Antihypertensives (44)

Question 1

Hypertension is abnormal increase in ____ blood pressure.

Answer 1

arterial

Question 2

Two types of HTN:

\_\_\_\_ or Primary HTN (90%) - no specific cause.
Secondary HTN (10%) - \_\_\_\_ and endocrine disorders

Answer 2

essential… renal

Question 3

Blood pressure is dependent on ____ output and ____ resistance

Answer 3

cardiac… peripheral.

Question 4

Tx of HTN is based on ____ and ____ factors.

1990s ____ approach

Answer 4

BP… risk… Stepped-care.

Question 5

Cardiovascular Risk Factors:
Smoking, high \_\_\_\_ cholesterol
obesity
alcohol
older than \_\_\_ years old
\_\_\_\_
\_\_\_\_ women
family hx of of \_\_\_\_ disease

Answer 5

serum.. 60.. male… postmenopausal… heart

Question 6

KNOW THE GUIDELINES FOR DETERMINING HYPERTENSION

Answer 6

KNOW THE GUIDELINES FOR DETERMINING HYPERTENSION

Question 7

Diuretics are the first-line drug for tx of ____. Many antihypertensive drugs cause ____ retention. Potentiate action of other oral antihypertensive agents.

Answer 7

mild HTN… fluid.

Question 8

Loop diuretics:

Furosemide (Lasix)
Bumetanide (Bumex)

Do not ____ renal blood flow
If the patient has ____ insufficiency, loop diuretics are a better choice than ____.

Answer 8

depress… renal… thiazides.

Question 9

Thiazide diuretics are not for ____ insufficiency.
Combinations:
K+ ____ & K+ ____ diuretics
Thiazide & antihypertensive

Answer 9

renal… sparing… wasting.

Question 10

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.

Answer 10

Beta-Adrenergic… Beta1… African-Americans

Question 11

Example (Cardioselective Beta 1):
Metoprolol - block beta 1 ____ n.s. - diminish sympathetic n.s response which leads to ____ resistance to diminish which decreases ____.

Answer 11

sympathetic… vascular… BP

Question 12

Metoprolol:
p.o (HTN) / IV (MI)

SE:
Fatigue, weakness, dizziness, drowsiness, HA, blurred vision. Should not be ____ abruptly otherwise will cause ____ HTN.

Answer 12

discontinued abruptly… Rebound

Question 13

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 ____.

Answer 13

contraction… bronchoconstriction… glycogen… glucose…. diabetic.

Question 14

Side effects of nonselective beta1 drugs:
Decrease ____
Markedly decreased ____
Nonselective (bronchospasm, inhibits ability to convert ____ to ____)

Answer 14

pulse rate.. BP… glycogen… glucose.

Question 15

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.

Answer 15

brainstem… peripheral….CNS… peripheral resistance… peripheral..

Question 16

Side Effects of Alpha2 agonists:
____ –> start doses in the evening.
____ ____
Bradycardia

Answer 16

Sedation… dry mouth.

Question 17

Examples of Alpha2 agonists:
methyldopa
clonidine (Catapres)

Answer 17

SEE OTHER SIDE

Question 18

When taking Alpha2 agonists - teach to not miss doses or d/c abruptly because it will cause ____ ____.

Answer 18

Rebound HTN.

Question 19

Centrally Acting Alpha2 Agonists:

Can cause ____ and ____ retention and are often given with ____.

Answer 19

sodium… water… diuretics.

Question 20

Direct Acting Vasodilators are ____ antihypertensive agents which directly ____peripheral ____ to decrease ____.

Answer 20

potent… dilates… arterioles… BP

Question 21

With direct acting vasodilators, the heart compensates by ____ and ____ so give with beta-adrenergic ____ agent to counteract effects of ____ ____.

Answer 21

palpitations… tachycardia… blocking… reflex tachycardia.

Question 22

Direct acting vasodilators decrease ____ which causes ____ and ____ retention which leads to peripheral ____ so NEED TO GIVE ____.

Answer 22

BP… sodium… water… edema… DIURETICS

Question 23

Side Effects of direct acting vasodilators:

Tachycardia, palpitations, edema, ____ congestion, ____, dizziness.

Answer 23

nasal… HA

Question 24

In hypertensive emergencies, take nitroprusside (Nipride, Nitropress) through ____.

Answer 24

IV.

Question 25

In moderate - severe HTN:
hydralazine (Apresoline)
minoxidil (Rogaine)

Answer 25

SEE OTHER SIDE

Question 26

ACE Inhibitors interfere with conversion of ____ to ____ which cause ____ vasodilation.

Answer 26

angiotensin I… angiotensin II… peripheral

Question 27

ACE inhibitors blocks release of ____ so sodium will be ____ and K+ will be ____.

Answer 27

aldosterone… excreted… retained

Question 28

Examples of ACE inhibitors:

benazeril (Lotensin)
captopril (Capoten)
lisinopril (Prinivil, Zestril)
enalapril (Vasotec)

Answer 28

SEE OTHER SIDE

Question 29

Side effects of ACE Inhibitors:

Irritating, dry cough.
n/v, diarrhea.
HA, dizziness, fatigue.
____, tachycardia.

Answer 29

hyperkalemia.

Question 30

Contraindications of ACE Inhibitors:
Women who are ____.
Should not be taken with ____ diuretics because it will cause ____.

Answer 30

pregnant… K+ sparing… hyperkalemia.

Question 31

When on ACE Inhibitors, monitor ____ function.

In DM clients, watch for ____ reaction.

Answer 31

renal… hypoglycemic

Question 32

When taking ACE inhibitors, teach not to ____ ____.
Do not take if ____ or contemplating ____.
Teach how to take own ____.

Answer 32

d/c abruptly… pregnant… pregnancy… BP.

Question 33

When on ACE Inhibitors, tell the patient she/he will be ____ 1st week of therapy. Also take ____ 20min - 1 hour before a meal.

Answer 33

dizzy/lightheadedness… Captopril (Capoten).

Question 34

Calcium increases ____ contraction, ____ resistance, and ____.

Answer 34

myocardial… peripheral… BP

Question 35

Calcium Channel Blockers promote ____ which decreases ____.

Answer 35

vasodilation… BP

Question 36

Examples of Calcium Channel Blockers:
verapamil (Calan)
nifedipine (Procardia)
diltiazem (Cardizem)

Answer 36

SEE OTHER SIDE

Question 37

Side Effects of Calcium Channel Blockers:
\_\_\_\_
Hypotension
\_\_\_\_
Flushing

Answer 37

HA… Dizziness.

Question 38

Long Term Management (HTN):
\_\_\_\_, exercise (aerobic)
Stop \_\_\_\_
Avoid \_\_\_\_
Coping with \_\_\_\_
OTC --> \_\_\_\_ labels

Answer 38

weight loss… smoking… alcohol… stress… read

Question 39

Long Term Management (HTN):

Teach not to stop taking meds just because BP is down and to stay active in ____.

Answer 39

self-care