Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharm Exam 2 > BP Agents > Flashcards

BP Agents Flashcards

1
Q

Blood pressure is determined by….

A

Heart Rate
Stroke Volume: Amount of blood pumped out of the ventricle with each heartbeat
Total Peripheral Resistance: Resistance of the muscular arteries to the blood being pumped through
Baroreceptors
Renin-Angiotensin-Aldosterone system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Renin-Angiotensin System

A
  1. Decreased perfusion pressure in the afferent arteriole stimulates secretion of renin by the juxtaglomerular cells
  2. Liver produces angiotensinogen
  3. Activation of angiotensin I to angiotensin II occurs in the pulmonary capillary bed by converting enzyme
  4. Angiotensin II: powerful vasoconstrictor
  5. Angiotensin II becomes angiotensin III which causes the release of aldosterone from the adrenal cortex
  6. Aldosterone causes increased sodium and water reabsorption by the tubules of the kidney. Result is increased blood volume
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Risks related to hypertension

A 
Coronary Artery Disease: thickening of the heart muscle; increased pressure generated by the muscle on contraction; increased workload of the heart
CAD and Cardiac Death
Stroke
Loss of vision
Renal failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Normal BP

A

SBP <120 mm Hg and DBP <80 mm Hg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Elevated BP

A

SBP 120-129 mmHg and DBP <80 mm Hg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Hypertension Stage 1

A

SBP 130-139 mm Hg and DBP 80-89 mm Hg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hypertension Stage 2

A

SBP >140 mm Hg and DBP >90 mm Hg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Factors that increase BP

A 
High levels of psychological stress
Exposure to high-frequency noise
High salt diet
Lack of rest
Genetic predisposition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Children

Use of drugs affecting BP across the lifespan

A

National Standards - new
May start in childhood
More likely to be secondary
Use of drug therapy with caution
Lifestyle changes first
Follow-up needed (monitor BP, monitor for adverse effects)
Mild diuretic - monitor glucose and electrolytes
Calcium Channel Blockers
Beta blockers - adverse effects possible
NO: angiotensin receptor blockers (ARBs) and angiotensin-converting enzymes (ACEs) - no established safety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Adults

Use of drugs affecting BP across the lifespan

A

Education - adverse effects that should be reported immediately
Safety precautions - situations that may cause dehydration
Drug-drug interactions
Lifestyle modifications
Caution with pregnancy and lactation - ACEI/ARB/Renin inhibitors should not be used; if benefit outweighs risk, labetalol is the first choice if absolutely needed in pregnancy; drugs enter breastmilk and can cause serious adverse effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Older Adults

Use of drugs affecting blood pressure across the lifespan

A

More susceptible to toxic effects
underlying conditions that may effect drug metabolism and excretion: reduced dose, close monitoring
Drug-Drug interactions including herbal therapies
Safety precautions: sustained-release or extended release medication (do not cut, crush or chew; may have a toxic dose); fall risk reduction; monitoring for dehydration; Evaluating BP (in institutional settings, BP should be taken immediately before administration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Stepped Care Management of Hypertension

A
  1. lifestyle modifications are instituted
  2. Inadequate response = drug therapy added
  3. Inadequate response = consider change in drug dose or class or addition of another drug for combined effect
  4. inadequate response = second or third agent or diuretic is added if not already prescribed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Drugs affecting the RAAS

A

ACE Inhibitors
Angiotensin II Receptor Blockers (ARBs)
Renin Inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Sympathetic Nervous System Blockers

A 
Beta Blockers (selective/nonselective)
Alpha Adrenergic Blockers (non selective and Alpha1 blockers)
Alpha and Beta Blockers (aka nonselective adrenergic blocking agents)
Alpha2 agonist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Antihypertensive agents

A 
Drugs affecting the RAAS
Calcium Channel blockers
Vasodilators
Diuretics
Sympathetic Nervous System Blockers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

ACE Inhibitors - action/indication

“-pril”

A

Action: Blocks ACE from converting angiotensin I to angiotensin II in the RAAS –> this blocks aldosterone leading to vasodilation, sodium and water excretion, and small increase in serum potassium
Indication: HTN; Congestive heart failure and left ventricular dysfunction (in conjunction with other meds); diabetic nephropathy prevention
Drugs: Benazepril, Captopril, Enalapril, Lisinopril, Ramipril

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

ACE Inhibitors - contraindications, caution, interactions, adverse effects

A

Contraindications: allergy; impaired renal function; pregnancy (Black box warning)
Caution: Acute/unstable CHF; african americans
Drug-Drug Interactions: Allopurinol; other drugs affecting the RAAS; NSAIDs
Adverse Effects related to vasodilation and alterations in blood flow: reflex tachycardia; hypotension;renal insufficiency; dizziness; fatigue; erectile dysfunction
Adverse effects (other): Pancytopenia; GI Irritation; Rash; Hyperkalemia; cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

ACE Inhibitors - Nursing Considerations

A

Assessment - Labs: CBC

Implementation - Administer on an empty stomach; patient teaching regarding cough

19
Q

Angiotensin II Receptor Blockers - action/indication

“-sartan”

A

Action: Angiotensin II receptor antagonist —> blocks angiotensin II from binding with the receptors on the vascular smooth muscle and in the adrenal cortex which prevents vasoconstriction and release of aldosterone
Indication: HTN, CHF, Diabetic nephropathy prevention
Drugs: Candesartan, Irbesartan, Losartan, Olmesartan, Telmisartan, Valsartan

20
Q

Angiotensin II Receptor Blockers - contraindications/cautions, adverse effects, interactions

A

Contraindications: Allergy, black box warning for pregnancy
Caution: hepatic dysfunction; renal dysfunction; hypovolemia
Adverse Effects: CNS: HA, dizziness, syncope, weakness; CV: hypotension; GI complaints; Rash; hyperkalemia; renal damage
Drug-Drug Interactions: NSAIDs, other drugs affecting RAAS

21
Q

Angiotensin II Receptor Blockers - Nursing Considerations

A

Assessment: Liver impairment; Labs - liver function
Implementation: Can take with or without food; If GI effects, give with food

22
Q

Renin Inhibitor: Aliskiren

A

Action: Inhibits renin which inhibits the RAAS —> Decreased BP —> decreased aldosterone —> decreased sodium reabsorption
Indications: HTN
Contraindications: Pregnancy
Adverse effects: Hyperkalemia
Drug-Drug Interactions: Furosemide, other drugs affecting the RAAS

23
Q

Drugs affecting the RAAS: Nursing Process

A

Assessment: History - allergy, pregnancy, impaired kidney function; Physical - baseline (cardiac, respiratory, abdominal, skin), vitals and weight; Labs - renal function tests, electrolytes, pregnancy test
Nursing Diagnoses: Ineffective tissue perfusion; impaired skin integrity; acute pain; deficient knowledge
Implementation: Encourage lifestyle changes, use of barrier contraceptives, monitor the patient carefully in any situation that might lead to a drop in fluid volume, provide thorough patient teaching
Evaluation: evaluate response to drug, effectiveness of teaching plan, effectiveness of comfort and safety measures, compliance with regimen

24
Q

Calcium Channel Blockers - actions/indications

“-dipine”; verapamil and diltiazem

A

Actions: inhibits the movement of calcium ions across the cell membranes of cardiac and arterial muscle, depressing the impulse and leading to slowed conduction, decreased myocardial contractility, and relaxing and dilating the arteries —> decreases BP, cardiac workload and myocardial oxygen consumption
Indications: HTN, angina, arrhythmias
Drugs: Amlodipine, felodipine, nifedipine, verapamil, diltiazem

25
Calcium Channel Blockers - Contraindications/Cautions, adverse effects, interactions
Contraindications/Cautions: Allergy, renal or hepatic dysfunction, heart block or sick sinus syndrome, CHF Adverse Effects: Related to effects on cardiac output - CNS, CV; Other - GI, Skin Interactions: Drug Drug - Cyclosporine and diltiazem; digoxin and verapamil; Drug Food - grapefruit juice
26
Calcium Channel Blockers - Nursing Process
Assessment: History - allergy, heart block, sick sinus syndrome, heart failure, liver and kidney impairment; Physical - skin, respiratory cardiac neuro abdominal, vitals, ECG, pain; Labs - liver and renal function Nursing Diagnoses: decreased cardiac output; risk for injury; ineffective tissue perfusion; deficient knowledge Implementation: monitor bP, cardiac rhythm and cardiac output; comfort measures including environmental controls; safety precautions; thorough patient teaching Evaluation: Evaluate response to drug, effectiveness of teaching plan, effectiveness of comfort and safety measures, compliance with regimen
27
Vasodilators - Actions/Indications
Actions: Acts directly on vascular smooth muscle to cause muscle relaxation and decrease in BP ---> also results in decreased peripheral vascular resistance which increases cardiac output Indications - severe HTN, malignant HTN, hypertensive emergencies Drugs: Hydralazine, nitroprusside, minoxidil
28
Vasodilators - Contraindications/cautions, interactions, adverse effects
Contraindications: Allergy Cautions: Conditions exacerbated by decreased BP - peripheral vascular disease, CAD, CHF, cerebral insufficiency or tachycardia Drug Drug Interactions: Based on individual drug Adverse Effects: Related to changes in BP- CNS and CV; skin; GI upset; Cyanide toxicity with Nitroprusside - pink/cherry red skin, headache, dizziness, tachycardia
29
Vasodilators - Nursing Process
Assessment: history - allergy, CV dysfunction; Physical - skin, cardiac, respiratory, abdominal;, vitals, ECG, weight; Labs: renal and hepatic function Nursing Diagnoses: ineffective tissue perfusion; impaired skin integrity; acute pain; deficient knowledge Implementation: Encourage lifestyle changes, monitor BP closely, monitor the patient carefully in any situation that might lead to a drop in fluid volume, comfort measures, thorough patient teaching Evaluation: Evaluate response to drug, effectiveness of teaching plan, effectiveness of comfort and safety measures, compliance with regimen
30
Diuretics
Action: Increase the excretion of sodium and water from the kidney to lower BP Thiazide and Thiazide-Like Diuretics: chlorothiazide, hydrochlorothiazide Potassium-Sparing Diuretics: Spironolactone, triamterene
31
Beta-Blockers - actions/indications Sympathetic Nervous System Blockers "-olol"
Actions: blocks beta receptors in the heart ---> decreases heart rate and cardiac muscle contraction ---> vasodilates which increases blood flow to the kidneys leading to a decrease in the release of renin Indications: Hypertension, angina, tachyarrhythmias, migraine headache, MI, glaucoma, heart failure and hyperthyroidism Drugs: Atenolol, Metroprolol, Propranolol (nonselective)
32
Beta-Blockers - contraindications/cautions, adverse effects, interactions
Contraindications: Acute/unstable heart failure, bradycardia and heart block; bronchospasm, COPD, acute asthma Cautions: Renal and hepatic dysfunction, diabetes Adverse Effects: CNS - headache, fatigue, dizziness, depression, sleep issues, disorientation, memory loss; CV - bradycardia, hypotension; Pulmonary - bronchospasm, laryngospasm, cough, pulmonary edema; GU - decreased libido and impotence; alterations in glucose levels Drug-Drug interactions: Clonidine, NSAIDs, insulin/hypoglycemic agents
33
Beta-Blockers - nursing considerations
Assessment: History of lung conditions or diabetes Implementation: Take apical pulse prior to administering and hold if below 60 bpm; do not abruptly stop medication; patients with diabetes should monitor blood glucose closely
34
Alpha-adrenic blocker (non-selective) - Actions/Indications Sympathetic Nervous System Blockers "Phen-" and "-amine"
Actions: blocks Alpha1 receptors - vasodilations resulting in decreased BP ---> blocks Alpha2 receptors - prevents norepinephrine feedback loop resulting in increase in reflex tachycardia Indications - diagnose and manage episodes of pheochromocytoma Drugs: Phenoxybenzamine, Phentolamine
35
Alpha-adrenergic blocker (non-selective) - contraindications/cautions, interactions, adverse effects
Contraindications/cautions: Allergy, CAD, MI Drug Drug interactions: alcohol Adverse Effects: Increased reflex tachycardia; GI effects; CNS - HA, weakness, dizziness; Related to vasodilation and decreased BP - hypotension, flushing, arrhythmia, angina
36
Alpha1-Blockers Sympathetic Nervous System Blockers "-azosin"
Actions: Blocks alpha1-receptor sites ---> decreases vascular tone resulting in vasodilation --> decreases blood pressure Indications: HTN Contraindications/Cautions: Allergy, heart failure, renal failure or hepatic impairment Adverse Effects: CNS, CV, GI/GU Drug Drug Interactions: Vasodilators/antihypertensives Drugs: Doxazosin, Prazosin, Terazosin
37
Alpha- and Beta- Blockers (nonselective adrenergic blocking agents) - actions/indications Sympathetic nervous system blockers
Actions: Blocks norepinephrine at all alpha and beta receptors in the SNS ---> lower BP and HR ---> increased renal perfusion ---> decreased renin Indications: HTN Drugs: Carvedilol, Labetalol
38
Alpha- and Beta- Blockers - contraindications/cautions, AEs, interactions, considerations
Contraindications/Cautions: Allergy, heart block, bradycardia, lung disease/bronchospasm, diabetics Adverse Effects: CNS, Cardiovascular, Pulmonary, hypoglycemia, rash, GI/GU issues Drug Drug Interactions: Antidiabetic Agents Nursing Considerations: Do not stop abruptly, ND: ineffective airway clearance r/t lack of bronchodilating effects
39
Alpha2-agonist: Clonidine | Sympathetic Nervous System Blocker
Actions: Stimulate the alpha receptors in the CNS and inhibits the CV centers, leading to a decrease in sympathetic outflow from the CNS resulting in a drop in BP Indications: HTN Adverse Effects: CNS, CV Drug Drug Interactions: beta-blockers, adrenergic antagonists, CNS depressants/alcohol Nursing Considerations: do not stop abruptly, given oral or transdermal for HTN
40
Sympathetic Nervous System Blockers - Nursing Process
Assessment: History- contraindications and cautions; Physical - baseline CNS, cardiac respiratory abdominal, urinary and perfusion. Vitals and ECG; Labs - electrolytes, renal and hepatic function, glucose Nursing Diagnoses: Acute pain; ineffective tissue perfusion; decreased cardiac output; risk for injury; risk for activity intolerance; non compliance; disturbed sensory perception; deficient knowledge Implementation: Take apical pulse prior to administration and hold if below 60 bpm, monitor blood pressure, do not abruptly stop meds, encourage patient to make lifestyle modifications; change position slowly, safety and comfort measures, do not crush ER formulations; Patient teaching - consult a healthcare professional before taking any OTC meds or herbal alternative therapies, emphasize importance of follow up exam Evaluation: evaluate response to drug, effectiveness of teaching plan, effectiveness of comfort and safety measures, compliance with regimen
41
Hypotension
When the heart muscle is damaged and unable to pump effectively; with severe blood or fluid loss, when volume drops dramatically; when there is extreme stress and the body's levels of norepinephrine are depleted leaving the body unable to respond to stimuli to raise BP
42
Antihypotensive Agents | Sympathetic adrenergic agonists/ Sympathomimetics/ Alpha- and Beta- adrenergic agonists/ vasopressors
Drugs: Dopamine and dobutamine; epinephrine and norepinephrine Action: stimulate all adrenergic receptors/SNS ---> HR and myocardial contractility increases ---> blood vessels constrict and BP increases ---> bronchi dilate and rate/depth of breathing increases Indications: Hypotensive states - shock, heart failure; anaphylaxis; bronchospasm; asthma Contraindications/Cautions: allergy, tachyarrhythmias/ventricular fibrillation; hypovolemia; pheochromocytoma Adverse Effects: CV, GI, CNS, Hypokalemia Drug Drug Interactions: Ma huang/guarana/caffeine; cold medicine
43
Antihypotensive Drugs - Nursing Process
History: Allergy, impaired kidney or liver function; CV dysfunction, visual problems, urinary retention, and pheochromocytoma; Physical - Respiratory, cardiac, abdominal, skin, perfusion, weight, vitals; Labs: kidney and liver function Nursing Diagnosis: ineffective tissue perfusion; disturbed sensory perception; acute pain; deficient knowledge Implementation: monitor BP and HR; provide thorough patient teaching; safety and comfort measures; monitor patient with known visual problems; encourage patient to void before taking a dose of the drug Evaluation: Evaluate response to drug, effectiveness of teaching plan, effectiveness of comfort and safety measures, compliance with regimen

Pharm Exam 2 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions