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NUR1141 PHARMACOLOGY > Chapter 22: Antihypertensive Drugs > Flashcards

Chapter 22: Antihypertensive Drugs Flashcards

1
Q

Goal of antihypertensive therapy

A

Reduce renal morbidity and mortality

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2
Q

Which antihypertensive drug has a black box warning?

A

Aliskiren

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3
Q

Which antihypertensive drug has asthma as a contraindication?

A

Carvedilol

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4
Q

Which alpha 1 blocker is commonly prescribed?

A

Doxazosin ( cardura).

Treats: HTN and BPH.

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5
Q

Which antihypertensive drug causes lesser degree is sexual dysfunction?

A

Nebivolol

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6
Q

Which black box warning is given on Nitroprusside?

A

Hypotension

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7
Q

What is true about calcium channel blockers (CCB)?

A

CCBs relax vascular smooth muscle.
It vasodilates the blood vessels to lower BP

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8
Q

What is the appropriate site for clonidine patch application?

A

Upper arm

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9
Q

What interaction can happen between an angiotensin II blocker and NSAID?

A

Decreased effect of angiotensin II receptor blocker

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10
Q

Which medication will decrease vasoconstriction by blocking angiotensin II receptors?

A

Valsartan

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11
Q

Which intervention is needed for a patient who is taking hydrochlothiazide?

A

Encourage intake of foods rich in potassium.

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12
Q

What would the nurse teach the patient who is receiving transdermal clonidine?

A

Remove the old patch before applying new patch.

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13
Q

Which is a priority for nursing intervention for patient who is prescribed nonselective beta blocker?

A

Respiratory assessment

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14
Q

Treprostinil

A

An antihypertensive used to treat pulmonary artery hypertension related to severe heart failure

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15
Q

Adverse effects of Hydralazine

A

Dizziness
Headache
Vomiting and diarrhea

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16
Q

An adverse effect of ACE inhibitor that need immediate attention

A

Angioedema

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17
Q

Which drug should be administered at bedtime for the first dose?

A

Doxazosin

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18
Q

Which antihypertensive medication to avoid giving to a patient with DM?

A

Propranolol.

Because it can mask the indicators of hypoglycemia by blocking the sympathetic stimulation caused by low blood sugar.

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19
Q

Side effect of Enalapril

A

Dry, hacking cough

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20
Q

Which antihypertensive drug can be given to a patient with liver dysfunction?

A

Captopril and Lisinopril

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21
Q

What adverse effect would happen if ACE inhibitor and Lithium are combined?

A

Toxic level of Lithium

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22
Q

Common side effect of Clonidine

A

Constipation

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23
Q

What is most important to assess in a patient receiving sodium nitroprusside infusion for 4 days?

A

Serum cyanide level.

Because cyanide toxicity can happen for prolonged treatment

24
Q

What is a nursing intervention for minoxidil toxicity?

A

Administer IV fluids.

Because minoxidil toxicity can cause excessive hypotension. IVF can counteract this.

25
Q

Which parameter would the nurse evaluate to determine effectiveness of lisinopril in a hypertensive patient with heart failure?

A

Breathing sounds.

Because ACE inhibitors like lisinopril cause vasodilation which decreases after load and increase excretion of sodium and water. Breathing sounds should improve.

26
Q

Which medication would be given to treat hypertension after having an MI?

A

Eplerenone. This medication treats HTN and improves survival after MI.

27
Q

What action should the nurse perform for a patient who developed lisinopril toxicity?

A

Patient needs to be sent for hemodialysis as this toxicity will only respond to dialysis.

28
Q

What do Ace Inhibitors do?

A
  • reduce after load
  • systemic vascular resistance (SVR) is decreased
29
Q

Which antihypertensives can cause tachycardia?

A

Diazoxide
Hydralazine

30
Q

Which medications could cause interaction with ACE inhibitors?

A

Spironolactone
Ibuprofen
Potassium chloride

31
Q

What is contraindicated with captopril?

A

Spironolactone

32
Q

What is the antidote for Beta Blockers/ Calcium Channel Blockers?

A

Glucagon (makes you puke).

33
Q

Alpha 1 causes

A

Vasoconstriction

34
Q

Alpha 1 antagonist
( Doxazosin)

A

Vasodilation, lowers BP

35
Q

Alpha 2 causes

A

Calming effect, decrease BP.

Example: Clonidine

36
Q

Clonidine

A

Lowers BP and HR by relaxing arteries.

37
Q

Selective Beta Blocker

A

Selectively blocks Beta 1 in the heart

38
Q

Non- Selective Beta Blocker

A

Blocks both Beta 1 & 2, Alpha 1.

39
Q

Contraindications of Nonselective Beta Blockers

A

Patients w/ COPD, asthma

40
Q

Natriuretic Peptides

A

Consists of ANP & BNP levels.

They naturally decrease BP.

41
Q

BNP levels

A

Anything over 100 means heart failure .

42
Q

RAAS System
(Renin Angiontensin Aldosterone System).

A

RAAS kicks in when it detects low blood volume and then increases BP.

43
Q

What happens when angiotensin 1 converts to angiontensin 2?

A

Angiotensin 2 causes vasoconstriction in the body.

Therefore, BP is increased.

Angiontensin 2 also stimulates Thirst.

44
Q

Aldosterone

A

Causes kidneys to retain Na & water, causing fluid retention. Therefore increase blood volume and BP.

Outcome: patient decrease in urination

45
Q

ADH
(Anti diuretic hormone)

A

Released by the pituitary gland.

ADH causes kidneys to hold water.

46
Q

Aldosterone excretes ____

A

Potassium out of the body

47
Q

Vasodilators

A

A form of antihypertensives.

  1. Hydralazine : treats HTN
  2. Bosentan: helps lower BP in the lungs
48
Q

Which 2 classes of antihypertensives are Nephro & Cardio protective?

A

ACE inhibitors and ARBS.

They slow progression of kidney failure, reduce cardiac work load and diabetes.

49
Q

Angiontensin 2 causes _________ in blood vessels

A

Constriction

50
Q

Rebound Hypertension

A

When you stop these medications abruptly, then BP comes back stronger.

(Rubberband effect)

51
Q

Classes of AntiHypertensives

A
  1. ACE inhibitors + ARBs
  2. Beta Blockers
  3. Calcium Channel Blockers (CCB)
  4. Vasodilators
52
Q

ACE inhibitors -pril

A

Examples: enalapril, captopril, lisinopril

Moa: prevents angiotensin 1 turning into 2

Cause: vasodilation (decrease BP and SVR). Also decreases Aldoesterone - causing excretion of Na + water, retains K.

S/E: (ACE) Angioedema, Cough, Elevated K

53
Q

ARBs - sartan

A

Examples: losartan, candesartan, valsartan.

Moa: blocks angiotensin 2 receptors.

Cause: vasodilation (decrease BP, SVR).

S/E: less likely to get angioedema or cough

54
Q

Beta Blocks - olol

A

Examples: metropolol, propanolol, carvedilol.

Moa: blocks Beta 1 receptors (sympathetic).

Cause: decrease HR & Bp, lower cardiac output and causes relaxation

S/E: (B’s) Bradycardia, Breathing problems, Blood sugar masking, hypotension

55
Q

Calcium Channel Blockers - VND
( Very Nice Drugs)

A

Example: Verapamil, Nifedipine, Diltiazem

Moa: blocks movement of calcium & decreasing contraction of the heart.

Cause: calms vessels by blocking calcium. Decreases cardiac workload, increase oxygen to heart.

S/E: bradycardia, AV blocks, peripheral edema.

NUR1141 PHARMACOLOGY (41 decks)

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