First-line HTN medications
These four drug classes are recommended as first-line therapy for hypertension according to JNC8 guidelines.
What are ACE inhibitors, ARBs, calcium channel blockers, and thiazide diuretics?
ACE inhibitors and ARBs are often used in patients with these two chronic conditions.
What are heart failure and chronic kidney disease?
All calcium channel blockers cause this effect on arterial smooth muscle, leading to decreased afterload.
What is vasodilation?
This thiazide is the most commonly prescribed and is also the least expensive.
What is hydrochlorothiazide (HCTZ)?
The primary therapeutic benefit of potassium-sparing diuretics is the retention of this electrolyte.
What is potassium?
This statin is the most potent, followed by atorvastatin.
What is rosuvastatin?
According to JNC8, this class of medications is not considered a first-line option for treating hypertension
What are beta blockers?
A mild rise in this lab value (up to 30%) after starting ACE inhibitors is expected and may indicate renal protection.
What is serum creatinine?
This beverage should be avoided while taking verapamil or diltiazem due to potential CYP 450 3A4 interactions.
What is grapefruit juice?
A potential risk of high-dose HCTZ is this electrolyte disturbance that can cause muscle cramps or arrhythmias.
What is hypokalemia?
Loop diuretics are a first-line treatment for fluid retention in this cardiac condition.
What is heart failure?
This is a severe adverse effect of statins characterized by muscle breakdown and risk of kidney failure.
What is rhabdomyolysis?
The two recommended first-line medications for Black patients according to JNC8.
What are thiazide diuretics and calcium channel blockers?
This serious adverse effect, marked by swelling of the face or throat, is more common in African American and Asian populations.
What is angioedema?
Verapamil and diltiazem can increase the levels of this cardiac glycoside.
What is digoxin?
Thiazides are not effective in patients with this level of renal dysfunction.
What is GFR <30 mL/min?
This loop diuretic has a longer duration of action than furosemide.
What is torsemide?
PCSK9 inhibitors are given by this route of administration.
What is subcutaneous injection?
These two conditions make ACE inhibitors or ARBs a preferred first-line treatment.
What are heart failure and chronic kidney disease?
This side effect is caused by bradykinin accumulation and is a common reason for discontinuing ACE inhibitors.
What is a dry, persistent cough (ACE cough)?
CCBs may cause this dental side effect, characterized by gum tissue overgrowth.
What is gingival hyperplasia?
Thiazides are contraindicated in people with an allergy to this drug class.
What are sulfonamides?
Spironolactone may cause this hormone-related side effect, especially in men.
What is gynecomastia?
These two conditions are major indications for PCSK9 inhibitors in patients who are uncontrolled with statins.
What are primary hypercholesterolemia and familial hypercholesterolemia?
This class of medications is especially beneficial for patients with proteinuric chronic kidney disease.
What are ACE inhibitors or ARBs?
DRIs do not provide this kind of organ protection as effectively as ACE inhibitors or ARBs.
What is renal protection?
Though effective for blood pressure, verapamil should be avoided in these patients due to its negative inotropic effect.
Who are heart failure patients?
Thiazides may raise the levels of this substance, making gout worse.
What is uric acid?
A potentially serious but rare auditory side effect of high-dose or rapid IV loop diuretics.
What is ototoxicity?
These mild upper respiratory and flu-like symptoms are common adverse effects of PCSK9 inhibitors
What are pharyngitis, rhinitis, and flu-like symptoms?