Blood Pressure Medications Flashcards by zorria nicole

What are the medication options for blood pressure? (hint: Deborah’s Bitch Ass Ate my Candy)

Diuretics
Beta-Blockers
Angiotensin-converting enzyme inhibitors (ACE inhibitors)
Angiotensin II receptor blockers
Calcium Channel Blockers
Hydralazine

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What are diuretics?

a medication that increases the production of urine
-considered first-line therapy for hypertension

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What Diuretics should you know? (hint: Chris Flexed However Maurice Spanked [his ass])

Chlorthalidone
Furosemide
Hydrochlorothiazide & Chlorthalidone
Mannitol
Spironolactone

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Common Uses of diuretics include

-treat edema (peripheral and pulmonary)
-treat hypertension and heart failure

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Diuretics Mechanism of Action

most diuretics cause you to excrete a lot more sodium. water follows sodium causing you to pee more
-each of the diuretics works in different parts of the nephron causing them to have different effects

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What type of diuretic is Furosemide?

-a loop diuretic meaning it works in a region called the loop of Henle
-loop diuretics are more powerful and produce rapid results

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Side effects of Furosemide

-low potassium (hypokalemia)
hearing loss (ototoxicity)

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What type of diuretic is Hydrochlorothiazide & Chlorthalidone?

-thiazide diuretic
-another first line treatment for hypertension

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Side effects of Hydrochlorothiazide (HCTZ)?

hypokalemia

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what type of diuretic is spironolactone?

Potassium-sparing diuretic/ weak diuretic
- causes nephrons to hold onto potassium rather than excrete it

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why is spironolactone prescribed?

to combat the potassium loss caused by other diuretics

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side effects of Spironolactone

hyperkalemia (muscle weakness, fatigue, dysrhythmias, nausea)

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what foods should clients taking spironolactone avoid?

potassium-rich foods and salt substitutes

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Mannitol is primarily used to treat

cerebral edema
-can only be administered intravenously

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what are the 2 problems with mannitol?

it leaks out of regular capillaries, causing edema. Thus, it’s likely to worsen heart failure and pulmonary edema.
it crystallizes at room temperature. So you have to store it in a warmer and use an IV
filter when administering it.
* A foley catheter should also be placed to facilitate and monitor
urinary output.

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What are the Cardioselective Beta Blockers you should know? (hint: a.m.)

Atenolol
Metoprolol

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Cardioselective beta blockers block which receptors?

beta 1 receptors

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What are the nonselective beta blockers you should know?

Carvedilol
Labetalol
Propranolol

Carvedilol and Labetalol block which receptors?

alpha 1, beta1, and beta 2 receptors

Propranolol blocks which receptors?

beta 1 and beta 2 receptors

Common Uses of Beta-blockers

-hypertension
-angina pectoris
-atrial fibrillation
-cardioprotection following a heart attack

Beta Blockers Mechanism of Action

In a stressful situation, your body releases adrenaline. Adrenaline activates several receptors in your body, causing your heart rate to increase, blood pressure to increase airways in your lung to expand, etc. in a life-or-death situation, this fight-or-flight response can save your life.

We can pharmacologically halt this adrenergic system by blocking these receptors. This can be very helpful for clients with hypertension and other conditions.
(refer to review questions)

Beta Blockers High Yield Concepts

1.) Bradycardia and Hypotension
* teach client to stand up slowly/ check BP and HR before giving
2.) Interferes with Blood Sugar Regulation (refer to review questions)
3.) Bronchoconstriction (narrowing of airways)
4.) Depression (Propranol esp. causes this)
5.) Erectile Dysfunciton

ACE inhibitor medications you should know

Benazepril
Lisinopril
Ramipril

ACE inhibitors common uses

-hypertension -heart failure -cardioprotection following heart attack

ACE inhibitors Mechanism of Action (RAAS steps)

1. The liver produces a substance called angiotensinogen. 2. An enzyme called renin cleaves off part of the molecule, leaving us with angiotensin-I. 3. An enzyme called angiotensin-converting enzyme (ACE) cuts off another part of the molecule, leaving us with angiotensin-II. 4. Angiotensin-II causes three major effects: 1. It causes vascular smooth muscle to contract. ------------This increases blood pressure. 2. It triggers receptors in the adrenal glands, causing them to release a hormone called aldosterone. --------- Aldosterone causes the kidneys to hold onto sodium. Since water follows sodium, this causes you to hold onto water, increasing your blood pressure. 3. More recently, we’ve learned that high levels of aldosterone cause harmful changes in heart muscle.

ACE inhibitors Mechanism of Action

ACE inhibitors block the enzyme that converts angiotensin-I into its active form. This causes vasodilation and prevents the release of aldosterone from the adrenal glands. Clients will thus produce more urine and have lower blood pressure.

ACE inhibitors High Yield Concepts

1. Hypotension 2. Hyperkalemia 3. Persistent, Dry Cough 4. Angioedema

What are the Angiotensin II Receptor Blockers (ARBs) You Should Know?

1. Losartan 2. Olmesartan 3. Valsartan

Common Uses of ARBs

-hypertension -heart failure -cardioprotection following heart attack -can slow the progression of chronic kidney disease by reducing pressure inside the kidney - pressure can be reduced too much, causing further kidney injury.

ARBs Mechanism of Action

ARBs block angiotensin II receptors in blood vessels and adrenal glands. This causes vasodilation and increases renal excretion of sodium and water.

ARBs High Yield Concepts

-hypotension -angioedema -less likely to cause hyperkalemia

What are the Dihydropyridines calcium channel blockers (CCBS) that you should know?

1. Amlodipine 2. Nifedipine

What are the Nondihydropyridines calcium channel blockers (CCBS) that you should know?

1. Diltiazem 2. Verapamil

Calcium Channel Blockers Common Uses

-hypertension -chest pain (angina pectoris) -atrial fibrillation (nondihydropyridines only)

Calcium Channel Blockers Mechanism of Action

-CCBs block calcium channels in arteries, causing vasodilation and decreased blood pressure. -the nondihydropyridines have a second effect: they also block calcium channels in the SA and AV nodes, causing a decreased heart rate.

If CCB worked too well it can cause hypotension due to

Vasodilation

Vasodilation can also cause

-peripheral edema -facial flushing and headaches -orthostatic hypotension (presents as dizziness when standing)

Nondihydropyridines are more likely than dihydropyridines to cause _____

Bradycardia especially if taking a beta blocker as well

Which CCB medication causes constipation?

verapamil

Common Uses of Hydralazine

-hypertension -typically prescribed with another antihypertensive (e.g. beta blocker or diuretic)

Hydralazine Mechanism of Action

The precise mechanism of action of hydralazine is poorly understood, but we know that it causes arterioles to dilate. It does not have this effect on veins. One downside to hydralazine is that it has a short half-life and requires frequent dosing.

Hydralazine High Yield Concepts

-causes hypotension -may present as orthostatic hypotension (lightheadedness or dizziness when standing)