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Pharmacology > 4.5 Anti-hypertensives > Flashcards

4.5 Anti-hypertensives Flashcards

1
Q

Hypertension is defined as…

A

A common, often asymptomatic disorder in which blood pressure persistantly exceeds 140 mm Hg or diastolic pressure exceeds 90 mm Hg

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2
Q

Hypertension in the normal general population is…

A

> 140/90 mm Hg

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3
Q

Hypertension in clients with renal disease or diabetes is…

A

> 130/80 mm Hg

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4
Q

The 6 main Antihypertensive agents include:

A
  • Adrenergic agents: Beta Blockers
  • Angiotensin converting enzyme (ACE) inhibitors
  • Angiotensin II receptor blockers (ARBs)
  • Calcium channel blockers
  • Diuretics
  • Vasodilators
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5
Q

The 2 Anti-hypertensive adrenergic agents are:

A

Alpha-2 agonists

Alpha-1 antagonists

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6
Q

The centrally acting alpha-2 agonists function to…

A

Modify SNS: reduces norepinephrine – reduces BP

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7
Q

The peripherally acting alpha-1 antagonists function to…

A

Blocks alpha 1 receptors- No SNS stimulation

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8
Q

Clonidine and Methyldopa are examples of…

A

Alpha-2 agonists

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9
Q

Methyldopa is commonly used to treat hypertension in what population?

A

Pregnant women

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10
Q

Prazosin and Terazosin are examples of…

A

Alpha-1 antagonists

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11
Q

Dual Alpha-1-beta blockers function to…

A

-Act peripherally at heart and blood vessels
-Reduce heart rate
- Cause vasodilation

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12
Q

Labetalol and Carvedilol are examples of…

A

Dual alpha-1-beta blockers

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13
Q

Beta-blockers function to…

A
  • Act in the periphery
  • Reduce heart rate due to beta-blockade
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14
Q

Propranolol, Atenolol, and Metoprolol are all examples of…

A

beta-blockers

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15
Q

Beta-adrenergic receptors in the heart are predominantly which kind of receptor? What are they responsible for?

A

beta1-adrenergic receptors

They are responsible for the conduction effects of the conduction system.

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16
Q

When blocked by beta-blockers, the SA node fires ____ (more or less) which leads to a __________(increased or decreased) heart rate

A

Less, decreased

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17
Q

The mechanism of action of beta-blockers is to…

A

Decrease heart rate
-decreased myocardial oxygen demand
-increased oxygen delivery to the heart

Decrease myocardial contractility
- Helps to conserve energy
- Decrease demand

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18
Q

The indications for beta-blockers include…

A
  • Angina
  • Antihypertensive
  • Cardioprotective effects, especially after MI
  • Some used for migraine headaches
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19
Q

The contraindications for beta-blockers include…

A

asthma, serious conduction disturbances

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20
Q

Side effects of beta-blockers on the cardiovascular system include…

A
  • Bradycardia
  • hypotension
  • 2nd or 3rd degree heart block
  • heart failure
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21
Q

Side effects of beta-blockers on the metabolic system

A

Altered glucose and lipid metabolism

22
Q

Side effects of beta blockers on the CNS

A

Dizziness
fatigue
mental depression
lethargy
drowsiness
unusual dreams

23
Q

Beta-blockers should never be suddenly discontinued due to risk of…

A

Rebound hypertension

24
Q

T/F, beta-blockers are used for short-term relief of of angina and BP regulation

A

False, it is a long-term treatment

25
Q

Clients taking beta-blockers should monitor pulse rate daily and report any rate lower than ____ beats per minute

A

60

26
Q

T/F dizziness and fainting are normal side effects of beta blockers and do not need to be reported

A

FALSE

27
Q

Constipation is a common problem; instruct clients to take in adequate fluids and eat foods high in what?

A

Fibre

28
Q

What does the ACE in ACE inhibitor stand for?

A

Angiotensin Converting Enzyme

29
Q

T/F ACE inhibitors are a large group of safe and effective drugs

A

true

30
Q

ACE inhibitors are often used as first-line agents for which disorders?

A

Congestive heart failure
Hypertension

31
Q

ACE inhibitors are often combined with which drugs?

A

Diuretics and calcium-channel blockers

32
Q

Angiotensin II is…

A

a potent vasoconstrictor and stimulator of aldosterone from the adrenal glands

33
Q

Aldosterone increases BP through…

A

Stimulation of sodium and water reabsorption

34
Q

The mechanism of action of ACE inhibitors is…

A

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

35
Q

Some indications for ACE inhibitors include…

A
  • Hypertension
  • Congestive Heart Failure
  • Slows progression of left ventricular hypertrophy post MI
  • Renal protective effects in clients with diabetes
36
Q

CatoPRIL, LisinoPRIL, RamiPRIL are all examples of what kind of drug?

A

ACE inhibitors

37
Q

Side effects of ACE inhibitors include…

A

Fatigue
Headache
Impaired taste
Hyperkalemia
Dizziness
Mood changes
Dry non-productive cough (reverses with drug d/c)

38
Q

After the first dose of an ACE inhibitor, what effect may occur?

A

Hypotensive effect

39
Q

Which drugs have similar effects to ACE inhibitors?

A

Angiotensin II blockers

40
Q

The function of angiotensin II blockers are to…

A

Compete with Angiotensin II for binding sites

Blocks the action of Angiotensin II on target cells –
- Blocks the VASOCONSTRICTING activity of Angiotensin II

41
Q

The function of calcium channel blockers is to…

A

Blocks Ca+ at receptor sites
- prevents muscle contraction
- smooth muscle relaxation

42
Q

A decreased peripheral smooth muscle tone due to CCB’s results in what?

A

Decreased systemic vascular resistance

43
Q

Indications for Calcium-channel blockers include…

A

Angina
Hypertension
Dysrhythmias
Migraine headaches

44
Q

Diltiazem is an example of…

A

Calcium-channel blockers

45
Q

The function of Vasodilators is to…

A

Act directly on arteriolar smooth muscle to relax

Results in decreased systemic vascular resistance

46
Q

minoxidil, Hydralizine, and diazoxide are examples of…

A

Vasodilators

47
Q

While on hypertensives, it is incredibly important that the client keep a detailed journal documenting what?

A

Regular BP checks

48
Q

Hypertensive drugs should not be stopped abruptly as it could result in what?

A

Rebound hypertensive crisis
Stroke

49
Q

Oral forms of hypertensives should be given when?

A

With food or at mealtimes. Food helps to make absorption more gradual and effective

50
Q

The normal daily fibre intake is…

A

between 21-38 mg a day

51
Q

The normal daily sodium intake is…

A

<23000 mg a day

52
Q

A good BMI range is between…

A

18-26

Pharmacology (26 decks)

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