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NCLEX > Antihypertensive Drugs > Flashcards

Antihypertensive Drugs Flashcards

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0
Q

Captopril

Chemical Classification

A

Angiotensin-Converting Enzyme (ACE) inhibitor

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1
Q

Captopril

Functional Classification

A

Antihypertensive

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2
Q

Captopril

Mechanism of Action

A

Selectively suppresses renin-angiotensin-aldosterone system; inhibits ACE; prevents conversion of angiotensin I to angiotensin II

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3
Q

Captopril

Uses

A

Hypertension, CHF, left ventricular dysfunction after MI, diabetic nephropathy

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4
Q

Captopril

Contraindications

A

Breastfeeding, children, hypersensitivity, heart block, potassium-sparing diuretics, bilateral renal artery stenosis, angioedema, Pregnancy (D)

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5
Q

Captopril

Side Effects

A

CNS: fever, chills
CV: Hypotension, postural hypotension, Tachycardia, angina
GI: loss of taste, increased LFT’s
GU: impotence, dysuria, nocturia, proteinuria, NEPHROTIC SYNDROME, ACUTE REVERSIBLE RENAL FAILURE, polyuria, oliguria, urinary frequency
HEMA: NEUTROPENIA, AGRANULOCYTOSIS, PANCYTOPENIA, THROMBOCYTOPENIA, anemia
INTEG: rash, pruritus
MISC: ANGIOEDEMA, hyperkalemia
RESP: BRONCHOSPASM, Dyspnea, Cough

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6
Q

Captopril

Nursing Considerations

A

ASSESS:

  • BLOOD DYSCRASIAS: blood studies: decreased platelets; WBC with differential at baseline and periodically q3mo; if neutrophils <1000/mm3, discontinue treatment (recommended with collagen-vascular or renal disease)
  • HYPERTENSION: BP, pulse rates at baseline, frequently
  • Renal studies: protein, BUN, creatinine; watch for raised levels, may indicate nephrotic syndrome; increased LFTs, uric acid; glucose may be increased
  • Allergic reaction: rash, fever, pruritus, urticaria; discontinue product if antihistamines fail to help
  • CHF: edema, dyspnea, wet crackles, increased BP, weight gain
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7
Q

Captopril

Overdose Treatment

A

0.9% NaCl IV/INF; hemodialysis

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8
Q

Clonidine

Functional Classification

A

Antihypertensive

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9
Q

Clonidine

Chemical Classification

A

Central alpha-adrenergic agonist

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10
Q

Clonidine

Mechanism of Action

A

Inhibits sympathetic vasomotor center in CNS, which reduces impulses in sympathetic nervous system; blood pressure, pulse rate, cardiac output decrease, prevents pain signal transmission in CNS by alpha-adrenergic receptor stimulation of the spinal cord

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11
Q

Clonidine

Uses

A

Mild to moderate hypertension, used alone or in combination; severe pain in cancer patients (epidural)

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12
Q

Clonidine

Contraindications

A

Hypersensitivity; (epidural) bleeding disorders, anticoagulants

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13
Q

Clonidine

Side Effects

A

CNS: Drowsiness, Sedation, Headache, Fatigue, nightmares, insomnia, mental changes, anxiety, depression, hallucinations, delirium
CV: Orthostatic Hypotension, Palpitations, CHF, ECG abnormalities, sinus tachycardia
EENT: taste change, parotid pain
ENDO: hyperglycemia
GI: Nausea, Vomiting, Malaise, constipation, Dry Mouth
GU: impotence, dysuria, nocturia, gynecomastia
INTEG: Rash, alopecia, facial pallor, pruritus, hives, edema, burning papules, excoriation (transdermal patches)
MISC: withdrawal symptoms
MS: muscle, joint pain; leg cramps

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14
Q

Clonidine

Nursing Considerations

A

ASSESS:

  • HYPERTENSION: BP, pulse; report significant changes
  • OPIATE WITHDRAWAL (UNLABELED): fever, diarrhea, nausea, vomiting, cramps, insomnia, shivering, dilated pupils
  • CANCER PAIN: location, intensity, character, alleviating, aggravating factors at baseline and frequently
  • Edema in feet, legs daily; monitor I&O; check for falling output
  • ALLERGIC REACTION: rash, fever, pruritus, urticaria; product should be discontinued if antihistamines fail to help
  • CHF: edema, dyspnea, wet crackle, BP
  • Renal symptoms: polyuria
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15
Q

Clonidine

Overdose Treatment

A

Supportive treatment, administer tolazoline, atropine, DOPamine prn

16
Q

Hydralazine

Functional Classification

A

Antihypertensive, direct-acting peripheral vasodilator

17
Q

Hydralazine

Chemical Classification

A

Phthalazine

18
Q

Hydralazine

Mechanism of Action

A

Vasodilates arteriolar smooth muscle by direct relaxation; reduction in blood pressure with reflex increases in heart rate, stroke volume, cardiac output

19
Q

Hydralazine

Uses

A

Essential hypertension; severe essential hypertension

20
Q

Hydralazine

Contraindications

A

Hypersensitivity to hydralazine’s, mitral valvular rheumatic heart disease, CAD

21
Q

Hydralazine

Side Effects

A

CNS: Headache, Tremors, Dizziness, Anxiety, peripheral neuritis, depression, fever, chills
CV: Palpitations, Reflex Tachycardia, Angina, SHOCK, rebound hypertension, orthostatic hypotension
GI: Nausea, Vomiting, Anorexia, Diarrhea, constipation, paralytic ileus
GU: urinary retention, glomerulonephritis, hematuria
HEMA: LEUKOPENIA, AGRANULOCYTOSIS, anemia, THROMBOCYTOPENIA
INTEG: rash, pruritus, urticaria
MISC: nasal congestion, muscle cramps, Lupuslike Symptoms, flushing, edema, dyspnea

22
Q

Hydralazine

Nursing Considerations

A

ASSESS:

  • Cardiac status: BP q5min x 2hr, the q 1hr x 2hr, then q4hr; pulse, jugular venous distention q4hr
  • Electrolytes, blood studies: K, Na, Cl, CO2, CBC, serum glucose, LE prep, ANA titer before, during treatment; assess for fever, joint pain, rash, sore throat (lupuslike symptoms); notify prescriber
  • Weight daily, I&O
  • Edema in feet, legs daily, skin turgor, dryness of mucous membranes for hydration status
  • Crackles, dyspnea, orthopnea
  • IV site for extravasation, rate
  • Mental status: affect, mood, behavior, anxiety; check for personality changes
23
Q

Hydralazine

Overdose Treatment

A

Administer vasopressors, volume expanders for shock; if PO, lavage or give activated charcoal, digitalization

24
Q

Losartan (Cozaar)

Functional Classification

A

Antihypertensive

25
Q

Losartan (Cozaar)

Chemical Classification

A

Angiotensin II receptor (type AT1) antagonist

26
Q

Losartan (Cozaar)

Mechanism of Action

A

Blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II; selectively blocks the binding of angiotensin II to the AT1 receptor found in tissues

27
Q

Losartan (Cozaar)

Uses

A

Hypertension, alone or in combination; nephropathy in type 2 diabetes; proteinuria; stroke prophylaxis for hypertensive patients with left ventricular hypertrophy

28
Q

Losartan (Cozaar)

Contraindications

A

Hypersensitivity

29
Q

Losartan (Cozaar)

Side Effects

A

CNS: Dizziness, Insomnia, anxiety, confusion, abnormal dreams, migraine, tremor, vertigo, headache, malaise, depression
CV: angina pectoris, 2nd-degree AV block, CEREBROVASCULAR ACCIDENT, hypotension, MI. Dysrhythmias
EENT: blurred vision, burning eyes, conjunctivitis
GI: Diarrhea, Dyspepsia, anorexia, constipation, dry mouth, flatulence, gastritis, vomiting
GU: impotence, nocturia, urinary frequency, UTI, RENAL FAILURE
HEMA: anemia, THROMBOCYTOPENIA
INTEG: alopecia, dermatitis, dry skin, flushing, photosensitivity, rash, pruritus, sweating, ANGIOEDEMA
META: gout
MS: cramps, myalgia, pain, stiffness
RESP: Cough, Upper Respiratory Infection, congestion, dyspnea, bronchitis

30
Q

Losartan (Cozaar)

Nursing Considerations

A

ASSESS:

  • BP with position changes, pulse before and periodically during treatment; note rate, rhythm, quality
  • Baselines of renal, hepatic studies before therapy begins and periodically thereafter
  • Skin turgor, dryness of mucous membranes for hydration status
  • Angioedema: facial swelling, dyspnea, wheezing; may occur rapidly; tongue swelling (rare)
  • CHF: jugular venous distention; edema in feet/legs, weight daily
  • BLOOD DYSCRASIAS: thrombocytopenia, anemia (rare)
  • Pregnancy before starting treatment: pregnancy (D) 2nd/3rd trimester

NCLEX (40 decks)

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