Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NURS 322 > Chapter 22 - Antihypertensive Drugs > Flashcards

Chapter 22 - Antihypertensive Drugs Flashcards

1
Q

What is hypertension?

A

High Blood Pressure

Older than 60 years old: Systolic pressure greater than 150 and a diastolic greater than 90 mm of Hg

Younger or with chronic kidney disease or diabetes: Systolic greater than 140 and Diastolic greater than 90

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

What is blood pressure?

A

Cardiac Output x Systemic Vascular Resistance

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

Hypertension is a risk factor for which two diseases?

A 
Coronary Artery Disease (CAD)
Cardiovascular Disease (CVD)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the JNC - 8?

A

Eighth Report of the Joint National Committee on Prevention, Detection, Education, and Treatment of High Blood Pressure
Important for determining what blood pressure medication to use

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

What is Primary Hypertension?

A
  • Unknown cause
  • Also referred to as essential, idiopathic, or primary hypertension
  • 90% of all cases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is Secondary Hypertension?

A
  • Known cause
  • 10% of all cases
  • Adrenal tumor, thyroid disease, parathyroid disease, preeclampsia (acute HTN during pregnancy), renal disease, sleep apnea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are Centrally Acting Adrenergic drugs?

A

Action:

  • Stimulate alpha-2 adrenergic receptors in the brain - (decrease norepinephrine production)
  • reduce renin activity

Meds: Clonidine and Methyldopa

Effect: Decreased BP

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

What are Peripherally Acting Alpha-1 Blockers?

A

Action:

  • Dilate arteries and veins
  • Used for the urinary system (benign prostatic hyperplasia - BPH - shrink it)
  • Increase urinary flow rates and decrease outflow obstruction by preventing smooth muscle contraction in the bladder neck and urethra

Meds: Doxazosin, Prazosin, Terazosin
(Doxins Practice Terribly)

Effect: Decreased BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are Beta Blockers?

A

Action:

  • Reduction of the heart rate through beta receptor blockade
  • Long term use causes reduced peripheral vascular resistance
  • Used for Angina and Conduction problems
  • Decreased production of renin

Drugs: Propanolol, Metoprolol, Atenolol
(Propane Met Attention)

Effect: Decreased BP

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

What are some adverse effects of Adrenergic Drugs?

A

-Risk of Orthostatic Hypotension
-First Dose Syncope - hypotensive effect that is severe enough to cause patient to loose consciousness
(patient should change positions slowly to give blood volume time to redistribute)
-Bradycardia with Tachycardia Reflex
-Dry Mouth
-Drowsiness and sedation
-Constipation
-Depression
-Edema
-Headaches
-Sleep Distrubances
-Nausea
-Rash
-Rebound HTN
-Sexual Dysfunction

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

What happens when mixing adrenergic drugs with alcohol, benzodiazapines, and opioids?

A

CNS Depression

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

Adrenergic drugs are used as first line defense T or F?

A

False - high incidence of unwanted effects, older drugs, used as adjunct meds (added onto new meds), used in conjunction with diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Along with decreasing blood pressure what is Clonidine used for?

A

Opioid Withdrawal

  • Oral or topical patch
  • Do not stop abruptly (rebound HTN)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Tamulosin controls blood pressure T or F?

A

False - Alpha blocker used to control BPH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Carvediol?

A

Dual-Action Alpha and Beta Receptor Blocker

  • well tolerated
  • Used for HTN and mild to moderate HF in conjunction with digoxin, diuretics, and ACE inhibitors
  • Contraindications: known drug allergy, cardiogenic shock, severe bradycardia or HF, bronchospastic conditions such as asthma, conduction problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is Bystolic (Nebivolol)?

A
  • Beta blocker
  • Used for for HTN and HF
  • Blocks Beta Receptors and produces vasodilation (resulting in decrease o systemic vascular resistance)
  • less chance of sexual dysfunction
  • tapered over 1 to 2 weeks
17
Q

What are ACE inhibitors?

A

Angiotensin Converting Enzyme Inhibitors (ACE Inhibitors)
Action:
-Inhibit Angiotensin Converting Enzyme (responsible for converting angiotensin I to angiotensin II - these are potent vasoconstrictors that induce aldosterone secretion by the adrenal gland

Drugs: End in “pril” - Captopril, Benazepril, Enalapril

Effect:

  • Decrease SVR (measure of afterload and preload) and therefore decrease BP
  • Diuresis: Decreases blood volume and return to the heart
  • Decreases preload (left ventricular end diastolic volume)
  • Decreases work required of the heart
  • Used to prevent complications after MI
  • Ventricular remodeling - left ventricular hypertrophy - protective
  • Decrease mortality and morbidity in patients with HF (drug of choice for patients with HF)
18
Q

What are the renal protective effects of ACE Inhibitors?

A
  • Reduces glomerular filtration rates
  • Cardiovascular drug of choice for patients with diabetes
  • Reduce proteinura
  • Prevents progression of diabetic neuropathy
19
Q

What are some adverse effects of ACE inhibitors?

A

-Most common: dry, nonproductive cough***
(will stop once ACE inhibitor is stopped)
-Angiodema - rare, fatal, starts shortly after starting med (tissue swelling under the skin), that causes difficulty breathing b/c of pressure on airway, periorbital edema (around eye)
-headache
-mood changes
-impaired taste
-possible hyperkalemia

20
Q

Which ACE inhibitor is used to prevent ventricular remodeling and HF after MI and has a short half life?

A

Captopril (Capoten) - Leonardo Decaprio has a short life

-must be administered multiple times a day

21
Q

What is Enalapril (Vasotec)?

A
  • Only Ace Inhibitor available in both oral and parenteral forms (Nala needs a parent)
  • Does not require cardiac monitoring
  • Prodrug
  • Reduces HF
22
Q

What is an ARB?

A

Angiotensin II Receptor Blocker
Action:
-Block the binding of Angiotensin II to the type I Angiotensin II receptors in these tissues
-Block vasoconstriction and the secretion of aldosterone
-Affect primarily smooth muscle and the adrenal gland

Meds: End in -sartan ex. Losartan (Cozaar), Eprosartan (Teveten)

Effects:

  • Just as effective as ACE in treating HTN
  • Do not cause cough
  • Evidence that ARBS are better tolerated and cause less mortality after MI than ACE
  • Not clear if as effective in treating HF or protecting kidneys in diabetes - used as adjunct drug
  • May be used alone or with other drugs such as dieuretics
23
Q

What are some adverse effects or ARBs?

A
  • Chest pain
  • Fatigue
  • Hypoglycemia
  • Diarrhea
  • UTI
  • Anemia
  • Weakness
  • Hyperkalemia and cough less likely to occur in ARBs
24
Q

What is Losartan (Cozaar)?

A
  • An ARB used for patients with HTN and HF
  • Used with caution in pts with renal or hepatic dysfunction and renal artery stenosis
  • Not safe for breastfeeding and pregnant women
25
Q

What are Calcium Channel Blockers?

A

Action:

  • Relaxation of smooth muscle by blocking binding of calcium to receptors
  • Used for HTN and Angina
  • used in chronic migraine sufferers
  • CCB - decrease peripheral smooth muscle allowing dilation and blood flow to patients hands (Raynaud’s disease)

Meds: Amlodipine (Norvasc)
(Diplo needs more calcium)

Effects: Decrease in smooth muscle tone, BP, SVR, and stroke volume

26
Q

What are Diuretics?

A

Action:

  • Decrease plasma and ECF volume
  • First line antihypertensives for the treatment of HTN

Drugs: Thiazide Diuretics most commonly used for HTN

Effects:

  • Decreased preload (stretch during filling of ventricles)
  • Decreased CO
  • Decreased total peripheral vascular resistance
  • Decreased overall workload of heart and BP
27
Q

What are vasodilators?

A

Action:

  • Directly relax arteriolar or venous smooth muscle
  • Treats HTN
  • Used in combination with other drugs
Meds:
Sodium Nitroprusside (Nitropress), Hydrazine (Apresoline), Minoxidil

Effects:

  • Decreased SVR
  • Decreased afterload
  • Peripheral vasodilation
28
Q

What vasodilators are used in emergency situations?

A

Sodium Nitroprusside and IV Diazoxide

29
Q

What are some adverse effects of Hydrazine?

A

Dizziness, headache, anxiety, tachycardia, edema, dyspnea, nausea, vomiting, diarrhea, hepatitis, Vitamin B6 deficiency and rash

30
Q

What are some adverse effects of Minoxidil?

A

T-wave electrocardiographic changes, pericardial effusion or tamponade, angina, breast tenderness, rash and thrombocytopenia (low platelet level)

31
Q

What are some adverse effects of Sodium Nitroprusside?

A

Bradycardia, decreased platelet aggregation, rash, hypothyroidism, hypotension, methemoglobinemia, cyanide toxicity

32
Q

What is pulmonary hypertension?

A

-affects the arteries in your lungs
-makes it harder for blood flow to occur to your lungs because of changes in pulmonary arterioles
(lower left ventricle has to work harder to pump blood through the lungs - causing heart muscle to weaken)

Symptoms: SOB, fatigue, dizziness, chest pain or pressure, swelling in the ankles, cyanosis to lips, and heart palpitations

Meds different than HTN

33
Q

What is Sildenafil?

A

Viagra

  • used for ED and treating high BP
  • important to ask if taking vasodilator because can bottom out BP
34
Q

Before beginning therapy what is the most important step?

A
  • health history and head to toe examination

- assess for contraindications to specific antihypertensive drugs

35
Q

Why should oral forms of meds be given with meals?

A

Absorption is more effective and gradual

36
Q

Along with medications for therapy what also is important?

A
  • diet (avoid high sodium foods)
  • stress level
  • weight
  • alcohol intake
  • encourage exercise
37
Q

What two lab values should be monitored with ACE inhibitors?

A

Creatinine - sign of renal impairment

Potassium - can cause hyperkalemia

NURS 322 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions