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1

What is a NORMAL BP

120/80

2

What is pre-HTN?

120-139 systolic
80-89 diastolic

3

What is stage I HTN?

140-159 systolic
90-99 diastolic

4

What is stage II HTN?

Greater than 160 systolic
Greater than 100 diastolic

5

What classifies a blood pressure as a hypertensive emergency?

DBP greater than 120mmHg

6

What are the 4 types of diuretics?

Thiazide
Thiazide-like
K+ sparing
"Loop diuretics"

7

What is the site of action of diuretics?

Renal nephron

8

Increases urinary Na+ and H2O excretion, decreases extracellular fluid and/or plasma volume which causes a decrease in TPR

Method of action of diuretics

9

What is the most commonly used medication for mild to moderate hypertension?

Diuretics

10

How do you dose diuretics?

Start with low potency, monitor for tolerance

11

What kind of diet do you recommend to a person on diuretics?

Low in Na+, high in K+

12

What should you warn your patient about when they take a diuretic?

Hypokalemia
Hypovalemia - low blood plasma
Dehydration

13

What do beta blockers do?

Decrease heart rate, decrease stroke volume, decrease TPR via decreasing renin and angiotensin II

14

What is the site of action of beta blockers?

Heart and kidney

15

Who should you caution use of beta blockers in?

Patients with pulmonary disease

16

What is the benefit of beta blockers post MI?

Cardio protective

17

What are some other uses for beta blockers?

Stage fright
Anxiety
Headache prevention/treatment
PTSD
Panic disorders

18

What should you monitor in a patient with renal insufficiency if they are taking an ACEI?

Monitor creatinine closely

19

If your patient is receiving hemodialysis and you want to start them on an ACEI, what should you do?

Communicate with nephrologist because increased incidence of negative effects

20

If your patient on an ACEI experiences edema, what should you do?

Take them off medication and do not try again! Once experienced they are always at risk and it can be life threatening

21

What vitamin should you keep an eye on if your patient is taking an ACEI?

K+

22

What is the site of action for an ACEI?

Renal (Renin-angiotensin system)

23

What do ACEIs do?

Inhibit conversion of Angiotensin I to angiotensin II

24

ACEIs _____ arteriolar resistance, _____ venous capacity, _____ cardiac output, and _______ vascular volume, and ______ renovascular resistance

Lower

Increase

Increase

Increase

Lower

25

Site of action of ARBs?

Smooth muscle of blood vessels

26

What do ARBs do?

Block angiotensin from binding to angiotensin receptors

Relaxes and dilates blood vessels

27

Site of action of direct renin inhibitor?

Renal

28

What do direct renin inhibitors do?

Inhibit renin which diminishes production of angiotensin

Dilates vessels, lowers TPR, lowers BP

29

Site of action of DCCB and NDCCB?

Vascular smooth muscle, SA and AV nodal conduction, myocardium

30

What may cause a positive ANA and a direct Coombs test?

Nifedipine