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Diuretics, Anti-HTN, HF, Vasopressin, Desmopressin


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What are the drugs of choice for someone with migraines and HTN?
Beta blockers
What are the drugs of choice for someone with previous MI and HTN?
Beta blockers or
What are the drugs of choice for someone with heart failure and HTN?
ACEI or Beta blockers
What are the drugs of choice for someone with no structural heart disease and at risk for HF?
Would you use Metroprolol with HF?
Why would you use Metroprolol for HF?
Start out at low dose and slowly increase it to prevent remodeling. It is a negative inotrope but paradoxically helps with HF
If a patient is in the ER with pulmonary edema and HF what would you do?
Give loop to decrease preload and decrease fluid in lungs.
What is the MOA in HF?
Dilate veins to decrease preload.
If you use a loop diuretic to treat HF, what effect would it have on CO? Why?
None really. On a healthy heart it will decrease CO, but d/t Frank Starling curve in HF it is flat.
A stabilized patient with HF is going on home on what drugs?
Beta blockers
Diuretic to prevent future edema
Why is eplerenone used with HF?
it is an aldosterone blocker --> prevents remodeling d/t too much aldosterone
What is the biggest SE of eplerenone?
What is the biggest problem with hyperkalemia?
A patient is in the hospital with HF on loops and NTG but they didnt help enough, what can you give them?
Postitive inotropic drug--dont use DIGOXIN
What can you use in a patietn with stage D HF?
A patient with HF taking beta blockers and a loop, but they have a history of angioedema, what do you use?
When would you use hydrazaline and isosorbide dinitrate in HF patients?
When they cant tolerate ACEI or ARBs due to pregnancy or bilateral renal artery stenosis (RAS)
What are the drugs of choice for someone with HTN and asthma?
Why use beta blockers with HTN and MI?
decrease mortality
What is high blood pressure?
What is the goal of BP in a diabetic?
Below 130/80
What is the biggest SE of nifedipine?
Reflex tachycardia
What is the best diuretic to treat liver disease and ascites?
aldosterone antagonist (spironolactone)
What are the drugs of choice for someone with HTN and pregnant?
Is clonidine an agonist or antagonist?
alpha 2 agonist
Which drugs can you use to treat hypercalcemia?
Would you use vasopressin for nephrogenic diabetes insipidous?
No, you use thiazides and fluid.
What would you use for central diabetes insipidous?
Desmopressin because it is more V2 selective.
If a child is taking desmopressin for bedwetting and wakes up with a seizure--what is going on?
Drank too much at bedtime --> hyponatremia --> seizure
If a person has gout, HTN, bilateral RAS, and a HR of 50 bpm, what do you give them?
DHP Ca channel blocker
What effect does ACEI have on CO and HR in treatment of HTN?
What can cause you to switch from an ACEI to an ARB?
cough and angioedema
Would you use an ACEI with HTN and COPD?
Yes, but not 1st choice
If a patient has a crushing injury and a problem with the kidneys and you need to alkaline the urine, how would you do this?
Carbonic anhydrase inhibitors (CAI)
How do you get loss of K with loop diuretics?
in the collecting duct --> Na for K
If you have increased TG, normal LDL, and low HDL--what would you use?
Niacin or fibric acid derivative

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