Top 400 - HTN + HF Flashcards PDF

Top 400 - HTN + HF Leave the first rating Others also viewed these textbooks Pharmacology: An Introduction 8th Edition • ISBN: 9781260470512 Barbara T Nagle, Hannah Ariel, Henry Hitner, Michele B. Kaufman, Yael Peimani-Lalehzarzadeh 1,355 solutions Search for a textbook or question Students also...

Top 400 - HTN + HF Leave the first rating Others also viewed these textbooks Pharmacology: An Introduction 8th Edition • ISBN: 9781260470512 Barbara T Nagle, Hannah Ariel, Henry Hitner, Michele B. Kaufman, Yael Peimani-Lalehzarzadeh 1,355 solutions Search for a textbook or question Students also viewed Cardio/Respiratory emergencies 6 terms foundations week 10- cardio Peds Quiz 2 68 terms TopJorjaBirrell 400 - HTN + HF Preview lindsaystillman7 LEC 13: Bradyarrhythmias; ZACH 16 terms Preview lexiepayne13 47 terms Preview Alonza_Klopfer1 Preview Terms in this set (57) Atenolol [B1-Blocker] Max dose: 100mg qd *All ↓insulin secretion and ↑BG Tenormin BBW: Do not stop abruptly to avoid acute tachycardia, HTN and/or ischemia CI:↓HR, heart block - Monitor w/ diltiazam, verapamil, clonidine, digoxin, amiodarone Caution: DM (worsen BG + mask ↓BG) + COPD/asthma SE: ↓HR, hypoTN, depression, ↓libido, fatigue, dizziness Metoprolol tartrate (IR) [B1-Blocker] Max: 450mg/d (doses are BID) Take WITH MEAL or RIGHT AFTER MEAL *All ↓insulin secretion and ↑BG IV:PO conversion is 1:2.5 Lopressor BBW: Do not stop abruptly to avoid acute tachycardia, HTN and/or ischemia CI:↓HR, heart block - Monitor w/ diltiazam, verapamil, clonidine, digoxin, amiodarone Caution: DM (worsen BG + mask ↓BG) + COPD/asthma SE: ↓HR, hypoTN, depression, ↓libido, fatigue, dizziness https://quizlet.com/549515787/top-400-htn-hf-flash-cards/?funnelUUID=bee42301-e0c9-47a1-9c6e-1d7fa7738a51 1/12/24, 11:10 PM Page 1 of 11 Metoprolol succinate [β1-Blocker] HTN: Max 400mg/day HF Target dose: 200mg/d Take WITH MEAL or RIGHT AFTER MEAL *All ↓insulin secretion and ↑BG Toprol XL BBW: Do not stop abruptly to avoid acute tachycardia, HTN and/or ischemia CI:↓HR, heart block - Monitor w/ diltiazam, verapamil, clonidine, digoxin, amiodarone Caution: DM (worsen BG + mask ↓BG) + COPD/asthma SE: ↓HR, hypoTN, depression, ↓libido, fatigue, dizziness Nebivolol [β1B-NO dependent vasodilation] Max dose 40mg/day Bystollic BBW: Do not stop abruptly to avoid acute tachycardia, HTN and/or ischemia CI:↓HR, heart block, Child-Pugh class B (or C?Lexi) - Monitor w/ diltiazam, verapamil, clonidine, digoxin, amiodarone Caution: DM (worsen BG + mask ↓BG) + COPD/asthma SE: ↓HR, hypoTN, depression, ↓libido, fatigue, dizziness Esmolol [β1-Blocker] *IV only for HTN emergency Brevibloc BBW: Do not stop abruptly to avoid acute tachycardia, HTN and/or ischemia CI:↓HR, heart block - Monitor w/ diltiazam, verapamil, clonidine, digoxin, amiodarone Caution: DM (worsen BG + mask ↓BG) + COPD/asthma SE: ↓HR, hypoTN, depression, ↓libido, fatigue, dizziness Propranolol [Nonselective BB] IR: 80mg BID ER: 80mg QD (Max: 640mg/d) Take WITH FOOD *Lipophilic → CNS effects for migraine PPX + anxiety Inderal LA or XL, InnoPran XL, Hemangeol (PO solution) BBW: Do not stop abruptly to avoid acute tachycardia, HTN and/or ischemia CI:↓HR, heart block - Monitor w/ diltiazam, verapamil, clonidine, digoxin, amiodarone Caution: DM (worsen BG + mask ↓BG) + COPD/asthma SE: ↓HR, hypoTN, depression, ↓libido, fatigue, dizziness Timolol [Nonselective BB] RxPO: 40mg PO BID *Only generic in USA Blocadren BBW: Do not stop abruptly to avoid acute tachycardia, HTN and/or ischemia CI:↓HR, heart block - Monitor w/ diltiazam, verapamil, clonidine, digoxin, amiodarone Caution: DM (worsen BG + mask ↓BG) + COPD/asthma SE: ↓HR, hypoTN, depression, ↓libido, fatigue, dizziness https://quizlet.com/549515787/top-400-htn-hf-flash-cards/?funnelUUID=bee42301-e0c9-47a1-9c6e-1d7fa7738a51 1/12/24, 11:10 PM Page 2 of 11 Labetalol [α1-blocker + BB] - IV + PO Max: 2400mg/d - dosed BID - start 100mg BID IV: 5-20 mg over 2 minutes; repeat q10min until target Take WITH FOOD DOC in pregnancy Normodyne, Trandate BBW: Do not stop abruptly to avoid acute tachycardia, HTN and/or ischemia CI:↓HR, heart block - Monitor w/ diltiazam, verapamil, clonidine, digoxin, amiodarone Caution: DM (worsen BG + mask ↓BG) + COPD/asthma SE: ↓HR, hypoTN, depression, ↓libido, fatigue, dizziness Carvedilol [α1-blocker + BB] HTN: 3.125-25 mg po BID take WITH FOOD HF target dose: 25mg BID (≤85KG), 50mg BID (>85KG) HF CR: start 10mg QD for 2wks, titrate to max 80mg QD IR:CR conversion → 3.125 BID = 10 mg QD Coreg BBW: Do not stop abruptly to avoid acute tachycardia, HTN and/or ischemia CI:↓HR, heart block - Monitor w/ diltiazem, verapamil, clonidine, digoxin, amiodarone Caution: DM (worsen BG + mask ↓BG) + COPD/asthma SE: ↓HR, hypoTN, depression, ↓libido, fatigue, dizziness Diltiazem [NDHP-CCB] I: HTN, angina, arrhythmias Max dose: 120mg/day (QD, BID, or TID) Cardizem *More negative inotropic effects Warnings: AV block/sinus bradycardia, skin rxns (SJS, TEN, etc. dc if it persists), hepatic effects, ↓HR) DDI: 3A4 inhibitor + substrate (use ↓dose with Simva, Lova, Atorva) + Pgp substrate SE: bradycardia, gingival hyperplasia, constipation, hypoTN, edema, dizziness Verapamil [NDHP-CCB] I: HTN, angina, arrhythmia Max dose: 120mg/day (QD, BID, or TID) *Preferred if CKD and nephropathy Calan, Isoptin, Verelan, Covera *More negative inotropic effects Warnings: AV block/sinus bradycardia, skin rxns (SJS, TEN, etc. dc if it persists), hepatic effects, ↓HR) SE: bradycardia, gingival hyperplasia, constipation, edema, hypoTN, dizziness DDI: 3A4 inhibitor + substrate (use ↓dose with Simva, Lova, Atorva) + Pgp substrate May worsen s/sxs of HF Amlodipine [DHP-CCB]. I: HTN, angina - *Best one for HFrEF Max dose: 10mg/d Norvasc CI: CHF, DNU w/ BB if acute MI (AV block + bradycardia) SE: reflex tachycardia, HA, flushing, edema, gingival hyperplasia DDI: Major 3A4 substrate https://quizlet.com/549515787/top-400-htn-hf-flash-cards/?funnelUUID=bee42301-e0c9-47a1-9c6e-1d7fa7738a51 1/12/24, 11:10 PM Page 3 of 11 Felodipine ER [DHP-CCB] I: HTN, angina Max dose: 10mg/d Plendil CI: CHF, DNU w/ BB if acute MI (AV block + bradycardia) SE: reflex tachycardia, HA, flushing, edema DDI: Major 3A4 substrate Isradipine CR [DHP-CCB] - Generic only I: HTN, angina Max dose: 10mg/d DynaCirc CI: CHF, DNU w/ BB if acute MI (AV block + bradycardia) SE: reflex tachycardia, HA, flushing, edema DDI: Major 3A4 substrate Nicardipine [DHP-CCB] - IV + PO I: HTN, angina RxPO: 20-40 mg TID (usual 60mg/day) Cardene CI: CHF, DNU w/ BB if acute MI (AV block + bradycardia) SE: reflex tachycardia, HA, flushing, edema DDI: Major 3A4 substrate Nifedipine ER [DHP-CCB] I: HTN, angina Max dose: 90mg/d Adalat CC, Procardia XL, Afeditab CR, Nifedical XL DOC for pregnancy CI: CHF, DNU w/ BB if acute MI (AV block + bradycardia) SE: reflex tachycardia, HA, flushing, edema DDI: Major 3A4 substrate Doxazosin [Non-selective Alpha Blocker] I: BPH, HTN (IR and only if BPH) IR: 1mg QHS, titrate slowly (orthostasis/syncope esp. w/ 1st dose) - Max 16 mg/d Cardura (HTN), Cardura XL Cardura XL: take 4mg WITH BKF max 8mg/d; ghost tablet in stool Must Taper off Warnings: CNS depression, Floppy iris syndrome, ↓WBC+Neutrophils, Priapism, orthostatic HypoTN Prazosin [Non-selective AlphaBlocker] I: BPH, HTN (only if BPH) RxPO: 5mg BID or TID (for both indications) Minipress Must taper off Warnings: CNS depression, Floppy iris syndrome, ↓WBC+Neutrophils, Priapism, orthostatic HypoTN Caution: syncope, dizziness, fatigue → Titrate Terazosin [Non-selective AlphaBlocker] - Generic only I: HTN (only if BPH), BPH BPH: start 1mg po QHS, titrate slowly (d/t syncope) Hytrin (Canada) *Normal dose: 10mg QHS (max 20mg) Must taper off Warnings: CNS depression, Floppy iris syndrome, ↓WBC+Neutrophils, Priapism, orthostatic HypoTN Caution: syncope, dizziness, fatigue → Titrate https://quizlet.com/549515787/top-400-htn-hf-flash-cards/?funnelUUID=bee42301-e0c9-47a1-9c6e-1d7fa7738a51 1/12/24, 11:10 PM Page 4 of 11 Clonidine ER [Alpha2 Agonist] I: ADHD (ER tab), HTN RxPO: 0.2 to 0.6 mg/day divided BID Patch: 0.1 -0.3 mg/24-hour patch applied q7days ADHD: 0.1mg QHS (max 0.4mg/day) Kapvay, Catapres-TTS, Catapres, Duraclon (epidural solutio) *If transitioning from PO to patch, overlap oral regimen for 1 to 3 days - patch takes ~3d for therapeutic effect AEs: ↓HR, dry mouth, fatigue, somnolence, dizziness, constipation, hypoTN Must be tapered off to ↓ risk of rebound hypertension, nervousness & anxiety DNU for HTN if PT has HFrEF of ischemic origin Patch Counseling: Apply to upper outer arm/chest + rotate site weekly Guanfacine ER [Alpha2 Agonist] I: ADHD (Intuniv ER), HTN (IR) HTN RxIR: 0.5 - 1 mg qHS; max 2 mg qHS - For HTN - PM to ↓ somnolence Intuniv ER: 1mg daily (max 7mg/d, 4mg/d w/stimulants) Intuniv, Tenex - For ADHD DNU with high-fat meal (↑ absorption) Warnings: Skin rash with exfoliation and pruritus (dc + monitor), CNS depression, AV block, brady, hypoTN, orthostasis, DDI: 3A4 substrate (w/ inducers ↑dose 50%, w/ inhibitors ↓ dose 50%) Must be tapered off to ↓ risk of rebound HTN, nervousness, anxiety Methyldopa [Alpha2 Agonist] - only PO RxPO: 250 - 1,000 mg divided BID (max 3,000 mg/day) Renal adjustment recommended DOC in pregnancy Aldomet SE: DILE (lupus), hepatitis, hemolytic anemia Caution: bradycardia, dry mouth, fatigue, depression, psych rxns, impotence, rebound HTN, Edema, sedation Must taper off Hydralazine [Direct Vasodilator] - generic only I: HTN RxPO: 100-200 mg/d divided QID Apresoline SE: DILE (with doses >200 mg/day) AEs: HA, hypotension, reflex tachycardia, palpitations, peripheral neuritis Combo tab: + Isosorbide dinitrate (BiDil) Minoxidil [Direct Vasodilator] I: HTN RxPO: 10-40 mg/day in 1- 3 divided doses Loniten BBW: pericarditis + pericardial effusion that may progress to tamponade. May increase O2 demand and exacerbate angina pectoris SE: hair growth (Hypertrichosis), edema (give w/ diuretics), Caution: reflex tachycardia https://quizlet.com/549515787/top-400-htn-hf-flash-cards/?funnelUUID=bee42301-e0c9-47a1-9c6e-1d7fa7738a51 1/12/24, 11:10 PM Page 5 of 11 Chlorothiazide [Thiazide] - PO is generic only IV + PO (500-2000mg/d dosed QD-BID) I: HTN, edema Diuril (Suspension) CI: Sulfa allergy Warnings: photosensitivity, orthostatic hypoTN SE: metab. alkalosis, ↓K, Na, Mg + ↑BG, TG, Chol, UA, Ca, DNU if CrCl < 30 mL/min ↓Lithium renal CL = ↑Lithium toxicity Avoid w/ NSAIDs Hydrochlorothiazide [Thiazide] - generic only I: HTN, edema RxPO: 12.5-50mg po QD (>25 mg/d = ↑ AE) *Preferred diuretic in normal renal function Microzide (Canada) CI: Sulfa allergy Warnings: photosensitivity, acute transient myopia, gout SE: metab. alkalosis, ↓K, Na, Mg + ↑BG, TG, Chol, UA, Ca DNU if CrCl < 30 mL/min Thiazides ↓Lithium renal CL = ↑Lithium toxicity Avoid w/ NSAIDs Chlorthalidone [Thiazide] I: HTN (Better ↓BP than loop diuretics, 1st line agent) RxPO: 12.5-25 QD, max 100mg/d Thalidone CI: Sulfa allergy Warnings: photosensitivity, gout SE: metab. alkalosis, ↓K, Na, Mg | ↑BG, TG, Chol, UA, Ca DNU if CrCl < 30 mL/min ↓Lithium renal CL = ↑Lithium toxicity Avoid w/ NSAIDs HCTZ/triamterene [Thiazide + Aldosterone Antagonist] I: HTN, edema RxPO: 1-2 tabs QD (25/37.5 mg, 25/50mg, 50/75mg) Dyazide CI: Sulfa allergy Warnings: photosensitivity, acute transient myopia, gout SE: metab. alkalosis, ↓K, Na, Mg | ↑BG, TG, Chol, UA, Ca DNU if CrCl < 30 mL/min Thiazides ↓Lithium renal CL = ↑Lithium toxicity Avoid w/ NSAIDs Metolazone [Thiazide] - generic only I: HF/renal edema, HTN (approved, not used) RxPO: 2.5 mg/day, Max 20mg/day Zaroxolyn (Canada) CI: Sulfa allergy SE: metab. alkalosis, ↓K, Na, Mg | ↑BG, TG, Chol, UA, Ca DNU if CrCl < 30 mL/min Thiazides ↓Lithium renal CL = ↑Lithium toxicity Avoid w/ NSAIDs https://quizlet.com/549515787/top-400-htn-hf-flash-cards/?funnelUUID=bee42301-e0c9-47a1-9c6e-1d7fa7738a51 1/12/24, 11:10 PM Page 6 of 11 Indapamide [Thiazide] - generic only I: HTN, edema RxPO: 5g QD (for HF + HTN) Lozol (Canada) CI: Sulfa allergy SE: metab. alkalosis, ↓K, Na, Mg | ↑BG, TG, Chol, UA, Ca DNU if CrCl < 30 mL/min Thiazides ↓Lithium renal CL = ↑Lithium toxicity Avoid w/ NSAIDs Torsemide [Loop] - generic only I: HTN, HF edema HTN:5-10 mg QD HF: 10-20 mg QD (max 200 mg/day) Demadex [DSC] CI: sulfa allergy Warnings: ototoxicity, nephrotoxicity, hyperUA SE: metab. alkalosis, ↓K+, Na+, Mg2+, Ca2+, BMD, ↑BG, TG, Chol, UA Diuretic of choice for renal disease Torse 20 mg = bume 1 mg = furo 40 mg = ethacry 50 mg Furosemide [Loop] - HF edema only RxPO: 20-40mg/day (max: 600mg/d) IV:PO conversion is 1:2 Lasix CI: sulfa allergy Warnings: ototoxicity, nephrotoxicity, hyperUA SE: metabolic alkalosis, ↓K+, Na+, Mg2+, Ca2+, BMD, ↑BG, TG, Chol, UA, photosensitivity Torse 20 mg = bume 1 mg = furo 40 mg = ethacry 50 mg Bumetanide [Loop] - HF edema only RxPO: 0.5-1mg po bid Bumex CI: sulfa allergy Warnings: ototoxicity, nephrotoxicity, hyperUA SE: metab. alkalosis, ↓K+, Na+, Mg2+, Ca2+, BMD, ↑BG, TG, Chol, UA Torse 20 mg = bume 1 mg = furo 40 mg = ethacry 50 mg Ethacrynic acid [Loop] - HF edema only RxPO: 50-200 mg divided QD-BID (max 400 mg/day) Edecrin *OK w/ Sulfa allergy Warnings: ototoxicity, nephrotoxicity SE: metab. alkalosis, ↓K+, Na+, Mg2+, Ca2+, BMD, ↑BG, TG, Chol, UA Torse 20 mg = bume 1 mg = furo 40 mg = ethacry 50 mg Triamterene [Aldosterone Antagonist/K+ sparing] I: HF edema + other origins + HTN (off label) RxPO: 100 mg BID (max 300mg/d) HTN: 50 - 100 mg divided QD-BID (used w/ thiazides to prevent hypoK) Dyrenium BBW: hyperkalemia Warnings: photosensitivity SE: ↑ K+, ↓ Ca2+, gout CI: CrCl <30, anuria, hepatic impairment https://quizlet.com/549515787/top-400-htn-hf-flash-cards/?funnelUUID=bee42301-e0c9-47a1-9c6e-1d7fa7738a51 1/12/24, 11:10 PM Page 7 of 11 Amiloride [Aldosterone Antagonist/K+ sparing] I: Ascites (of-label) + HF + HTN - Counteract K+ loss RxPO: 10 mg/day Midamor (Canada) BBW: hyperkalemia SE: ↑ K+, ↓ Ca2+, gout CI: CrCl <30, anuria, K >5.5 mEq/L, DM, diabetic nephropathy Spironolactone [Aldosterone Antagonist/K+ sparing] I: HF (↑survival in EF <35%), HTN (resistant HTN), ascites HF target: 50 mg/d divided QD-BID HTN dose: 25-100 mg QD *Take WITH FOOD to ↑ absorption + ↓GI effects - To start; Scr ≤2.5 mg/dL M and ≤2 mg/dL F or eGFR >30 and K <5 mEq/L Aldactone, CaroSpir (Suspension) Warnings: hyperkalemia, gout, gynecomastia SE: ↑ K+, ↓ Ca2+, gout, irregular menses, impotence, breast tenderness (d/t androgen block) CI: hyperkalemia *Suspension is not therapeutically equivalent to tablets Renal dose adjust **↑survival, manage edema, ↓hospita. in NYHA III-IV Eplerenone [Aldosterone Antagonist/K+ sparing] I: post MI w/ HF, HTN HTN: 50 mg BID HF: 50 mg daily Inspra CI: K >5.5 mEq/L at initiation; CrCl ≤30; w/ strong CYP3A4 inhibitors (azoles, nefazodone, clarithromycin, ritonavir, nelfinavir). SE: ↑K+, ↑TG ↓Lithium renal CL = ↑Lithium toxicity Selective - no endocrine effects Benazepril [ACEi] - HTN RxPO: 5-40mg QD or BID CI: hx of angioedema, within 36h of ARNI (Entresto) Lotensin BBW: pregnancy, bilateral renal artery stenosis SE: metab. acidosis, ↑K+, dry cough, angioedema, cholestatic jaundice *Avoid w/ NSAIDs - renal damage ↓Lithium renal CL = ↑Lithium toxicity Renal dose adjust Captopril [ACEi] - generic only I: HTN, HFrEF, diabetic nephropathy, MI w/ LV dysFXN RxPO: 50 mg TID (max) Capoten (Canada) CI: hx of angioedema, within 36h of ARNI (Entresto) BBW: pregnancy, bilateral renal artery stenosis SE: metab. acidosis, ↑K+, dry cough, angioedema, cholestatic jaundice *Avoid w/ NSAIDs - renal damage ↓Lithium renal CL = ↑Lithium toxicity Renal dose adjust https://quizlet.com/549515787/top-400-htn-hf-flash-cards/?funnelUUID=bee42301-e0c9-47a1-9c6e-1d7fa7738a51 1/12/24, 11:10 PM Page 8 of 11 Enalapril [ACEi] I: HTN, HF RxPO: 40mg/day HF target: 10-20mg BID Vasotec, Epaned (Solution) CI: hx of angioedema, within 36h of ARNI (Entresto) BBW: pregnancy, bilateral renal artery stenosis SE: metab. acidosis, ↑K+, dry cough, angioedema, cholestatic jaundice *Avoid w/ NSAIDs - renal damage ↓Lithium renal CL = ↑Lithium toxicity Renal dose adjust Fosinopril. [ACEi] - generic only I: HTN, HF HTN: 10mg QD to max 80 mg/day HF: 40mg QD Monopril (Canada) CI: hx of angioedema, within 36h of ARNI (Entresto) BBW: pregnancy, bilateral renal artery stenosis SE: metab. acidosis, ↑K+, dry cough, angioedema, cholestatic jaundice *Avoid w/ NSAIDs - renal damage ↓Lithium renal CL = ↑Lithium toxicity Renal dose adjust Lisinopril [ACEi] I: HTN, HF, ST elevation MI RxPO: 5-40 mg QD HF target: 40 mg QD Zestril, Prinivil, Qbrelis (solution) CI: hx of angioedema, within 36h of ARNI (Entresto) BBW: pregnancy, bilateral renal artery stenosis SE: metab. acidosis, ↑K+, dry cough, angioedema, cholestatic jaundice *Avoid w/ NSAIDs - renal damage ↓Lithium renal CL = ↑Lithium toxicity Renal dose adjust Quinapril [ACEI] I: HTN, HF Accupril HF target: 20 mg BID BP: 5-40mg QD, max 80 mg/d Renal dose adjust Ramipril [ACEi] I: HTN, HF, ≥55 years ↓MI + stroke + death risk Altace RxPO: 2.5-20 mg QD HF target: 5 mg BID ↓risk: 10mg QD Renal dose adjust Candesartan [ARB] I: HTN, HF HF Target: 32mg QD Atacand CI: hx of angioedema BBW: pregnancy, bilateral renal artery stenosis SE: metabolic acidosis, ↑K+, ↓dry cough + angioedema ↓Lithium renal CL = ↑Lithium toxicity Hepatic dose adjust https://quizlet.com/549515787/top-400-htn-hf-flash-cards/?funnelUUID=bee42301-e0c9-47a1-9c6e-1d7fa7738a51 1/12/24, 11:10 PM Page 9 of 11 Irbesartan [ARB] I: HTN, diabetic nephropathy HTN: 150-300mg QD (start 75mg if volume depleted) DN: 300 mg QD Avapro CI: hx of angioedema BBW: pregnancy, bilateral renal artery stenosis SE: metabolic acidosis, ↑K+, ↓dry cough + angioedema ↓Lithium renal CL = ↑Lithium toxicity Losartan [ARB] I: HTN, Proteinuric CKD HF target: 150 mg QD (off label) RxPO: 25-50 mg QD Cozaar CI: hx of angioedema BBW: pregnancy, bilateral renal artery stenosis SE: metabolic acidosis, ↑K+, ↓dry cough + angioedema ↓Lithium renal CL = ↑Lithium toxicity Valsartan [ARB] I: HTN, HFrEF, MI HF target: 160 mg BID RxPO: 80 - 160 mg QD, max 320mg Diovan CI: hx of angioedema BBW: pregnancy, bilateral renal artery stenosis SE: metabolic acidosis, ↑K+, ↓dry cough + angioedema ↓Lithium renal CL = ↑Lithium toxicity Olmesartan [ARB] I: HTN RxPO: 40mg po qd Benicar CI: hx of angioedema BBW: pregnancy, bilateral renal artery stenosis SE: spruce-like enteropathy, metabolic acidosis, ↑K+, ↓dry cough + angioedema, GI (diarrhea w/weight loss, abd pain, fatigue, bloating), N/V, anemia ↓Lithium renal CL = ↑Lithium toxicity Telmisartan [ARB] Micardis I: HTN RxPO: 20-40mg QD, max 80mg/day Aliskiren [Renin inhibitor] I: HTN RxPO: 300mg QD WITH/WITHOUT FOOD, but CONSISTENT (high fat meals ↓absorption) Tekturna BBW: pregnancy, bilateral renal artery stenosis SE: metabolic acidosis, increase K+, dry cough, angioedema *Avoid w/ NSAIDs bc of renal damage https://quizlet.com/549515787/top-400-htn-hf-flash-cards/?funnelUUID=bee42301-e0c9-47a1-9c6e-1d7fa7738a51 1/12/24, 11:10 PM Page 10 of 11 Isosorbide mononitrate [LA NTG] - generic only I: Angina, HF (off label) Imdur (Canada) CI: PDE-5 inhibitors + riociguat = ↓BP SE: HA, flushing, syncope Avoid alcohol - ↑vasodilatory effect Isosorbide dinitrate [LA NTG] I: angina prevention, HF (off label) HF-IR: max 120 mg/day Angina: 5-80 mg BID-TID Dilatrate-SR; Isordil Titradose, BiDil (+ hydralazine) CI: PDE-5 inhibitors + riociguat = ↓BP SE: HA, hypotension, dizziness, lightheadedness, flushing, syncope, tachyphylaxis (10-12h nitrate free) Avoid alcohol - ↑vasodilatory effect Sacubitril + Valsartan [Neprilysin inh + ARB) I: NYHA class II-IV (↓ HF hosp + CV death) Tabs: 24/26mg, 49/51 mg, 97/103 mg) Entresto BBW: injury + death to developing fetus in 2nd/3rd trimester, DC once pregnancy detected AEs: cough, dizziness Warnings: angioedema, renal impairment, hyperkalemia, hypoTN DNU with other ACEi - 36h washout w/ ACEi ↓Lithium renal CL = ↑ lithium toxicity Renal + Hepatic adjust - Child-Pugh class C not recomm. Potassium Chloride [K+ supplement] PPX: 20-40 mEq/d in 1-2 doses TX: 40-100 mEq/d in 2-5 doses Klor-Con, Micro-K Notes: KCl 10% = 20 mEq/15mL Micro-K - open and sprinkle contents w/o chewing K-tab/Klor-Con - swallow whole Klor-Con M: swallow whole, tab can cut in half and swallow separately or dissolve in 4oz water Digoxin [Na/K ATPase inh] +inotrope / -chronotrope I: AF, HFrEF HF dose: 0.125-0.25 mg QD - Use 0.125 if >70Y, poor renal FXN, ↓lean body mass *same dose Afib* *Take 2h before/after food *PO → IV reduce dose by 25% (80% bioavailability) Renal dose - CrCl <50: ↓ dose or frequency Warnings: vesicant, 2nd/3rd degree ♥ block, pro-arrhythmic, toxicity (loss of appetite, bradycardia, Lanoxin, Digitek N/V - initial/ blurriness, yellow/green vision, halos, confusion, delirium, prolonged PR intervals, arrhythmias - severe) SE: dizziness, mental disturbances, HA, N/V/D Monitor: renal, electrolytes (toxic risk ↑ if ↓K, ↓Mg, ↑Ca) *Antidote: Digibind or DigiFab DDI: 3A4+P-gp substrate, inhibitors ↑ Dig levels: amiodarone/dronedarone ( ↓dig dose 50%), quinidine, non-DHPCCB, erythro+clarithromycin, azoles, propafenone, etc. TDM: [Trough] prior to/6-8h after LD in 5-7d after Δs. If loading dose, check level 12-24h after initial admin. -HF: 0.5-1 ng/mL -AF: 0.8-1.2 https://quizlet.com/549515787/top-400-htn-hf-flash-cards/?funnelUUID=bee42301-e0c9-47a1-9c6e-1d7fa7738a51 1/12/24, 11:10 PM Page 11 of 11