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Nurs 5229 Clinical Pharmacotherapeutics > Anti-Hypertension Drug Therapy Deck 2 > Flashcards

Anti-Hypertension Drug Therapy Deck 2 Flashcards

1
Q

Beta blocker types

A

Cardio-Selective
Nonselective
Combined

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2
Q

Cardio-Selective example

A

atenolol, metoprolol

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3
Q

nonselective example

A

propranolol block B1 and B2

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4
Q

combined example

A

Carvedilol: blocks alpha 1 and beta 1 and beta 2
Labetalol: block alpha 1 and beta 1

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5
Q

beta blocker indication

A

Use to manage HTN in patients with: angina, tachyarrhythmias, MI, and glaucoma

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6
Q

beta blocker are not to be used as f

A

first line therapy, especially in patients over age 60

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7
Q

BB Action

A

Impedes the action of catecholamines at adrenergic receptors
Reduces heart rate
Reduces force of myocardial contraction
Reduces the velocity of impulse conduction through AV node
Reduces the automaticity of ectopic pacemakers
Reduces the release of renin in the kidneys

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8
Q

BB net effect

A

Net effect: decreased cardiac output, sympathetic outflow; reduce cardiac morbidity and mortality

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9
Q

BB SE

A

Side effects: may cause – bronchospasm, depression, bradyarrhythmia, insomnia, mask hypoglycemia

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10
Q

BB are

A

Lipid soluble, adjust dosage with advancing age

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11
Q

BB are bio transofred in the

A

Bio-transformed in the liver, rest eliminated in kidney

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12
Q

Metoprolol is easier

A

easier on kidneys than atenolol

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13
Q

BB Contraindications

A

Do not use in patients with a history of sick sinus syndrome, heart failure, or 2nd or 3rd degree AV block

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14
Q

BB precautions

A

not stop abruptly in patient with CVD

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15
Q

BB do not

A

not stop abruptly in patient with CVD

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16
Q

BB not specific recomend

A

Net effect: decreased cardiac output, sympathetic outflow; reduce cardiac morbidity and mortality

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17
Q

Supplemental Drug Classes

A

Centrally Acting Alpha2 Agonists
Peripherally Acting Adrenergic Antagonists
Direct-Acting Peripheral Vasodilators
Alpha 1 Receptor Blockers

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18
Q

Centrally Acting Alpha 2 Agonists example

A

Clonidine, methyldopa

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19
Q

Centrally Acting Alpha 2 Agonists MOA

A

Stimulates alpha 2 receptors in the brainstem
Subdues sympathetic outflow to heart, kidneys, and peripheral vasculature
Reduces renin activity

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20
Q

Centrally Acting Alpha 2 Agonists net effect

A

Not considered first line treatment except in Pregnancy (methyldopa)

21
Q

Centrally Acting Alpha 2 Agonists not considered

A

Not considered first line treatment except in Pregnancy (methyldopa)

22
Q

Centrally Acting Alpha 2 Agonists are

A

2nd or 3rd adjunct therapy.

23
Q

Centrally Acting Alpha 2 Agonists often adminstered with a

A

diuretic because of tendency to cause fluid rention

24
Q

Centrally Acting Alpha2 Agonists SE

A

Side effects: Na retention with weight gain, drowsiness, sedation, dizziness, orthostatic hypotension, restlessness and nervousness, depression, dry mouth

25
Q

Centrally Acting Alpha2 Agonists SE GI

A

SE GI: constipation, abdominal pain, hepatitis

26
Q

Centrally Acting Alpha2 Agonists first dose

A

severe coronary insufficiency, renal failure

27
Q

Centrally Acting Alpha2 Agonists abrupt

A

severe coronary insufficiency, renal failure

28
Q

Centrally Acting Alpha2 Agonists precations

A

severe coronary insufficiency, renal failure

29
Q

Peripherally Acting Adrenergic Antagonists example

A

reserpine

30
Q

Peripherally Acting Adrenergic Antagonists MOA

A

Inhibits the sympathetic nervous system by depleting norepinephrine stores in the vesicles of adrenergic nerve endings
Depletes dopamine, precursor to norepinephrine

31
Q

Peripherally Acting Adrenergic Antagonists net effect

A

Net effect: Decrease in peripheral vascular resistance (PVR) and decrease in BP

32
Q

Peripherally Acting Adrenergic Antagonists only availible

A

Only available agent is reserpine

33
Q

Peripherally Acting Adrenergic Antagonists now widely

A

Not widely used due to side effects

34
Q

Peripherally Acting Adrenergic Antagonists less

A

effective over time

35
Q

Peripherally Acting Adrenergic Antagonists SE

A

multiple psycho-emotional and neurological; weight gain and fluid retention over time, orthostatic hypotension, arrhythmias, angina, impaired sexual functioning

36
Q

Peripherally Acting Adrenergic Antagonists precautions

A

cardiac, cerebrovascular or renal insufficiency

37
Q

Peripherally Acting Adrenergic Antagonists contraindications

A

Depression, PUD, ulcerative colitis, gallstones, ECT

38
Q

Selective dilation of arteriolies example

A

Hydralazine

39
Q

Selective dilation of veins

example

A

Nitroglycerin

40
Q

Dilation of arterioles and veins example

A

Prazosin

41
Q

Hydralazine for vasodialaotrs

A 
Essential hypertension
Hypertensive crisis
Angina pectoris
Heart failure
Myocardial infarction
Pheochromocytoma
Peripheral vascular disease
Pulmonary arterial hypertension
Production of controlled hypotension during surgery
42
Q

Adverse effects related to vasodilation

A

Postural hypotension
Reflex tachycardia
Expansion of blood volume

43
Q

Postural hypotension

Teach patients about symptoms of

A

hypotension (lightheadedness, dizziness) and advise them to sit or lie down if these occur. Avoid abrupt transitions from a supine or seated position to an upright position.

44
Q

Hydralazine does what

A

Selective dilation of arterioles

Mechanism unknown

45
Q

Hydralazine postural hypotension is

A

minimal

46
Q

Hydralazine uses

A

Essential hypertension
Hypertensive crisis
Heart failure

47
Q

Hydralazine ADR

A

Reflex tachycardia
Increased blood volume
Systemic lupus erythematosus–like syndrome
Headache, dizziness, weakness, and fatigue

48
Q

Interactions

A

Other antihypertensive agents
Avoid excessive hypotension
Combined with beta blocker to protect against reflex tachycardia and with diuretics to prevent sodium and water retention and expansion of blood volume

Nurs 5229 Clinical Pharmacotherapeutics (78 decks)

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