Antihypertensives (44) Flashcards
Hypertension is abnormal increase in ____ blood pressure.
arterial
Two types of HTN:
\_\_\_\_ or Primary HTN (90%) - no specific cause. Secondary HTN (10%) - \_\_\_\_ and endocrine disorders
essential… renal
Blood pressure is dependent on ____ output and ____ resistance
cardiac… peripheral.
Tx of HTN is based on ____ and ____ factors.
1990s ____ approach
BP… risk… Stepped-care.
Cardiovascular Risk Factors: Smoking, high \_\_\_\_ cholesterol obesity alcohol older than \_\_\_ years old \_\_\_\_ \_\_\_\_ women family hx of of \_\_\_\_ disease
serum.. 60.. male… postmenopausal… heart
KNOW THE GUIDELINES FOR DETERMINING HYPERTENSION
KNOW THE GUIDELINES FOR DETERMINING HYPERTENSION
Diuretics are the first-line drug for tx of ____. Many antihypertensive drugs cause ____ retention. Potentiate action of other oral antihypertensive agents.
mild HTN… fluid.
Loop diuretics:
Furosemide (Lasix)
Bumetanide (Bumex)
Do not ____ renal blood flow
If the patient has ____ insufficiency, loop diuretics are a better choice than ____.
depress… renal… thiazides.
Thiazide diuretics are not for ____ insufficiency.
Combinations:
K+ ____ & K+ ____ diuretics
Thiazide & antihypertensive
renal… sparing… wasting.
Sympatholytics: \_\_\_\_ blockers (\_\_\_\_ are preferred for HTN) - use with a diuretic and do not give to \_\_\_\_ clients because they do not respond well to beta-blockers.
Beta-Adrenergic… Beta1… African-Americans
Example (Cardioselective Beta 1):
Metoprolol - block beta 1 ____ n.s. - diminish sympathetic n.s response which leads to ____ resistance to diminish which decreases ____.
sympathetic… vascular… BP
Metoprolol:
p.o (HTN) / IV (MI)
SE:
Fatigue, weakness, dizziness, drowsiness, HA, blurred vision. Should not be ____ abruptly otherwise will cause ____ HTN.
discontinued abruptly… Rebound
Examples of Nonselective Beta1 Drugs:
Propranolol (Inderal)
Nadolol (Corgard)
Reduce heart rate & force of ____.
Causes ____
Inhibits liver’s ability to convert ____ to ____ so be careful with someone who is ____.
contraction… bronchoconstriction… glycogen… glucose…. diabetic.
Side effects of nonselective beta1 drugs:
Decrease ____
Markedly decreased ____
Nonselective (bronchospasm, inhibits ability to convert ____ to ____)
pulse rate.. BP… glycogen… glucose.
Centrally acting Alpha2 Agonists decrease sympathetic response from ____ to ____ vessels. They stimulate alpha2 adrenergic receptors in ____ which decreases sympathetic activity –> reduces ____ ____ resistance and dilates ____ blood vessels –> decreases BP.
brainstem… peripheral….CNS… peripheral resistance… peripheral..
Side Effects of Alpha2 agonists:
____ –> start doses in the evening.
____ ____
Bradycardia
Sedation… dry mouth.
Examples of Alpha2 agonists:
methyldopa
clonidine (Catapres)
SEE OTHER SIDE
When taking Alpha2 agonists - teach to not miss doses or d/c abruptly because it will cause ____ ____.
Rebound HTN.
Centrally Acting Alpha2 Agonists:
Can cause ____ and ____ retention and are often given with ____.
sodium… water… diuretics.
Direct Acting Vasodilators are ____ antihypertensive agents which directly ____peripheral ____ to decrease ____.
potent… dilates… arterioles… BP
With direct acting vasodilators, the heart compensates by ____ and ____ so give with beta-adrenergic ____ agent to counteract effects of ____ ____.
palpitations… tachycardia… blocking… reflex tachycardia.
Direct acting vasodilators decrease ____ which causes ____ and ____ retention which leads to peripheral ____ so NEED TO GIVE ____.
BP… sodium… water… edema… DIURETICS
Side Effects of direct acting vasodilators:
Tachycardia, palpitations, edema, ____ congestion, ____, dizziness.
nasal… HA
In hypertensive emergencies, take nitroprusside (Nipride, Nitropress) through ____.
IV.
In moderate - severe HTN:
hydralazine (Apresoline)
minoxidil (Rogaine)
SEE OTHER SIDE
ACE Inhibitors interfere with conversion of ____ to ____ which cause ____ vasodilation.
angiotensin I… angiotensin II… peripheral
ACE inhibitors blocks release of ____ so sodium will be ____ and K+ will be ____.
aldosterone… excreted… retained
Examples of ACE inhibitors:
benazeril (Lotensin)
captopril (Capoten)
lisinopril (Prinivil, Zestril)
enalapril (Vasotec)
SEE OTHER SIDE
Side effects of ACE Inhibitors:
Irritating, dry cough.
n/v, diarrhea.
HA, dizziness, fatigue.
____, tachycardia.
hyperkalemia.
Contraindications of ACE Inhibitors:
Women who are ____.
Should not be taken with ____ diuretics because it will cause ____.
pregnant… K+ sparing… hyperkalemia.
When on ACE Inhibitors, monitor ____ function.
In DM clients, watch for ____ reaction.
renal… hypoglycemic
When taking ACE inhibitors, teach not to ____ ____.
Do not take if ____ or contemplating ____.
Teach how to take own ____.
d/c abruptly… pregnant… pregnancy… BP.
When on ACE Inhibitors, tell the patient she/he will be ____ 1st week of therapy. Also take ____ 20min - 1 hour before a meal.
dizzy/lightheadedness… Captopril (Capoten).
Calcium increases ____ contraction, ____ resistance, and ____.
myocardial… peripheral… BP
Calcium Channel Blockers promote ____ which decreases ____.
vasodilation… BP
Examples of Calcium Channel Blockers:
verapamil (Calan)
nifedipine (Procardia)
diltiazem (Cardizem)
SEE OTHER SIDE
Side Effects of Calcium Channel Blockers: \_\_\_\_ Hypotension \_\_\_\_ Flushing
HA… Dizziness.
Long Term Management (HTN): \_\_\_\_, exercise (aerobic) Stop \_\_\_\_ Avoid \_\_\_\_ Coping with \_\_\_\_ OTC --> \_\_\_\_ labels
weight loss… smoking… alcohol… stress… read
Long Term Management (HTN):
Teach not to stop taking meds just because BP is down and to stay active in ____.
self-care
