Anti-Hypertensive Therapy: Part 1 Flashcards
1
Q
α2 agonists a. clonidine, methyldopa b. prazosin c. metoprolol carvedilol, propranolol, labetalol d. Lisinopril e. losartan f. aliskiren
A
a. clonidine, methyldopa
2
Q
• α1 blockers a. clonidine, methyldopa b. prazosin c. metoprolol carvedilol, propranolol, labetalol d. Lisinopril e. losartan f. aliskiren
A
b. prazosin
3
Q
• ß blockers a. clonidine, methyldopa b. prazosin c. metoprolol carvedilol, propranolol, labetalol d. Lisinopril e. losartan f. aliskiren
A
c. metoprolol
carvedilol, propranolol, labetalol
4
Q
•ACE Inhibitors a. clonidine, methyldopa b. prazosin c. metoprolol carvedilol, propranolol, labetalol d. Lisinopril e. losartan f. aliskiren
A
d. Lisinopril
5
Q
•ARBs a. clonidine, methyldopa b. prazosin c. metoprolol carvedilol, propranolol, labetalol d. Lisinopril e. losartan f. aliskiren
A
e. losartan
6
Q
•Direct Renin Inhibitor a. clonidine, methyldopa b. prazosin c. metoprolol carvedilol, propranolol, labetalol d. Lisinopril e. losartan f. aliskiren
A
f. aliskiren
7
Q
.Sympathetic Nervous System a. clonidine, methyldopa b. prazosin c. metoprolol carvedilol, propranolol, labetalol d. Lisinopril e. losartan f. aliskiren
A
a. clonidine, methyldopa
b. prazosin
c. metoprolol
carvedilol, propranolol, labetalol
8
Q
2.Renin-Angiotensin-Aldosterone System (RAAS)
a. clonidine, methyldopa
b. prazosin
c. metoprolol
carvedilol, propranolol, labetalol
d. Lisinopril
e. losartan
f. aliskiren
A
d. Lisinopril
e. losartan
f. aliskiren
9
Q
USED TO TREAT ◦ MAIN USE #1: Benign prostatic hyperplasia (BPH) a. clonidine, methyldopa b. prazosin c. metoprolol carvedilol, propranolol, labetalol d. Lisinopril e. losartan f. aliskiren
A
b. prazosin
10
Q
USED TO TREAT ◦ MAIN USE # 2: Bladder Outlet Obstruction (kidney stones!) a. clonidine, methyldopa b. prazosin c. metoprolol carvedilol, propranolol, labetalol d. Lisinopril e. losartan f. aliskiren
A
b. prazosin
11
Q
• defined as a fall in blood pressure brought on by moving from a supine
or seated position to an upright position
a. ORTHOSTATIC/POSTURAL HYPOTENSION
b. REFLEX TACHYCARDIA
A
a. ORTHOSTATIC/POSTURAL HYPOTENSION
12
Q
◦ Caused by dilation of arteries/veins (sudden drop in BP)
a. ORTHOSTATIC/POSTURAL HYPOTENSION
b. REFLEX TACHYCARDIA
A
b. REFLEX TACHYCARDIA
13
Q
ADVERSE EFFECTS ◦ First dose Orthostatic (postural) hypotension ◦ Reflex tachycardia ◦ Sexual dysfunction ◦ Rebound hypertension a. clonidine, methyldopa b. prazosin c. metoprolol carvedilol, propranolol, labetalol
A
b. prazosin
14
Q
ADMINISTRATION:
◦ Common to see this drug class given at bedtime to reduce
risk for postural/orthostatic hypotension
a. clonidine, methyldopa
b. prazosin
c. metoprolol
carvedilol, propranolol, labetalol
A
b. prazosin
15
Q
NURSING PROCESS ASSESSMENT- Check Blood pressure before giving a. clonidine, methyldopa b. prazosin c. metoprolol carvedilol, propranolol, labetalol
A
b. prazosin
16
Q
NURSING PROCESS PLAN/IMPLEMENTATION- Educate about sexual dysfunction, “first dose phenomenon”, never stop suddenly a. clonidine, methyldopa b. prazosin c. metoprolol carvedilol, propranolol, labetalol
A
b. prazosin
17
Q
NURSING PROCESS EVALUATION- Increased Urine Output, relief of retention symptoms, lower Blood Pressure a. clonidine, methyldopa b. prazosin c. metoprolol carvedilol, propranolol, labetalol
A
b. prazosin
18
Q
NURSING PROCESS Orthostatic hypotension/reflex tachycardia a. clonidine, methyldopa b. prazosin c. metoprolol carvedilol, propranolol, labetalol
A
b. prazosin
19
Q
ADMINISTRATION Patients often times take at bedtime to avoid the “first dose” phenomenon a. clonidine, methyldopa b. prazosin c. metoprolol carvedilol, propranolol, labetalol
A
b. prazosin
20
Q
USED TO TREAT: ADHD, Pain Management (epidurals) a. clonidine, methyldopa b. prazosin c. metoprolol carvedilol, propranolol, labetalol
A
clonidine
21
Q
USED TO TREAT: ◦ Withdrawal- Substance Use Disorders a. clonidine, methyldopa b. prazosin c. metoprolol carvedilol, propranolol, labetalol
A
clonidine
22
Q
USED TO TREAT: ◦ Symptoms of Withdrawal- Opioid Withdrawal a. clonidine, methyldopa b. prazosin c. metoprolol carvedilol, propranolol, labetalol
A
clonidine
23
Q
USED TO TREAT: - Used for Hypertension in pregnancy a. clonidine, methyldopa b. prazosin c. metoprolol carvedilol, propranolol, labetalol
A
methyldopa
24
Q
ADVERSE EFFECTS: ◦ Drowsiness/CNS Depressant ◦ Dry Mouth ◦ Rebound Hypertension ◦ Orthostatic Hypotension a. clonidine, methyldopa b. prazosin c. metoprolol carvedilol, propranolol, labetalol
A
a. clonidine, methyldopa
25
```
NURSING CONSIDERATIONS:
◦ Reassure clients that dry mouth usually resolves in 2 to 4 weeks.
a. clonidine, methyldopa
b. prazosin
c. metoprolol
carvedilol, propranolol, labetalol
```
a. clonidine, methyldopa
26
```
◦ Encourage clients to chew gum or suck on hard candy, and to take small
amounts of water or ice chips.
a. clonidine, methyldopa
b. prazosin
c. metoprolol
carvedilol, propranolol, labetalol
```
a. clonidine, methyldopa
27
a. clonidine, methyldopa
NURSING CONSIDERATIONS:
◦ Reassure clients that dry mouth usually resolves in ? to ? weeks.
2 to 4
28
```
is a tablet
◦ Used daily and PRN
a. clonidine, methyldopa
b. prazosin
c. metoprolol
carvedilol, propranolol, labetalol
```
clonidine
29
```
is a Patch
◦ once weekly patch
a. clonidine, methyldopa
b. prazosin
c. metoprolol
carvedilol, propranolol, labetalol
```
clonidine
30
```
Adverse Side effect
◦ Dry Mouth
a. clonidine, methyldopa
b. prazosin
c. metoprolol
carvedilol, propranolol, labetalol
```
a. clonidine, methyldopa
31
Which it true to APPLY to clonidine patch
◦ Hairless part of body
◦ Intact skin
◦ Clean with soap and water (Not Alcohol!)
Clean with soap and water
◦ (With Alcohol!)
◦ Hairless part of body
◦ Intact skin
◦ Clean with soap and water (Not Alcohol!)
32
```
◦ Prevent glycogenolysisin liver (further hypoglycemia)
a. clonidine, methyldopa
b. prazosin
c. metoprolol
carvedilol, propranolol, labetalol
```
c. metoprolol
| carvedilol, propranolol, labetalol
33
```
Ischemic Heart Disease
a. clonidine, methyldopa
b. prazosin
c. metoprolol
carvedilol, propranolol, labetalol
```
c. metoprolol
| carvedilol, propranolol, labetalol
34
```
Make sure to educate about sexual dysfunction
a. clonidine, methyldopa
b. prazosin
c. metoprolol
carvedilol, propranolol, labetalol
```
c. metoprolol
| carvedilol, propranolol, labetalol
35
COUNSELLING POINT: Patients should immediately report a weight
gain of 2 lb or more in 1 day or 5 lb or more in 1 week (WEIGH
DAILY)
a. clonidine, methyldopa
b. prazosin
c. metoprolol
carvedilol, propranolol, labetalol
c. metoprolol
| carvedilol, propranolol, labetalol
36
```
SUDDEN STOPPAGE- MAY CAUSE MYOCARDIAL INFARCTION
a. clonidine, methyldopa
b. prazosin
c. metoprolol
carvedilol, propranolol, labetalol
```
c. metoprolol
| carvedilol, propranolol, labetalol
37
ACE-Inhibitors, the “?”
prils
sartans
Aliskiren
prils
38
Angiotensin II Receptor Blockers (ARBS), the “?”
prils
sartans
Aliskiren
sartans
39
Direct Renin Inhibitor (DRI)s, only one out,?
prils
sartans
Aliskiren
Aliskiren
40
- Decreased aldosterone release
- Decreased vasoconstriction
- Decreases Preload and Afterload (SVR)
d. Lisinopril
e. losartan
f. aliskiren
d. Lisinopril
e. losartan
f. aliskiren
41
```
ADVERSE EFFECTS
◦ Hyperkalemia
◦ Chronic, non-productive cough
◦ Angioedema
d. Lisinopril
e. losartan
f. aliskiren
```
d. Lisinopril
e. losartan
f. aliskiren
42
```
ADVERSE EFFECTS
Bradykinin retention
◦ Very serious and can be fatal
d. Lisinopril
e. losartan
f. aliskiren
```
d. Lisinopril
43
```
– BOXED WARNING:
• Drugs that work on the RAAS can cause
injury and death to a developing fetus
d. Lisinopril
e. losartan
f. aliskiren
```
d. Lisinopril
e. losartan
f. aliskiren
44
Not recommended in pregnancy (class C in 1st
trimester and class D in 2nd/3rd trimester)
d. Lisinopril
e. losartan
f. aliskiren
d. Lisinopril
e. losartan
f. aliskiren
45
```
First dose orthostatic hypotension
– Monitor blood pressure for 2 hr after initiation of
treatment.
d. Lisinopril
e. losartan
f. aliskiren
```
d. Lisinopril
e. losartan
f. aliskiren
46
```
◦ Rash- report!
◦ Altered Taste!
◦ Neutropenia
d. Lisinopril
e. losartan
f. aliskiren
```
d. Lisinopril
47
◦ Neutropenia
d. Lisinopril
e. losartan
f. aliskiren
d. Lisinopril
48
◦ Rash- report!
d. Lisinopril
e. losartan
f. aliskiren
d. Lisinopril
49
◦ Altered Taste!
d. Lisinopril
e. losartan
f. aliskiren
d. Lisinopril
50
RAS?
d. Lisinopril
e. losartan
f. aliskiren
d. Lisinopril
51
```
DRUG INTERACTIONS
◦ Hyperkalemia
d. Lisinopril
e. losartan
f. aliskiren
```
d. Lisinopril
e. losartan
f. aliskiren
52
```
DRUG INTERACTIONS
◦ Additive Hypotensive Effect (especially with diuretics)
d. Lisinopril
e. losartan
f. aliskiren
```
d. Lisinopril
e. losartan
f. aliskiren
53
```
DRUG INTERACTIONS
◦ Lithium can accumulate, potential for toxicity
d. Lisinopril
e. losartan
f. aliskiren
```
d. Lisinopril
e. losartan
f. aliskiren
54
```
DRUG INTERACTIONS
◦ COX Inhibitors/NSAIDs
◦ use can decrease effectiveness
◦ increase risk for AKI
d. Lisinopril
e. losartan
f. aliskiren
```
d. Lisinopril
e. losartan
f. aliskiren
55
```
NURSING CONSIDERATIONS
Avoid potassium supplements (+ Salt
substitutes)
d. Lisinopril
e. losartan
f. aliskiren
```
d. Lisinopril
e. losartan
f. aliskiren
56
```
MECHANISM OF ACTION
◦ blocks the binding of angiotensin II
d. Lisinopril
e. losartan
f. aliskiren
```
e. losartan
57
```
Used to Treat
HTN
Post- MI
Heart Failure
d. Lisinopril
e. losartan
f. aliskiren
```
d. Lisinopril
e. losartan
f. aliskiren
58
Kidney Injury, Sexual dysfunction
d. Lisinopril
e. losartan
f. aliskiren
d. Lisinopril
e. losartan
f. aliskiren
59
```
MECHANISM OF ACTION
◦ direct renin inhibitor, resulting in blockade of the conversion of angiotensinogen to
angiotensin I
d. Lisinopril
e. losartan
f. aliskiren
```
f. aliskiren
