HTN Pharm

Thiazide Diuretic names?

Chlorthalidone and hydrochlorothiazide

Thiazide Diuretic metabolic effects

Hypokalemia

Hyperuricemia

Hyperglycemia

Hypercholesterolemia

Hypertriglyceridemia

Thiazide diuretics must be used above what GFR?

>30

Potassium-Sparing Diuretics names

Spironolactone and epleronone

Potassium-Sparing Diuretics are best used for

treatment-resistant hypertension

What is one major side effect of spironolactone?

gynecomastia

Potassium sparing diuretics must be used above what GFR?

>45

most common ACE name?

lisinopril

ACE side effects

hyperkalemia, angioedema, and bradykinin cough

Aces and Arbs can cause acute renal failure when a patient has…

bilateral renal artery stenosis (RAS)

ARBs names?

Olmesartan and losartan

ARBs are better than ACEs in that they do not cause what side effect?

cough due to bradykinin

If a patient has angioedema from an ACE, can we switch them to an ARB?

yes, wait six weeks prior to starting

What are the 4 first line drugs for hypertension?

ACEs, ARBs, thiazide diuretics, calcium channel blockers

What benefit do non-DHP CCBs have over DHP CCBs?

they reduce cardiac output, which can be beneficial for patient with tachycardia or a fib

What are the main side effects to monitor with CCBs?

constipation and peripheral edema

Which CCB is safe to use in pregnancy?

nifedipine

What drug class should be avoided when using a non-DHP CCB?

beta blockers

Beta blocker names?

propranolol, metoprolol, Timolol

What are the main side effects to monitor when using beta blockers?

Bradycardia and bronchospasm

Are beta blockers absolutely contraindicated in patients with asthma?

no, they are relatively contraindicated

What is a benefit of beta blockers as it pertains to an MI?

they have been shown to prevent a second MI after one has already occurred

Which beta blockers reduce morbidity and mortality in patients with HFrEF

Metoprolol succinate and bisoprolol

What is one consideration when stopping a beta blocker

Abrupt discontinuation is not recommended. Taper slowly

doxasozin and prazosin are used for

benign prosthetic hyperplasia

doxasozin and prazosin side effects

Syncope/orthostatic hypotension (first dose)

doxasozin and prazosin are best doses at what time to avoid side effects?

before bed

What are the two most common alpha beta blockers?

carvedilol and labetalol

carvedilol is beneficial for what condition?

heart failure with reduced ejection fraction

What three drugs for hypertension are safe to use in pregnancy?

labetalol, nifedipine, methyldopa

What drug is preferred in CKD + albuminuria

ACE/ARB

What drug(s) are preferred if a patient is post-MI?

Beta blocker + ACE/ARB

What drug(s) are preferred if a patient has HFrEF

RAAS drug + beta blocker + diuretic as needed

What drug is preferred if a patient has resistant hypertension?

spironolactone

Loop Diuretics names?

furosemide and torsemide

When are loop diuretics used?

Symptomatic relief for patient with heart failure, or fluid overload

What is one benefit of loop diuretics over thiazide diuretics

they can be used if GFR is below 30. Preferred in CKD

What are the only two drug classes that cause hypokalemia?

loop diuretics and thiazide diuretics

prior stroke drug regimen?

ACEi + CCB OR ACEi + Thiazide

What classes should be avoided in patients with Renal Artery Stenosis

ACEs/arbs