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57 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Definition of Hypertension
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Systolic Blood Pressure > 140 mmHg
Diastolic Blood Pressure > 90 mmHg |
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Clinical Presentation and Complications: Cardiovascular Effects
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Left ventricular Hypertrophy
Congestive Heart Failure (CHF) Peripheral Arterial Disease Angina Pectoris Myocardial Infarction Sudden Death |
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Clinical Presentation and Complications: Renal Effects
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Nephropathy
Renal failure Requirements for dialysis |
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Clinical Presentation and Complications: Cerebrovascular Effects
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Transient Ischemic Attacks
Stroke |
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Clinical Presentation and Complications: Opthalmologic Effects
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Retinal Hemorrhage
Retinopathy Blindness |
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Blood Pressure = ?
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BP = (Stroke Volume x Heart Rate) x Peripheral Resistance
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Beta-1 Stimulation leads to ______ heart rate and contractility, causing ______ cardiac output
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Increased, Increased
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Beta-2 Stimulation leads to arterial ________
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vasodilation
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Beta Stimulation also causes ________ renin release, causing ________ angiotensin II production
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Increased, Increased
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Alpha-1 Stimulation leads to arterial and venous __________
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vasoconstriction
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Decreased renal perfusion pressure causes ________ in renin levels
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Increases
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Angiotensin-converting enzyme causes AT-I to become ________
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Angiotensin II
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Angiotensin II is a potent _______ and stimulates _______ release, which increases sodium and fluid retention
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vasoconstrictor, Aldosterone
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Secondary Hypertension - types
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Renovascular disease
Primary aldosteronism Cushing's syndrome Pheochromocytoma Aortic coarctation |
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Blood Pressure Classification - Normal
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< 120 , < 80
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Blood Pressure Classification - Prehypertension
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120 - 139 , 80-89
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Blood Pressure Classification - Stage 1
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140 - 159 , 90 - 99
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Blood Pressure Classification - Stage 2
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> 160 , > 100
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Drug-induced Hypertension
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Alcohol
Cocaine Cyclosporine & Tacrolimus Erythropoietin Estrogen Licorice MAOI NSAIDs Steroids Tricyclic antidepressants |
Alcohol bottle on steps, Paris Hilton Cocaine mound on doormat, Charlie Sheen Cyclosporine Tacrolimus, Transplant patient in living room Erythropoetin, Dialysis patient next to door Birth control packets on kitchen table Licorice on counter Fat boy MAOI, TCAs taken by Tiger Woods NSAIDs, aspirin celebrex on computer desk, Jackie Chan taking them for pain |
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Recommended Drugs for Indication -
Heart Failure |
Diuretic
BB ACEI ARB Aldo ANT |
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Recommended Drugs for Indication -
Post-MI |
BB
ACEI ALDO ANT |
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Recommended Drugs for Indication -
High Coronary Disease Risk |
Diuretic
BB ACEI CCB |
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Recommended Drugs for Indication -
Diabetes |
Diuretic
BB ACEI ARB CCB |
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Recommended Drugs for Indication -
CKD |
ACEI
ARB |
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Recommended Drugs for Indication -
Recurrent Stroke Prevention |
Diuretic
ACEI |
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Thiazide Diuretics - MOA
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Reduction of total fluid volume through inhibition of sodium reabsorption in the distal tubules
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Thiazide Diuretics - Patient Counseling
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Can be taken with food or milk
Take early in the day to avoid nocturia Increase sensitivity to sunlight May increase blood glucose |
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Thiazide Diuretics - Drug Interactions
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NSAIDs blunt thiazide response
Probenecid and Lithium block thiazide effects Decreased lithium renal clearance |
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Loop Diuretics - MOA
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Inhibition of sodium and chloride reabsorption in ascending loop of Henle
Better than thiazides in CrCl < 30 |
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Loop Diuretics - Patient Counseling
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May be taken with food or milk
Take early in day to avoid nocturia May increase sensitivity to sunlight May increase blood glucose |
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Loop Diuretics - Drug Interactions
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Aminoglycosides can precipitate ototoxicity
NSAIDs blunt diuretic response Probenecid blocks loop diuretic effects by interfering with excretion into the urine |
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Potassium-sparing Diuretics - MOA
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Interfere with potassium and sodium exchange in the distal tubule
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Potassium-sparing Diuretics - Patient Counseling
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Take early in day to avoid nocturia
Take after meals Avoid potassium salt |
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Potassium-sparing Diuretics - Drug Interactions
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ACEI may increase risk of hyperkalemia
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Postganglionic neuron blockers - MOA
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Cause presynaptic inhibition of the release of the neurotransmitter from peripheral neurons by agonistic activity on the alpha-2 receptor
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Postganglionic neuron blockers - Patient Counseling
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Report symptoms of dizziness or hypotension
Do not take OTC cold products without asking doctor Rise slowly from lying position |
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Postganglionic neuron blockers - Drug Interaction
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TCA and chlorpromazine antagonize therapeutic effects of guanethidine
Pheochromocytoma is a contraindication Avoid in patients with CHF, angina, and cerebrovascular disease |
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Centrally active alpha-2 agonists - MOA
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Decreased sympathetic outflow to the cardiovascular system by agonistic activity on central alpha-2 receptors
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Centrally active alpha-2 agonists -
Counseling |
Dizziness or hypotension
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Centrally active alpha-2 agonists - Drug Interactions
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Use cautiously with other sedating medications
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Peripherally acting alpha-1 blockers- MOA
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Blocks alpha-1 postsynaptic receptors which causes vasodilation of both arteries and veins
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Peripherally acting alpha-1 blockers- Counseling
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Take firstr dose of no more than 1 mg of any agent, and take at bedtime
Rise slowly from lying position Dizziness |
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Peripherally acting alpha-1 blockers- Drug Interactions
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NSAIDs decrease effects
Increased effects with diuretics and Beta Blockers |
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Beta-Blockers - MOA
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Decrease cardiac contractility and heart rate, thereby cardiac output
Decrease central sympathetic output |
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Beta-Blockers - Counseling
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Dizziness or Hypotension
Avoid abrupt withdrawal Sexual dysfunction possible |
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Direct vasodilators - MOA
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Direct relaxation of peripheral arterial muscle
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Direct vasodilators - Counseling
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Dizziness or Hypotension
Hirsutism possible Rise slowly from lying position |
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Direct vasodilators - Drug Interaction
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Use with caution in renal failure or CHF or recent MI
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Calcium Antagonists - MOA
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Inhibits the influx of calcium ions through slow channels in vascular smooth muscle
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Calcium Antagonists - Counseling
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Dizziness or Hypotension
Rise slowly from lying position |
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Calcium Antagonists - Drug Interactions
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Use with caution in patients on Beta-blockers, may increase CHF and bradycardia
Use extreme caution in patients with conduction disturbances in the SA and AV node |
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ACEI - MOA
ARB - MOA |
Inhibits the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor
Inhibits the binding of angiotensin II to the angiotensin II receptor, Alternative to ACEI if cough |
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ACEI, ARB - Counseling
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Dizziness or Hypotension
Swelling of lips, mouth, or face should be considered an emergency (angioedema) Do not use potassium salts |
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ACEI, ARB - Drug Interactions
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NSAIDs- decreases effectiveness
Potassium - increase risk of hyperkalemia Avoid in bilateral renal artery stenosis or stenosis in single kidney Avoid in pregnancy |
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Direct Renin Inhibitor - MOA
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Inhibits renin, decreases renin activity and inhibits the conversion of angiotensinogen to angiotensin I
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Direct Renin Inhibitor - Counseling
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High fat meals reduce absorption
Dizziness, Hypotension Diarrhea Angioedema |
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Direct Renin Inhibitor - Drug Interactions
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Not recommended with cyclosporin
Potassium - increased risk of hyperkalemia Avoid in Pregnancy |
