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PHARM EX2 > BLOOD PRESSURE MEDICATION > Flashcards

BLOOD PRESSURE MEDICATION Flashcards

1
Q

What are the 3 conditions that can cause HTN?

A
  1. OSA
  2. Kidney Dx
  3. HYPERthyroidism
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2
Q

Why are some patients reluctant to take hypertensive medications?

A

Because it has no Sign and Symptons ‘SILENT KILLER” and they feel “okay”

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3
Q

What is the use of Diuretics?

A

Decrease the amount of fluid in the bloodstream —–> decrease in BP

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4
Q

This type of diuretics is the “FIRST LINE” therapy for HTN

A

THIAZIDE

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5
Q

What are the 5 Classes of Diuretics?

A
  1. CHLORTHAlidone
  2. Furosemide
  3. Hydrochlorothiazide
  4. Mannitol
  5. Spironolatone
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6
Q

Aside from HTN, what are the other uses of Diuretics?

A
  1. Peripheral Edema
  2. Pulmonary Edema
  3. Heart Failure
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7
Q

This type of diuretics is mainly use for cerebral edema

A

MANNITOL

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8
Q

which part of nephron does Furosemide work on?

A

ASCENDING loop of HENLE

—> that is why it is referred to as “LOOP DIURETICS”

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9
Q

What are the adverse effects of Diuretics?

A

-Dehydration
-Hypotension
-Electrolyte Imbalance (HYPOKALEMIA)

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10
Q

How do you prevent “Nocturia” when taking diuretics?

A

Take the medication before 2 pm

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11
Q

What are the 2 things that you should know about Furosemide?

A
  1. Powerful
  2. Produce Rapid Result
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12
Q

What are the CM of Hypokalemia?

A

FATIGUE
Weakness
Muscle Cramps
N/V
Dysrhythmias

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13
Q

How do you counteract Hypokalemia when taking Furosemide?

A

Eat Potassium Rich Foods

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14
Q

What are examples of Potassium rich foods? (remember yellow and orange)

A

-Winter squash
-Sweet potatoes
-Baked Potatoes
-White Beans
-Yogurt
-Orange Juice
-Broccoli
-Cantaloupe

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15
Q

What are the 2 rare adverse effects of FUROSEMIDE?

A
  1. Ototoxicity
  2. Tinnitus

—-> this is reversible once the medication is stop

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16
Q

What type of diuretics is HYDROCHLOROTHIAZIDE and CHLORTHALIDONE?

A

Thiazide diuretics

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17
Q

What type of furosemide are the first line treatment fro HTN?

A

Thiazide

-Hydrochlorothiazide
-Chlorthalidone

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18
Q

Why is thiazide diuretics considered as the first line treatment for HTN?

A
  1. Safe
  2. Effective
  3. Inexpensive
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19
Q

What are the key issues for Thiazide that can also be seen with Loop diuretics?

A

They both cause Hypokalemia

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20
Q

What should a nurse do if a patient is taking loop diuretics and thiazide?

A
  1. Monitor for S&S of Hypokalemia
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21
Q

What kind of diuretics is Spinorolactone?

A

POTASSIUM SPARRING

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22
Q

What does Potassium Sparring means?

A

It causes nephrons to hold on to potassium rather than excreting it

—> may lead to HYPERKALEMIA

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23
Q

If Spinorolactone is considered as “WEAK” diuretics, why is it still prescribed?

A

To counteract the potassium loss by diuretics like furosemide and HCTZ

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24
Q

What kind of food should a patient taking Potassium Sparring diuretics should avoid?

A
  1. Potassium rich foods
  2. Salt substitute (they are high in K+)
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25
Q

Muscle cramps is associated with?

A

HYPOKALEMIA

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26
Q

Muscle Weakness is associated with?

A

HYPERKALEMIA

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27
Q

Mannitol can only be administered _______

A

IV

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28
Q

What does mannitol do to the blood?

A

HYPERTONIC

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29
Q

Describe the mechanism of Mannitol

A

Once it reaches the Kidney, it is filtered by glomerulus which pulls water out into the urine (makes you pee)

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30
Q

How can a mannitol treat CEREBRAL EDEMA?

A

Mannitol cannot cross BBB
so it creates an OSMOTIC FORCE that pulls extra fluid out of the brain

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31
Q

this type of diuretics is important in treating Head Trauma?

A

Mannitol

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32
Q

What are the 2 key issues with Mannitol

A
  1. It leaks out of regular capillaries = EDEMA / [worsens HF and P.Edema]
  2. It crystallizes at room temperature
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33
Q

How do you avoid the crystallization of Mannitol?

A

Store it in room warmer temperature

Use IV FILTER when administering it

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34
Q

What medical device should you put to monitor U/O for patient taking Mannitol?

A

Urinary Catheter

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35
Q

What are the 2 other names of Beta Blockers?

A

-Sympatholytics

-beta adrenergic antagonist

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36
Q

Beta blockers are commonly prescribe for?

A

-HTN
-Angina Pectoris
-Atrial Fibrillation
-Cardioprotection [following a heart attack]

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37
Q

What are the 2 types of Beta Blocker?

A
  1. Cardioselective agents
  2. Non selective agents
38
Q

What are the 2 cardioselective agents? (BETA BLOCKER)

A
  1. ATENOlol
  2. METOPROlol
39
Q

What are the 3 Nonselective Agents? (BETA BLOCKERS)

A
  1. CARVEDIlol
  2. LABELAtol
  3. PROPANOlol
40
Q

which beta blockers are alpha1, beta1, and beta2 receptors?

A

Carvedilol and Labelatol

41
Q

Which receptors does Propanolol blocks?

A

beta1 and beta2

42
Q

Which hormone is beta blocker related to?

A

Adrenaline

43
Q

What happens when adrenaline is activated?

A

Increase BP, HR, and expanded AIRWAYS [lungs]

44
Q

How does beta blockers work?

A

It stops the adrenaline system by blocking receptors

45
Q

This receptor is located in the ARTERIES and VEINS

A

Alpha1

46
Q

What happens when ALPHA1 is: ACTIVATED vs BLOCKED

A

Activated = VASOCONSTRICTION (increase BP)

Blocked = VASODILATION (decrease BP + decrease the workload of heart)

47
Q

What happens when Beta1 is: ACTIVATED vs BLOCKED

A

Activated = cause heart to beat FASTER and STRONGER (increase BP)

Blocked = decreases HR and stregth of contraction (decrease BP) + improves heart rhythm problems

48
Q

This receptor is located in the heart

A

Beta1

49
Q

This receptor is located in the lungs

A

Beta2

50
Q

What happens when Beta2 is: ACTIVATED vs BLOCKED

A

Activated = Bronchodilation

Blocked = Bronchoconstriction [not good]

51
Q

What happens when beta blockers work too well?

A

BRADYCARDIA + HYPOTENSION

—> beta blockers lower HR and BP, so if they work too well, they will cause Bradycardia and Hypotension

52
Q

TRUE OR FALSE: ALPHA1 Receptors DOES NOT change the HR?

A

TRUE

53
Q

A patient taking beta blocker should ___________ and ______________ before starting strenuous activity

A
  1. stand up SLOWLY
  2. Check how body is reacting to beta blockers
54
Q

When should you HOLD the beta blocker?

A

HR is <50

SBP is <100

55
Q

Before administering beta blockers, what should the nurse ALWAYS DO/check?

A

Check Hr and BP

56
Q

What are the issues of Beta Blockers for patient with DIABETES?

A

HYPOGLYCEMIA

  1. when beta 2 is blocked [receptor responsible in triggering muscles and live to release stored glucose when patient has low BS], stored glucose will no be produced
  2. When HR is increased, you may feel SHAKY and SWEATY, which is a signal for pt with diabetes to check and blood sugar and correct it

—>Beta blockers mask this symptom making it harder for them to recognize if they are being HYPOGLYCEMIC

57
Q

What is a good education for a patient with diabetes taking beta blockers?

A

ALWAYS CHECK BS

58
Q

Why should patient with ASTHMA or COPD avoid taking nonselective beta blockers?

A

patient with asthma or COPD uses albuterol [beta2 antagonist], which means it activates the beta2 receptor. On the other hand, non selective betablockers BLOCKS the beta2 receptors

59
Q

Why do beta blockers cause Depression?

A

because they cross BBB

60
Q

What should a client considered when giving beta blockers for patient with history of depression?

A

Beta blockers can cause depression because they cross BBB

61
Q

what is an example of beta blocker that crosses BBB and cause depression?

A

Pronapolol

62
Q

What is the disadvantage of beta blockers for patients that are men?

A

It may cause erectile dysfunction

—> hypertension may also cause E.D

63
Q

What are the 3 ACE inhibitors?

A
  1. Benazepril
  2. Lisonopril
  3. Ramipiril
64
Q

Ace inhibitors are prescribed for?

A

-HTN
-Heart Failure
-cardioprotection

65
Q

Angiotensin II is responsible for ______ and ________

A
  1. Vasoconstriction (increase bp)
  2. Aldosterone Secretion (increase blood volume = increase bp)
66
Q

What are the 3 Major effects of Angiotensin II?

A
  1. Vascular Smooth Muscle contraction (increase bp)
  2. triggers receptors in the adrenal gland causing released of ALDOSTERONE (water retention = increase blood volume = increase bp)
  3. High levels of aldosterone = harmful changes in heart muscle
67
Q

How does Ace inhibitor works?

A

It blocks the enzyme “ACE” that converts angiotensin I into its active form [angiotensin II]

—–> This causes VASODILATION and PREVENTS release of aldosterone

—————> clients will urinate more and will have a lower bp + heart is protected against pathological changes that occur after MI

68
Q

What are the side effects of Ace INHIBITORS?

A
  1. HYPOTENSION
  2. HYPERKALEMIA
  3. PERSISTENT DRY COUGH
  4. ANGIODEMA
69
Q

What is the meaning of ARBS?

A

Angiotensin II Receptor Blockers

70
Q

What are the 3 ARBS?

A
  1. Losartan
  2. Olmesartan
  3. Valsartan
71
Q

Aside from treating HTN, HF, and cardioprotection, what other treatments are ARBS used for?

A

slows the progression of CKD by reducing the pressure inside the kidney

72
Q

What is the mechanism of action of ARBS?

A

it blocks angiotensin II receptor in blood vessels (VASODILATION) and adrenal glands (SECRETION OF SODIUM AND WATER)

73
Q

What are the side effects of ARBS?

A

HYPOTENSION
ANGIODEMA

74
Q

What are the side effects of ACE INHIBITOR that ARBS does not have?

A

Hyperkalemia and Cough

75
Q

If ARBS only has 2 less side effects compared to Ace inhibitor, why is it not prescribed more?

A

the evidence for CARDIOPROTECTION is much stronger for ACE INHIBITOR

76
Q

What are the 2 types of Calcium Channel Blocker?

A
  1. Dihydropyridines
  2. NonDihydropyridines
77
Q

What are the 2 Dihydropyridines?

A
  1. Amlopidine
  2. Nifedipine
78
Q

What are the 2 NonDihydropyridines?

A
  1. Diltiazem
  2. Verapamil
79
Q

What should the client avoid when taking NonDihydropyridines?

A

Grapefruit Juice

80
Q

How are Calcium channel blockers prescribed?

A

-HTN
-Chest Pain
-Atrial Fibrillation

81
Q

What kind of Calcium Channel Blockers are prescribed for atrial fibrillation?

A

NonDihydropyridines

82
Q

How does CCBs works?

A

CCBs block calcium channels in arteries = VASODILATION and Decereased BP

83
Q

What are the second effect of NonDihydropyridines aside from blocking calcium channel in arteries?

A

they block calcium channels in SA and AV nodes causing decrease in HR

84
Q

What are the adverse Effect of CCBs?

A

VASODILATION
-HYPOTENSION
-O.H
-Edema on ankles and feet
-Facial Flushing
-H.A

85
Q

When client experiences Edema on ankles and feet, what does the prescriber do to avoid this?

A

-Decrease the dose of CCBs

-Add Ace Inhibitor

-Compression Stockings

86
Q

What are the side effects of NonDihydropyridines?

A

BRADYCARDIA

—> this will be worse if patient is also taking a beta blocker

87
Q

What is the other side effects of Verapamil?

A

CONSTIPATION

88
Q

Why does Verapamil cause constipation?

A

Verapamil blocks the calcium channel blocker in smooth muscle of intestines

89
Q

This medication is prescribed for HTN and combined with other antihypertensive medication?`

A

Hydralazine

90
Q

How does hydralazine works?

A

causes arterioles to dilate

It has short life and requires frequent dosing

91
Q

What are the side effects of hydralizine?

A

Hypoytension
HA

–>watch out for diziness and lightheadedness

PHARM EX2 (4 decks)

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