antihypertensives PG 882 Flashcards
what is considered normal blood pressure
<120/<80
what is considered elevated blood pressure
120-129/80
what is considered stage 1 hypertension
130-139/80-89
what is considered stage 2 hypertension
> 140/>90
what is step 1 of treating hypertension
lifestyle changes
what is stage 2 of treating hypertension
thiazide diuretic, ACE inhibitor, ARB, or CCB (use 1)
consider using which type of medication in African American patients due to increased risk of angioedema
use ARB instead of ACE inhibitor
what is stage 3 of treating hypertension
increase dose of drugs or combine two drugs
what is step 4 of treating hypertension
combine 2-3 of step 3
what are the different classes of antihypertensive medication
ACE inhibitors/angiotensin II antagonists (ARBs)
diuretics
calcium channel blockers
beta blockers
action of ACE inhibitors
lower BP by dilating arterial blood vessels
what medication is used in first line treatment of HTN in patients with DM
ACE inhibitors
adverse effects of ACE inhibitors
postural/orthostatic hypotension
angioedema (in african american patients)
dry hacking cough
contraindications of ACE inhibitors
renal or hepatic disease
electrolyte imbalance
action of calcium channel blockers
causes peripheral vasodilation
inhibits calcium from getting in to muscle cells to cause contraction
what are the 2 categories of calcium channel blockers
dihydropyridines - little to no negative effect on cardiac contractility or conduction
non-dihydropyridines - greater depressive effect on cardiac conduction and contractility
adverse effects of dihydropyridines
headache, lightheadedness, flushing, peripheral edema
adverse effects of non-dihydropyridines
constipation, bradycardia, heart failure, heart block
contraindications of dihydropyridines
hepatic impairment, severe coronary artery disease, and sever aortic stenosis
contraindications of non-dihydropyridines
second or third degree heart block, acute MI, congestive heart failure
action of beta blockers
compete with adrenergic neurotransmitters (epi and norepi) for adrenergic receptor sites
where are beta1 receptor sites usually located
in the heart
where are beta2 receptors usually located
bronchial and vascular smooth muscle and the uterus
which beta receptors do selective beta blockers work on
beta1
which beta receptors do non selective beta blockers work on
beta1 and beta2
adverse effects of beta blockers
orthostatic hypotension, bradycardia, bronchospasm
contraindications of beta blockers
sinus bradycardia, heart block, hypotension
