PHARMACOLOGY CARDIAC MEDS EXAM
PREP
JNC-8 (2014) AHA/ACC
Guidelines (2017)
Definitions
Normal: <120/<80
Pre-hypertension: 120-139/80-89
Stage 1:
... [Show More] 140-159/90-99
Stage 2: >160/>100
Normal: <120/80
Elevated: SBP 120-
129
Stage 1: 130-
139/80-89
Stage 2: >140/>90
>60 yo: >150/90
Thresholds for
initiating treatment <60 yo or comorbid conditions
(DM, CKD): >140/90
>130 SBP or >80
DBP if history of
CVD or
>10% ASCVD risk.
>140/90 if no
clinical CVD and
<10% ASCVD risk
Treatment goals
<140/90 if <60 yo or comorbid
conditions (DM, CKD); (Grade
E recommendation)
<130/80
<150/90 if >60 yo (Grade A
recommendation)
lHTN
Thiazide diuretics include:
• HCTZ (hydrocholorothiazide) 12. to 25 mg PO daily
• Hygroton (chlorthalidone) 12.5 to 25mg PO daily
• Lozol (indapamide) PO daily
preferred agent for treating stage 1 hypertension, and the preferred initial therapy for
treating African Americans with hypertension. All diuretics decrease blood volume,
venous pressure, and preload. More specifically, thiazide diuretics block the sodium-
chloride channel in the kidney, decreasing the cross of sodium over the luminal
membrane, which in turn decreases the action of the sodium-potassium pump and
sodium and water passage to the renal interstitium. These changes increase urinary
output and require the monitoring of potassium and other electrolytes to prevent
adverse effects. All thiazides contain sulfa compounds; therefore, these medications
should be avoided in patients allergic to sulfa. Thiazide diuretics are also used to
manage osteopenia or osteoporosis, as they slow calcium loss in bones.
SE: Hyper
o Hyperglycemia (evidence unclear about interactions
o Hyperuricemia (can precipitate gout)
o May cause hyperlipidemia
Hypo
o Hypokalemia (potentiates digoxin toxicity and increases risk of arrhythmias)
o Hyponatremia (hold diuretic, restrict water intake, replace K+ loss)
o Hypomagnesemia
Contraindications: Allergy to SULFA or thiazide [Show Less]