Antihypertensives

Question 1

What are the Hypertension Guidelines?

Answer 1

Normal BP = <120/<80 mm HG

Elevated BP = 120-129/<80 mm HG

Hypertension Stage 1 = 130-139 or 80-89 mm HG

Hypertension stage 2 = > 140 or >90 mm Hg

Before classifying HTN, HCP must get at least two consistent BP readings.

Question 2

What is the most common condition that leads to MI, CVA, renal failure, and death?

Answer 2

HTN

Question 3

What are some Nonpharmacologic control of Hypertension?

Answer 3

Exercise,

Weight loss,

Salt restriction of less than 2g of salt per day,

Caffeine restriction,

Decrease alcohol consumption,

Smoking cessation

Question 4

What drug is classified as Beta blockers?

Answer 4

Metoprolol

Question 5

What is the MOA of Metoprolol?

Answer 5

Promote blood pressure reduction by cardio selective beta-blocking effect

Reduce HR, contractility and Renin Release

Question 6

What is Metoprolol used for?

Answer 6

To control HTN, acute MI, angina, and Heart Failure

Question 7

What are the ASE and Side effects of Metoprolol?

Answer 7

Fatigue
Weakness 
Blurred vision
ED
Peripheral Edema 
Tinnitus
Bradycardia
Hypotension
Stroke
Thrombocytopenia 
Diabetes Mellitus

Question 8

What are some Life threatening effects of Metoprolol?

Answer 8

AV heart block

Bronchospasm

Agranulocytosis

HF

Question 9

A patient is on Metoprolol and is in pain. The patient is asking for an NSAID for relief. What should be done?

Answer 9

DO NOT TAKE NSAIDS WITH METOPROLOL.

Question 10

What should be taught to the patient that is on Metoprolol?

Answer 10

DO NOT ABRUPTLY WITHDRAW. This can cause an increased risk of heart attack

Take the DASH or Mediterranean Diet

Question 11

What drug is classified as Alpha-Adrenergic Blocker?

Answer 11

Prazosin hydrochloride

Question 12

What is the MOA of Prazosin hydrochloride?

Answer 12

Dilates peripheral blood vessels by blocking alpha-adrenergic receptors

Question 13

What is Prazosin hydrochloride used for?

Answer 13

HTN

Question 14

What are the ASE of Prazosin hydrochloride that should be looked out for?

Answer 14

Orthostatic hypotension, tachycardia, elevated liver enzymes, dry mouth, erectile dysfunction, urinary incontinence, tinnitus

Question 15

With Prazosin hydrochloride, what is the first-dose phenomenon?

Answer 15

Orthostatic hypotension, palpitations, dizziness, and syncope 1 to 3 hours after first dose.

Take at bedtime to decrease risk. Can cause Na and water retention.

Question 16

True or false? Alcohol with Prazosin hydrochloride can intensify hypotensive state?

Answer 16

True

Question 17

What should taught to patients on Prazosin hydrochloride?

Answer 17

Do not abrupt discontinue medication due to risk for rebound hypertension

Slow position changes

Daily weights

Dash diet

Question 18

What should a nurse monitor for when a patient is taking Prazosin hydrochloride?

Answer 18

VS, fluid retention, and weight gain

Question 19

What drug is classified as Angiotensin-Converting Enzyme Inhibitor?

Answer 19

Lisinopril

Question 20

What is the MOA of Lisinopril?

Answer 20

Inhibits conversion of Angiotensin 1 to Angiotensin 2

Blocks release of aldosterone

Lowers peripheral resistance with little change in cardiac output or heart rate.

Question 21

What is Lisinopril used for?

Answer 21

HTN, MI, HF

Question 22

A pregnant woman has been diagnosed with HTN and was prescribed with Lisinopril. What should the nurse do?

Answer 22

Do not give lisinopril due to risk of cardiac malformations and risk of impairing renal function

Question 23

What are the ASE of Lisinopril?

Answer 23

Hypotension, headache, dizziness, syncope, hyperkalemia, hacking cough, angioedema, dry cough

Question 24

If a patient on ACEi is having a consistent dry coughing, what should the nurse do?

Answer 24

Tell the patient that the medication can be switched to an ARB

Question 25

What lab value should be monitored for a patient on Lisinopril?

Answer 25

Potassium to watch out for hyperkalemia.

Question 26

What should be taught to a patient on Lisinopril?

Answer 26

Do not take if pregnant

Change positions slowly

How to take BP at home

Seek help if angioedema occurs

Question 27

What drug is classified as Angiotensin II-Receptor Blocker?

Answer 27

Losartan.

Question 28

What is the MOA of Losartan?

Answer 28

Inhibits the binding of angiotensin 2 and prevents release of aldosterone.

Question 29

What is Losartan used for?

Answer 29

HTN; Diabetic nephropathy with elevated serum CRE and proteinuria.

Question 30

What are the ASE of Losartan?

Answer 30

Weakness, Dizziness, Cough, hypotension, anemia, angioedema, Hyperkalemia

Question 31

Should a pregnant woman take losartan?

Answer 31

NO! Increased risk of injury and death in developing fetus.

Question 32

What drug is classified as Calcium Channel Blockers?

Answer 32

Diltiazem

Question 33

What is the MOA of Diltiazem?

Answer 33

Blocks calcium channel in the vascular smooth muscle.

Promote vasodilation.

Free calcium increases muscle contractility, peripheral resistance, and blood pressure.

Question 34

What is Diltiazem used for?

Answer 34

HTN, angina, Dysrhythmia

Question 35

What are the contraindications for Diltiazem?

Answer 35

Patients on beta-blockers

HF with reduced ejection fraction

Sinus node dysfunction.

Second or third degree AV block without pacemaker.

Question 36

What are the ASE of Diltiazem?

Answer 36

Peripheral edema, dizziness, dyspepsia, bradycardia, hypotension

Question 37

What should be taught to a patient on Diltiazem?

Answer 37

Monitor HR/BP

Expect peripheral edema so patient should elevate legs and avoid salts

Slow positional changes