anti HTN

Question 1

HCTZ: class

Answer 1

• thiazide diuretic
• anti HTN

Question 2

HCTZ: MOA

Answer 2

• blocks the reabsorption of Na and Cl in the early DCT
  
  • retention of Na and Cl in the nephron causes water to be retained, so inc flow of urine
• must have adequate kidney function/GFR to work

Question 3

HCTZ: Indications

Answer 3

• HTN
• edema

Question 4

HCTZ: SEs

Answer 4

• hyponatremia
• hypochloremia
• dehydration
• hypokalemia
• hyperglycemia
• hyperuricemia
• inc LDL

Question 5

HCTZ: nursing implications

Answer 5

• evalute fluid and electrolyte levels
• weigh patient
• if K+ falls below 3.5, treat with K supplement or K sparing diuretics
  
  • eat K rich foods
• measure uric acid levels
• watch blood glucose levels
• take in the morning

Question 6

metoprolol: class

Answer 6

• anti HTN
• beta blocker

Question 7

metoprolol: MOA

Answer 7

• promotes selective blockade of beta 1 receptors in the heart

Question 8

metoprolol: indications

Answer 8

• HTN
• angina
• HF
  MI

Question 9

metoprolol: SEs

Answer 9

• fatigue
• weakness

Question 10

metoprolol: ADRs

Answer 10

• bradycardia
• heart block
• HF (if used incautiously)
• reduced CO
• rebound cardiac excitement w/ abrupt withdrawal

Question 11

metoprolol: nursing implications

Answer 11

• contraindicated: bradycardia, AV heart block
• caution in pts with HF
• can be used more safely in asthmatic pts b/c selectively binds to beta 1
• masks common signs of hypoglycemia so need to watch for fatigue, hunger, weakness
• do not d/c abruptly
• monitor BP and HR
• stand up slowly due to possible orthostatic hypoTN

Question 12

losartan: class

Answer 12

• ARB
• anti HTN

Question 13

losartan: MOA

Answer 13

• they block access of Ang II to its receptor
  
  • so cause dilation of arterioles and veins
• dec release of aldosterone
• inc excretion of Na and water

Question 14

losartan: indication

Answer 14

• HTN
• HF
• diabetic nephropathy
• MI
• stroke prevention

Question 15

losartan: SEs

Answer 15

• dizziness
• hyperkalemia (b/c K sparing)
• NO COUGH

Question 16

losartan: ADRs

Answer 16

• angioedema
• fetal harm
• renal failure

Question 17

losartan: nursing implication

Answer 17

• contraindicated in the 2nd and 3rd trimester of pregnancy, pts with bilateral renal A stenosis, hx of angioedema
• can take w/ or w/o food
• monitor BP, daily weights
• monitor K+ levels

Question 18

clonidine: class

Answer 18

• centrally acting alpha 2 adrenergic agonist
• anti HTN

Question 19

clonidine: MOA

Answer 19

• causes selective activation of alpha 2 receptors in the CNS
  
  • especially in the brainstem area assoc with autonomic regulation of the CV system
• reduces sympathetic outflow to the blood vessels and to the heart

Question 20

clonidine: indications

Answer 20

• HTN
• severe pain
• ADHD
• uses under research: smoking cessation, opioid withdrawal, txing Tourette’s

Question 21

clonidine: SEs

Answer 21

• drowsiness
• xerostomia
• constipation
• CNS rxns: nightmares, vivd dreams, depression

Question 22

clonidine: ADRs

Answer 22

• rebound HTN (w/ nervousness, tachycardia, sweating)
• embryotoxic
• abuse

Question 23

clonidine: nursing implications

Answer 23

• avoid hazardous activity due to drowsiness
• reduce xerostomia by chewing gum, drinking fluids
• need to monitor BP
• do not d/c abruptly to avoid rebound HTN
• do not use in pregnant
• take at bedtime