Antihypertensives Flashcards
When do we treat BP
130/80
Primary vs secondary HT
primary no cause
difference between 1st line antihypertensives and second line what are the classes for each?
first -proven to decrease morbidity and mortality
1-Diuretics, ACE, ARB, CCBs
2- adrenergic antagonists-beta blockers and direct acting vasodilators
where are ang 1 and 11 in the body?
1-In the blood
11- in the lungs endothelium
what does Ang 11 do? 3 be specific
Vasoconstricts VASCULAR smooth mm
Increases sympathetic Nervous system
Increases aldosterone-increases Na+ reabsorption
What three things do ACE inhibs do?
Decrease peripheral resistance
decrease blood volume
decrease hypertrophy- added benefit
ACE inhib saying
In ACEPRIL Brady lost a baby because of heartfail, HTN and Acute MI
What does a build up of bradkinin do in the body and one more thing about it
It causes inflammation angioedema, and cough
Small chance of hyperK because of decrease in aldosterone
What does aldosterone do?
A steroid hormone made by the adrenal cortex (the outer layer of the adrenal gland). It helps control the balance of water and salts in the kidney by keeping sodium in and releasing potassium from the body.
What is the difference between ARBS and ACE inhibs?
The site-
ARBS- block ANG 11 at site so ang 2 is still made
Uses of ARBS 5
prevents HTN, scaring, renal damage, decrease in diabetic neuropothy and decrease stroke risk
ARBs trick and 2 things
At the start of Arbor day. I took lithium and lost a baby
Plus hypo risks including HA and angioedema and cough are rare because there is not a build up of bradykinin
Differences in CCB
What they do and drug names
Dihydropyridines and non- Nifedipine
d-Vascular smooth mm
nond- Vascular smooth mm and Myocardium so works on dysR
both- HTN and Angina-Verapamil and diltrazem
AE of nifedipine and way to remember it
increase dig levels=bradycardia alcohol=increase in vasodilation and drop in BP
a wet knife gives you a chub
How to remember the dihydropyridines
vera likes to use a dry dildo it can decrease or increase her heart rate and she likes to drink wine because grapefruit juice increases the effects of her drug and decreases her HR shes peripheral edema
Reflex tachy
120-130
Beta blockers
Adrenergic antags beta blockers
Block fight or flight decrease bp, hr, co
LOL at a blockbuster is good for your heart
What is first line for HTN
Diuretics, ACE, ARBS, CCBS
What are the secondline tx for HTN
Beta blockers and Direct acting
What are the direct acting AHTN
Hydralazine, Minoxidil, Nitroprusside
there is a mino reading a magazine about how to direct a pussy
be careful with what drugs/
dihydro and hydrolazine
and
diltrazem-ccb and minoxidil
Hydralazine mnemonic and 3 things
The magazine is mod-severly inappropriate if it goes wrong you will get a fast heart rate, stomach issues, and edema.
It only works on arterioles so no issues with ortho. For emergencies or if others fail
caution with depressed kids- MAOIS ( Decrease BP) and kidneys
Minoxidil 2
The mino has hair and is more toxic than the mag
Nitroprusside sodium
Only use pussy in an EMERGENCY dia- >120
it will relax your smooth mm but only for a little
You need to continually monitor it and little relfex tachy
How is heart fail classified?
Heart is unable to pump sufficient blood to meet metabolic needs of the body
R side heart fail
Weak- organ enlargement- esp liver
L heart fail
2 kinds about both
and about both-3
Systolic - More common decrease CO from decrease in contractility
or diastolic- Too stiff to relax and cant fill CO is not afffected backs up into lungs there is pressure in the vents
Fluid retention in pulm caps hypertrophy BNP
Causes of heart fail means and give 5 examples
Acceleration of weakening heart mm
Chronic HTN, Myocardial infarction, Mitral stenosis, diabetes, coronary art disease
S/s of heart fail apear?
6 examples
Arise when compensation stops working
decreased CO
ventricular hypertrophy Cardiac remodeling
Activation of SNS- vasoconstriction and increased HR
increase plasma volume
decreased blood flow to the kidneys=RAAS=Na+ and H2o retention=fluidload=Cough
dif breathing when laying down.
drugs that affect preload in heart fail 4
and one that effects SNS and one thing about it
Diuretics, vasodilators, ACE, ARBS
Beta blockers reverses remodeling
What drug is the cardiac glucoside and what the uses? MA?
digoxin- dysR and HF increases CO and contractility
Affect sodium potassium pump- Na stays out and calcium joins=contraction
three benefits of dig
increase urine output because more blood flow to the kidneys
decrease HR-more fill time
potential to reverse symptoms of CHF
what are the AE for dig? 4 go in-depth on one
DysR ventricular- SCD
Dig tox
Visual disterb
HypoK- K competes for binding sites with dig if there is a decrease in k then dig tox
Drug interactions with Dig 2
Beta blockers decrease HR and anything that decreases k
Nursing considerations for dig 3
Long 1/2 life
hold if Hr is below 60
narrow saftey- 0.5-2.0
What causes too much fluid in the body
Hypertn, heart fail, chronic kid disease, liver fail, pulmonary conditions, anascara
What are the five types of diuretics with names and where they are located
Loop-furos-loop of hen ascending thiazides-early seg of distal convoluted tube k sparing spiro-distal tube osmotic-manito- proximal tube carbonic anhydrase-? all?
Teaching with diuretics 7
Give in am weigh 2 lb 24 hour rule K=fruits and veggies take with food or milk avoid dehydration avoid getting up fast BP every day hold if 90/60
loop
That bro henley is in the loop so he is the best he kicks out that simple guy porter and k
he is great with that kid with the disease but he is hard of hearing, he has gout and is hypoglycemic. we dont give him insulin, or dig but we do need to give him potassium
what BP is too low
90/60
thiazides
End in zide yay
most prescribed for HTN
That guy mic is mildly cool he is friends with henley but blocks that simple guy porter in a different spot and gets rid of k although hes a dick to that kid with the disease he can hear but he also has gout and hypoglycemia we also only dont give him insulin
potassium sparing
spironolatone
This spirochete fights aldosterone but spares K but he takes 2 days to do it because he is mild. Because he spares k he may have dysR, parathesia, fatigue. We dont know if the bird is male or female but we do know they are a perv so no babies or breast feeding around them.
What are sex characteristic names and what drug causes them
gynecomastia- enlargement of breast tissue
impotence-ED
menstrual abnormalities, breast tenderness and hirsutism- unwanted hair
spiro
osmotic diuretic
manitol
Tx kid injury ICP Glaucoma
off label- sweetener
Carbonic Anhydrase inhbitor
Acetazolamide inhibits enzyme that reabsorbs bicarb so na doesnt get reabsorbed
mild and can cause metabolic acidosis
use to tx glaucoma and motion sick
