4.5 Anti-hypertensives Flashcards
Hypertension is defined as…
A common, often asymptomatic disorder in which blood pressure persistantly exceeds 140 mm Hg or diastolic pressure exceeds 90 mm Hg
Hypertension in the normal general population is…
> 140/90 mm Hg
Hypertension in clients with renal disease or diabetes is…
> 130/80 mm Hg
The 6 main Antihypertensive agents include:
- Adrenergic agents: Beta Blockers
- Angiotensin converting enzyme (ACE) inhibitors
- Angiotensin II receptor blockers (ARBs)
- Calcium channel blockers
- Diuretics
- Vasodilators
The 2 Anti-hypertensive adrenergic agents are:
Alpha-2 agonists
Alpha-1 antagonists
The centrally acting alpha-2 agonists function to…
Modify SNS: reduces norepinephrine – reduces BP
The peripherally acting alpha-1 antagonists function to…
Blocks alpha 1 receptors- No SNS stimulation
Clonidine and Methyldopa are examples of…
Alpha-2 agonists
Methyldopa is commonly used to treat hypertension in what population?
Pregnant women
Prazosin and Terazosin are examples of…
Alpha-1 antagonists
Dual Alpha-1-beta blockers function to…
-Act peripherally at heart and blood vessels
-Reduce heart rate
- Cause vasodilation
Labetalol and Carvedilol are examples of…
Dual alpha-1-beta blockers
Beta-blockers function to…
- Act in the periphery
- Reduce heart rate due to beta-blockade
Propranolol, Atenolol, and Metoprolol are all examples of…
beta-blockers
Beta-adrenergic receptors in the heart are predominantly which kind of receptor? What are they responsible for?
beta1-adrenergic receptors
They are responsible for the conduction effects of the conduction system.
When blocked by beta-blockers, the SA node fires ____ (more or less) which leads to a __________(increased or decreased) heart rate
Less, decreased
The mechanism of action of beta-blockers is to…
Decrease heart rate
-decreased myocardial oxygen demand
-increased oxygen delivery to the heart
Decrease myocardial contractility
- Helps to conserve energy
- Decrease demand
The indications for beta-blockers include…
- Angina
- Antihypertensive
- Cardioprotective effects, especially after MI
- Some used for migraine headaches
The contraindications for beta-blockers include…
asthma, serious conduction disturbances
Side effects of beta-blockers on the cardiovascular system include…
- Bradycardia
- hypotension
- 2nd or 3rd degree heart block
- heart failure
Side effects of beta-blockers on the metabolic system
Altered glucose and lipid metabolism
Side effects of beta blockers on the CNS
Dizziness
fatigue
mental depression
lethargy
drowsiness
unusual dreams
Beta-blockers should never be suddenly discontinued due to risk of…
Rebound hypertension
T/F, beta-blockers are used for short-term relief of of angina and BP regulation
False, it is a long-term treatment
Clients taking beta-blockers should monitor pulse rate daily and report any rate lower than ____ beats per minute
60
T/F dizziness and fainting are normal side effects of beta blockers and do not need to be reported
FALSE
Constipation is a common problem; instruct clients to take in adequate fluids and eat foods high in what?
Fibre
What does the ACE in ACE inhibitor stand for?
Angiotensin Converting Enzyme
T/F ACE inhibitors are a large group of safe and effective drugs
true
ACE inhibitors are often used as first-line agents for which disorders?
Congestive heart failure
Hypertension
ACE inhibitors are often combined with which drugs?
Diuretics and calcium-channel blockers
Angiotensin II is…
a potent vasoconstrictor and stimulator of aldosterone from the adrenal glands
Aldosterone increases BP through…
Stimulation of sodium and water reabsorption
The mechanism of action of ACE inhibitors is…
ACE inhibitors block the angiotensin-converting enzyme, thus preventing the formation of angiotensin II
The result of this is:
- decreased systemic vascular resistance - vasodilation
- decreased BP
Some indications for ACE inhibitors include…
- Hypertension
- Congestive Heart Failure
- Slows progression of left ventricular hypertrophy post MI
- Renal protective effects in clients with diabetes
CatoPRIL, LisinoPRIL, RamiPRIL are all examples of what kind of drug?
ACE inhibitors
Side effects of ACE inhibitors include…
Fatigue
Headache
Impaired taste
Hyperkalemia
Dizziness
Mood changes
Dry non-productive cough (reverses with drug d/c)
After the first dose of an ACE inhibitor, what effect may occur?
Hypotensive effect
Which drugs have similar effects to ACE inhibitors?
Angiotensin II blockers
The function of angiotensin II blockers are to…
Compete with Angiotensin II for binding sites
Blocks the action of Angiotensin II on target cells –
- Blocks the VASOCONSTRICTING activity of Angiotensin II
The function of calcium channel blockers is to…
Blocks Ca+ at receptor sites
- prevents muscle contraction
- smooth muscle relaxation
A decreased peripheral smooth muscle tone due to CCB’s results in what?
Decreased systemic vascular resistance
Indications for Calcium-channel blockers include…
Angina
Hypertension
Dysrhythmias
Migraine headaches
Diltiazem is an example of…
Calcium-channel blockers
The function of Vasodilators is to…
Act directly on arteriolar smooth muscle to relax
Results in decreased systemic vascular resistance
minoxidil, Hydralizine, and diazoxide are examples of…
Vasodilators
While on hypertensives, it is incredibly important that the client keep a detailed journal documenting what?
Regular BP checks
Hypertensive drugs should not be stopped abruptly as it could result in what?
Rebound hypertensive crisis
Stroke
Oral forms of hypertensives should be given when?
With food or at mealtimes. Food helps to make absorption more gradual and effective
The normal daily fibre intake is…
between 21-38 mg a day
The normal daily sodium intake is…
<23000 mg a day
A good BMI range is between…
18-26
