1When a patient has ischemic heart disease why would you want to avoid potent vasodilators?
this would cause reflex tachycardia which could lead to increase in myocardial oxygen demand
2What is first line treatment for hypertension in pregnancy?
methyldopa, labetalol, hydralazine and nifedipine
3What are second line drugs for treatment of hypertension in pregnancy?
thiazides, clonidine
4Which drugs are contraindicated in HTN during pregnancy?
furosemide, ACEI, ARB and renin inhibitors
5How would you treat HTN in children?
treat underlying cause
lifestyle changes
medications if symptomatic HTN, DM, CKD, and end organ damage or if there is no response to lifestyle changes
6What are some drugs that can be used to treat HTN in children?
ACEI, ARBs or CCB
7If a child has DM and HTN which drugs are preferred?
either an ACEI or ARBs
8What happens when a patient takes an ace inhibitor?
inhibits ACE which decreases conversion of angiotensin I to angiotensin II which will decrease BP
9What are some examples of ACEI?
lisinopril
enalapril
captopril
ramipril
benazepril
10What are the absolute contraindication of ACEI and ARBs?
hypersensitivity
C1 esterase inhibitor deficiency
pregnancy
breastfeeding
11What drugs should you avoid when taking ACEI or ARBs?
NSAIDs
K+ sparing diuretics
lithium
allopurinol
122 thiazides?
HCTZ
chlorthalidone
13What are some contraindications of thiazides?
Gout
Anuria
Severe hypokalemia
14What are some AE with thiazides?
hypokalemia
metabolic alkalosis
hyponatremia
hypercalcemia
hyperglycemia
hyperlipidemia
hyperuricemia
allergic reactions to sulfonamide
15What is a AE of long term use with thiazides?
hypokalemia
16What is the initial intervention for black patients and patients with isolated systolic hypertension?
thiazides
17What are some AE with thiazides?
hypokalemia
metabolic acidosis
hyponatremia
hypercalcemia
hyperglycemia
hyperlipidemia
hyperuricemia
allergic reactions to sulfonamide
18What do you worry about with chlorthalidone in large doses?
too much serum uric acid
hypokalemia
19Dihydropyridine examples
amlodipine
nifedipine
clevidipine
felodipine
nimodipine
20Which dihydropyridine CCB do you give for hypertensive crisis?
clevidipine
21Which dihydopyridine CCB do you give for subarachnoid hemorrhage?
nimodipine
22What are the contraindications for dihydropyridine CCB?
heart failure
aortic stenosis
hypertrophic obstructive cardiomyopathy
23What are some SE/AE of dihydropyridine?
h/a
peripheral edema
flushing
reflex tachy
gingival hyperplasia
pulmonary edema
dizziness
24What are some examples of non-dihyropyridine CCBs?
verapamil and diltiazem
25Which non-dihyropyridine CCB is used more often due to less DDI?
diltiazema
26What is verapamil good for?
headaches
27What is the MOA for non-dihyropyridine CCB?
bind to L type calcium channels in the SA and AV nodes as well as exerting effects on myocardium and vasculature-causes
reduced calcium entry into smooth muscles
coronary and peripheral vasodilation
decrease contractility
decrease BP
28What are some adverse effects of non-dihyropyridine CCB
bradycardia
AV block
Gingival hyperplasia
LV dysfunction
29What is a specific AE/SE with verpamil?
constipation and hyperprolactinemia
30What are some DDI for non-dihyropyridine CCB
statins
digoxin
31What are the beta 1 selective blockers
metoprolol succinate and tartrate
bisoprolol
atenolol
32What is the beta 1 non selective blocker?
propranolol
33What drugs do you give in hypertensive emergency?
nicardipine, labetalol or sodium nitroprusside
34Which antihypertensive drug would you consider if a patient is diabetic?
ACEI or ARB
35Which antihypertensive drug would you consider if a patient is diabetic and African American?
Thiazide or CCB
36Which antihypertensive drug would you consider if a patient had CKD?
ACEI or ARB
37What antihypertensive drug would you consider if a patient had a TIA or Stroke?
ACEI or ARB
38Which antihypertensive drug would you consider if a patient had coronary artery disease?
ACEI or ARB and BB
39Which antihypertensive drug would you consider if a patient had an ejection fraction less than 40%?
ACEI or ARB and BB and AA and diuretic
40Which antihypertensive drug would you consider if a patient had heart failure with an ejection fraction greater than 40%?
ACEI or ARB and BB and diuretic
41What are the mixed alpha and beta blockers?
labetalol
carvedilol
42What are some CI for all beta blockers
PVD
raynauds
decompensated HF
bradycardia
43What are some cautions for all betablockers?
heart block (if existing or can induce)
monitor carefully in compensated HF
44What disease can beta blockers mask s/s of?
hyperthyroidism
45MOA for labetolol?
acts on alpha 1 and beta receptors causes vasodilation and decreases peripheral resistance which causes
decrease in BP
HR, CO and stroke volume not impacted
46What is the MOA for carvedilol?
antagonist to both beta and alpha 1 receptors
lower standing BP more than supine
47What do you have to be cautious of with carvedilol?
orthostatic hypotension
48Alpha 1 antagonists are?
doxazosin, prazosin and terazosin
49What are alpha 1 antagonists used to treat?
HTN caused by pheochromocytoma or BPH
50Which drugs are alpha 2 agonists?
clonidine and methyldopa
51Which conditions can you not take BB with?
COPD or asthma since they will cause bronchoconstriction
52Metoprolol tartrate is _______ release?
immediate
53Metoprolol succinate is ______ release?
extended