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Naplex
HTN clinical pearls
| Question | Answer |
|---|---|
| Contraindication if Asthma | Nonselective beta-blockers |
| Amlodipine SEs | • Headache • Flushing • Peripheral edema • Reflex tachycardia/palpitations |
| Cause bradycardia | • Non-DHP - CCBs • Beta-blockers • Centrally-acting alpha-2 agonists |
| Drug-induced lupus (Malar ("butterfly") rash, Fever, fatigue, weight loss & anorexia, photosensitivity, Myalgia & arthralgia) | Hydralazine, methyldopa |
| Beta-1 selective | Atenolol, Metoprolol, Esmolol, Nebivolol, Betaxolol, Bisoprolol |
| Nonselective beta blockers | Nadolol, Propranolol, Pindolol, Timolol |
| Nonselective beta-blocker + alpha-1 blocker | Carvedilol, Labetalol |
| spironolactone | breasts to feel tender / Gynecomastia |
| ACE / ARBs | BBW to avoid in pregnancy |
| Nifedipine IR | NOT used for chronic hypertension |
| CCBs | gingival hyperplasia |
| Metoprolol tartrate IV:PO conversion | 1 : 2.5 |
| Clevidipine | Contraindicated with soy, soybean, or egg allergy |
| Empty tablet shell in stool (ghost table) | Procardia XL (nifedipine extended-release) |
| ER formulations that can be safely cut in half | Toprol XL (Metoprolol succinate) |
| Beta blocker SEs | Bradycardia, Fatigue, Impotence, hypoglycemia |
| Cl w sulfa allergy | Thiazide |
| Constipation | verapamil >> diltiazem, Clonidine, Guanfacine, Methyldopa |
| Anticholinergic side effects: dry mouth, somnolence, fatigue, constipation | Clonidine, Guanfacine, Methyldopa |
| Vasodilatory side effects: headache, flushing, peripheral edema, reflex tachycardia, palpitations | Hydralazine, Minoxidil, DHP CCBs |
| Do not discontinue abruptly | Beta blocker, Clonidine, Guanfacine, Methyldopa |
| Minoxidil box warning | angina exacerbations, Pericardial effusion, Manage with B Blocker, diuretics |
| Beta blocker w intrinsic sympathomimetic activity (ISA) | Acebutolol (less effect on HR reduction vs selective beta 1 blocker) |
| Impotence (B-T-C-S = Bad To Cause Sex dysfunction) | Beta blocker, thiazide, Clonidine, Spirinolactone guanfacine |
| Photosensitive | thiazide |
| IV DHP CCBs | Nicardipine, Clevidipine |
| IV ACE inhibitor | Enalaprilat |
| IV Beta-blockers | Esmolol, Labetalol |
| IV Vasodilators | Hydralazine, Nitroglycerin, Nitroprusside |
| increase lithium serum concentrations | Thiazide, ACE / ARBs, NSAIDs |
| Drug-induced hemolytic anemia (Positive direct Coombs test, Fatigue, dyspnea, pallor, jaundice, dark urine) | Methyldopa |
| Conditions can be exacerbated by a thiazide | (1) Diabetes mellitus, (2) Dyslipidemia, (3) Erectile dysfunction, (4) Gout |
| Depression | Beta blocker |
| nifedipine IR SEs | hypotension & ischemic events (eg, MI) |
| Portal HTN | Nadolol (Corgard), propranolol |
| Catapres-TTS counseling points | Replace the patch every 7 days, Remove the patch before magnetic resonance imaging (MRI), Localized skin reactions, The patch should not be abruptly discontinued |
| Spironolactone SEs | Hyperkalemia, Gynecomastia, Impotence, Renal impairment |
| Drug-induced hemolytic anemia | Methyldopa, Levodopa, Penicillins, Cephalosporins, Sulfonamides, Isoniazid, Rifampin, Quinidine, Quinine |
| Medication should be avoided because it can exacerbate HF | non-DHP CCBs (diltiazem and verapamil) |
| BP med causes diarrhea | Olmesartan (Benicar) |
| Adverse effects of clonidine & guanfacine | Bradycardia, hypotension, Dry mouth, constipation, Somnolence, fatigue, dizziness, Impotence |
| CNS-related effects • Fatigue, dizziness, depression • Risk with lipophilic beta-blockers (eg, propranolol) | beta-blockers |
| BP meds causes both hyperkalemia and renal dysfunction | ACE , ARBs & ARNIs |
| short-acting oral antihypertensives for HTN urgency (PO) | captopril, clonidine, hydralazine |
Created by:
dao.vo11017