Jnc 8

[WVUPharm2007]

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...when can we expect to crack open that thing? They've been saying Summer 2011 for a while now. I wonder what new and marginally exciting things they'll be deciding for hundreds of millions of peoples' medication regiments.

I figure they'll stop having HCTZ as the front line medication...

 

[Its Z]

why don't you wait til Summer 2011.

 

[WVUPharm2007]

why don't you wait til Summer 2011.

They usually have a "public review" thingy before the actual release where you can get a sneak peak.

 

[All4MyDaughter]

I've heard lower goals for people with certain indications (DM, heart failure, etc). I have no more info that that; just heard it mentioned during a topic discussion recently.

 

[WVUPharm2007]

I love rumors! Facts can be so misleading, where rumors, true or false, are often revealing.

 

[All4MyDaughter]

I heard the new first line agents will be Azor and ExForge.

 

[aboveliquidice]

...when can we expect to crack open that thing? They've been saying Summer 2011 for a while now. I wonder what new and marginally exciting things they'll be deciding for hundreds of millions of peoples' medication regiments.

I figure they'll stop having HCTZ as the front line medication...

They are aligning with ACC/AHA guidelines for IHD and the ESH hypertension. JNC7 hasn't been relevant for awhile. It will be interesting to see if they align completely.

If you haven't read the ESH guidelines, you are missing out. That is how it should be done.

 

[All4MyDaughter]

They are aligning with ACC/AHA guidelines for IHD and the ESH hypertension. JNC7 hasn't been relevant for awhile. It will be interesting to see if they align completely.

If you haven't read the ESH guidelines, you are missing out. That is how it should be done.

Want to give us a Cliffs Notes version? 😀

 

[aboveliquidice]

Want to give us a Cliffs Notes version? 😀

Listen soon-to-be-PGY1... you know you're gonna be reading it soon anyway.

Here's the LINK. You will have to register, which is quick and free.

EDIT: Also checkout the 2009 update... which pretty much drives home the lack of research concerning essential HTN in the geriatric population.

 

[spacecowgirl]

I can't decide if I'm more excited for this or ATP IV. Nerd.

Definitely thinking HCTZ will be out http://content.onlinejacc.org/cgi/content/abstract/57/5/590

 

[All4MyDaughter]

I think my brain is closed to processing much new information. Temporarily, I hope. I'm blaming it on third trimester hormones/fatigue/something! I need to get over it soon so I can study for law exams.

I have saved the link and will take a look later! 😀

Thanks! 🙂

 

[aboveliquidice]

I can't decide if I'm more excited for this or ATP IV. Nerd.

Definitely thinking HCTZ will be out http://content.onlinejacc.org/cgi/content/abstract/57/5/590

Yeah - major difference between jnc and ACC/AHA and ESH is the initiation of therapy. HCTZ isn't out necessarily, but it isn't the defacto first line. Five classes can be the initial therapy (thiazide diuretics, calcium antagonists,ACE-I, ARBs, and Beta-blockers) , depending upon patient specific data. Also, the average HTN patient is managed on 3 medications. So the addition of a second / third agent is better addressed as well.

Haven't heard anything about ATP IV

 

[aboveliquidice]

I think my brain is closed to processing much new information. Temporarily, I hope. I'm blaming it on third trimester hormones/fatigue/something! I need to get over it soon so I can study for law exams.

I have saved the link and will take a look later! 😀

Thanks! 🙂

Between this site, little one, and final year pharm... I think you get a pass

 

[All4MyDaughter]

Between this site, little one, and final year pharm... I think you get a pass

Thanks. I'm exhausted. It's my last day of Spring Break and I have spent 90+% of it in bed. I have had THREE separate infections. Started out with a cold (thanks, hubby!). Then I got a horrible GI virus (ewww!) and now I have bacterial sinusitis. My last rotation starts tomorrow, but thankfully I do not have to be there until 11 a.m. so I'll get a bit more rest. Only five more weeks of school and less than two months until baby time!! 😀

 

[wezvidz]

Maybe it's finally chlorthalidone's time to shine? Maybe not, we'll see.

 

[Ackj]

They usually have a "public review" thingy before the actual release where you can get a sneak peak.

Summer '11 is the public review, full release pushed back until spring '12.

http://www.nhlbi.nih.gov/guidelines/hypertension/jnc8/index.htm

 

[WVUPharm2007]

Maybe it's finally chlorthalidone's time to shine? Maybe not, we'll see.

i'd expect chlorthalidone and indapamide to ascend to the top of the coaches poll after hctz wa found to be so overrated. Hctz is the notre dame of htn...

 

[ethyl]

I remember a CE last year mentioning JNC8 will recommend dual BP med therapy in almost everybody from the start of HTN diagnosis.

 

[spacecowgirl]

I'm reading the meta-analysis and it found sig lower BP with HCTZ 50 mg. I was taught or heard somewhere that doses >25 mg don't confer additional benefit vs risks. I don't see HCTZ 50 mg ever here, but when I do float work, I do.

😕

 

[eddie269]

i'd expect chlorthalidone and indapamide to ascend to the top of the coaches poll after hctz wa found to be so overrated. Hctz is the notre dame of htn...[/QUOTE]




Basically all those "useless" drugs I studied for my boards for HTN will actually be useful again.

i.e. indapamide, chlorthalidone, etc.

I always knew ACE's would be #1 someday.

 

[bananaface]

I heard the new first line agents will be Azor and ExForge.

cool. They should be generic by then.

 

[Pharmavixen]

I'm reading the meta-analysis and it found sig lower BP with HCTZ 50 mg. I was taught or heard somewhere that doses >25 mg don't confer additional benefit vs risks. I don't see HCTZ 50 mg ever here, but when I do float work, I do.

😕

The 50mg hctz dose was commonplace when I was first practising. Hypokalemia was a problem @ this dose, and then there were the GI problems from the K supplements.

 

[iphetamine]

HCTZ also worsens the glycemic control of metabolic syndrome patients.

 

[Old Timer]

The 50mg hctz dose was commonplace when I was first practising. Hypokalemia was a problem @ this dose, and then there were the GI problems from the K supplements.

Heck when I started out, Hydrodiuril (HCTZ by MSD) came in 100mg tablets. Chlorthalidone only came in 50mg and 100 mg, as Hygroton.

 

[Pharmavixen]

Heck when I started out, Hydrodiuril (HCTZ by MSD) came in 100mg tablets. Chlorthalidone only came in 50mg and 100 mg, as Hygroton.

😱

I do remember trade-name Hydrodiuril & Hygroton (for a minute and a half anyhow).

 

[Old Timer]

😱

I do remember trade-name Hydrodiuril & Hygroton (for a minute and a half anyhow).

M.S.D.:

Hydrodiuril (Hctz)
Aldomet (Methyldopa)
Aldoril (Methyldopa+HCTZ)

​

Ciba:

Esidrix (HCTZ)
Serpasil (Reserpine)
Apresoline (Hydralazine)
Ser-Ap-Es (Reserpine+Hydralazine+HCTZ)
​

Some people were prescribing Rauwolfia Alkaloids

Propranolol was a breakthrough drug for treating angina that was used off label for hypertension. There was clonidine. Then came Capoten (captopril) and then we were off to the races...

 

[Praziquantel86]

M.S.D.:

Hydrodiuril (Hctz)
Aldomet (Methyldopa)
Aldoril (Methyldopa+HCTZ)

​

Ciba:

Esidrix (HCTZ)
Serpasil (Reserpine)
Apresoline (Hydralazine)
Ser-Ap-Es (Reserpine+Hydralazine+HCTZ)
​

Some people were prescribing Rauwolfia Alkaloids

Propranolol was a breakthrough drug for treating angina that was used off label for hypertension. There was clonidine. Then came Capoten (captopril) and then we were off to the races...

Must give you some great perspective on practice today. I think folks in my generation have a tough time realizing just how far medicine has come in the last 25 years or so.

 

[Old Timer]

Must give you some great perspective on practice today. I think folks in my generation have a tough time realizing just how far medicine has come in the last 25 years or so.

I remember when Tagamet was breakthrough drug. Before that it was Bentyl, Donnatal, & compounded capsules with belladonna and calcium carbonate. Kid's today, your focus is so short sighted.