: What can the orthostatic hypotension adverse reaction result in? |
* Orthostatic Hypotension: can result in dizziness and syncope |
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alpha1-Adrenergic Blocking Agents - Adverse Reactions:
What are the CNS adverse reactions? |
* CNS: can cause CNS depression, producing either drowsiness or excitation and headache
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alpha1-Adrenergic Blocking Agents - Adverse Reactions:
What are the Cardiovascular adverse reactions? What is another side effect? |
* Cardiovascular: tachycardia, arrhythmias, and palpitations can occure
-- Peripheral edema is another side effect |
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alpha1-Adrenergic Blocking Agents: What do alpha1-adrenergic blockers end in? |
* alpha1-adrenergic drugs end in -azosin
e.g. doxazosin (Cardura), prazosin (Minipress), and terazosin (Hytrin) |
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alpha1-Adrenergic Blocking Agents: In addition to hypertension, Doxazosin and Terazosin are both indicated for the management of what? |
In addition to the treatment of hypertension, Daxazosin and Terazosin are both indicated for the management of benign prostetic hypertrophy (BPH) |
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Other Anti-hypertensive Agents: Why are these other anti-hypertensive agents used less often than the previous drug classes? |
* Because they generally have more or less tolerated adverse reactions |
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Other Anti-hypertensive Agents:
"Other anti-hypertensive agents" includes what other centrally acting agents? |
* Clonidine
* Guanethidine * Reserpine * Hydralazine |
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clonidine (Catapres): What is clonidine (Catapres)? |
* A CNS- mediated (centrally acting) antihypertensive drug that reduces peripheral resistance through a CNS-mediated action on the alpha receptor |
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clonidine (Catapres):
What does stimulation of presynaptic central alpha2- adrenergic receptors result in? |
* results in a decreased sympathetic outflow
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clonidine (Catapres): How does it affect hypertension? |
* Reduces heart rate, cardiac output, and total peripheral resistance |
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clonidine (Catapres): How is it administered? |
* May be administered orally or by transdermal patch |
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clonidine (Catapres) - Adverse Reactions: Adverse reactions inclused a high incidence of what? |
* sedation and dizziness |
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clonidine (Catapres) - Adverse Reactions: Why can abrupt discontinuation result in? |
* Rapid elevation of blood pressure has occurred with abrupt discontinuation |
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clonidine (Catapres) - Adverse Reactions:
What contributes to postural hypotension when used in a patient taking clonidine? |
* CNS depressants often used for conscious-sedation techniques in dentistry
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clonidine (Catapres) - Adverse Reactions:
clonidine has a high incidence of what 3 things; (?%) of one ? |
* A high incidence of xerostomia (40%), parotid gland swelling, and pain
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Other Centrally Acting Anti-hypertensive Agents: What are the other two centrally acting antihypertensive agents available? |
* methyldopa (Aldomet) and guanabenz (Wytensin) |
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Other Centrally Acting Anti-hypertensive Agents:
What are the adverse effects and indications of methyldopa and guanabenz? |
* adverse effects are similar and indications are similar to clonidine
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Other Centrally Acting Anti-hypertensive Agents: What may methyldopa and guanabenz be combined with in essential hypertension management? |
* may be combined with diuretics in essential hypertension management |
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Management of the Dental Patient Taking Anti-hypertensive Agents: What should be checked for and managed? |
* Xerostomia |
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Management of the Dental Patient Taking Anti-hypertensive Agents: If taking CCB's, what should be checked for? |
* Gingival enlargement |
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Management of the Dental Patient Taking Anti-hypertensive Agents: What should be checked at each appointment |
* Blood pressure |
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Management of the Dental Patient Taking Anti-hypertensive Agents: What may be indicated for high stressed patients? |
* stress reduction protocol, anti-anxiety medication |
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Management of the Dental Patient Taking Anti-hypertensive Agents: If on diuretics, what symptoms should be checked for? |
* check for symptoms of hypokalemia, which may exacerbate arrhythmias from epinephrine |