Chapter 22-Antihypertensive Drugs Flashcards
What is pre-hypertensive BP?
S 120-139/ D80-89
What is the BP for Stage 1 hypertension?
S 140-159/ D90-99
What is the BP for Stage 2 hypertension?
S >160/ D >100
This nervous system system stimulates smooth muscle, cardiac muscle and glands?
Parasympathetic nervous system
This nervous system stimulates the heart, blood vessels, skeletal muscle
Sympathetic nervous system
What do the following drug treat;
Adrenergic drugs, angiotensin-converting enzymes (ACE) inhibitors, Angiotensin II receptor blockers (ARBs), Calcium Channel Blockers (CCBs), Diuretics, vasodilators, and Direct Renin Inhibitors
Hypertension
Which drug class decreases norepinephrine?
Andrenergic drugs
Which drug class reduces renin activity in the kidneys, stimulates alpha-adrenergic receptors in the brain, and decreases BP?
Alpha receptor agonists
Which drug class decreases sympathetic outflow from the CNS?
Alpha receptor agonists
Which Andrenergic drug is safe to be used for hypertension during pregnancy?
Methyldopa (Aldomet)
Which drug class are Clonidine (Catapres) & methyldopa (Aldomet)
Alpha receptor agonists
Which drug class are those with the suffix -azosin?
Alpha Blockers/antagonists
Which drugs are Alpha Blockers/Agonists?
Doxazosin (Cardura),
Terazosin Hytrin),
Prazosin (Minipress)
Long term use of these adrenergic drugs causes reduced peripheral vascular resistance
Beta blockers
Which class of adrenergic drug has the suffix -olol?
Beta Blockers
What class of drug are the following;
Nebivlol (Bystolic),
Propranolol (Inderal),
Atenolol (Tenormin)
Beta Blockers
Which drugs are alpha and beta receptor blockers?
Carvedilol (Coreg)
Reduces heart rate and causes vasodilation
What is tamsulosin (Flomax) used for?
Management of severe heart failure when used with cardiac glycosides and diuretics
What are the most common adverse effects of adrenergic drugs?
Bradycardia with reflex tachycardia, Dry mouth, Drowsiness/sedation, Constipation, Depression, Edema, Sexual dysfunction
What are the less common adverse effects of adrenergic drugs?
Headaches, Sleep disturbances, Nausea, Rash, Cardiac disturbances (palpitations)
When administering an alpha-adrenergic drug for hypertension, it is important for the nurse to assess the patient for the development of ______.
Hypotension
What are the first line drugs for heart failure and hypertension?
ACE inhibitors
Which class of adrenergic drugs has the suffix -pril?
ACE inhibitors
_______ is a potent vasoconstrictor and causes aldosterone secretion from the adrenal glands.
Angiotensin II
_______ inhibit the Angiotensin Converting Enzyme, which is responsible for converting Angiotensin I to Angiotensin II
ACE inhibitors
______ use results in decreased systemic vascular resistance (afterload), vasodilation, and therefore decreased blood pressure
ACE inhibitors
What are the indications for ACE inhibitors?
Hypertension,
HF,
Slow progression of left ventricular hyper trophy after MI (cardio protective),
Renal protective effects in patients with diabetes
Which ACE inhibitors are not prodrugs and must be metabolized by the liver?
Captopril (Capoten) & Lisinopril (Prinivil)
These can be used for patients with liver dysfunction
What are the adverse effects of ace inhibitors?
Fatigue, dizziness, headache, mood changes, impaired taste, possible hyperkalemia, drnonproductive
_____ are inactive in their administered form and must be metabolized in the liver to an active form to be effective
Prodrugs
Catapril and Lisinopril are NOT prodrugs
______ to not cause a dry cough
Angiotensin II Receptor Blockers (ARBs)
Doxazosin (Cardura),
Terazosin (Hytrin),
Prazosin (Minipress)
These drug are in which classification ?
Alpha blockers/antagonists
______ is useful in the management of withdrawal symptoms in opioid dependent persons
Clonidine
Captopril (Capoten), Benazepril (Lotensin), Enalapril (Vasotec), Fosinopril (Monopril), Lisinopril (Prinivil), Moexipril (Univasc), Quinapril (Accupril)
These are all in which drug classification
ACE inhibitors
A patient with a history of pancreatitis and Cirrhosis is also being treated for hypertension. Which drug will most likely be ordered for this patient?
Captopril
The suffix -sartan is most associated with this drug classification
Angiotensin II Receptor Blockers (ARBs)
What is the mechanism of action for angiotensin II receptor blocker’s (ARBs)?
Block vasoconstriction and release of aldosterone
What are the types of adrenergic (antihypertensive) drugs?
ACE inhibitors, Angiotensin II receptor blocker (ARBs), Calcium channel blocker's (CCBs), Diuretics, Vasodilators, Direct renin inhibitors
What is a common adverse effect for ACE inhibitors?
Fatigue, dizziness, mood changes, headaches, dry nonproductive cough
What is the mechanism of action for ACE inhibitors?
Vasodilators that prevent sodium and water resorption and reduce blood pressure
What are the interactions for ACE inhibitors?
NSAIDs (predisposes for renal failure),
Lithium,
Potassium (can cause hyperkalemia)
What is the mechanism of action for ARBs?
They block the binding of A-II to the receptors
This category of antihypertensive drugs lowers mortality after MI?
ARBs
Where are the adverse affects for ARBs?
Upper respiratory infection
What are the contradictions for ARBs?
Allergies,
Pregnancy,
Lactation,
Caution with elderly
What is the mechanism of action for calcium Channel Blockers?
Peripheral vasodilation
What are the contradictions for calcium channel blockers?
Cerebral edema,
Head trauma,
Acute MI
Toxicity and overdose of some CCBs produce what symptoms?
Hypotension,
tachycardia,
headache,
generalized skin flushing
Hydrazine (Apresoline), Sodium Nitroprusside (Nitropress)
Are whate type of antihypertensive?
CCBs
What lab result is an indicator that a heart attack this taken place?
Elevated serum troponin
This is elevated 4 to 6 hours after a heart attack begins and maybe reliable up to 14 days after a heart attack
First dose orthostatic hypotension may occur within 2 to 6 hours after administration of ________
Doxazosin (Cardura)
What is the mechanism of action for diuretics?
Decrease workload of the heart,
Decrease blood pressure
They directly relax arteriolar and/or venous smooth muscle, decreasing systemic vascular response, decreasing afterload, and peripheral vasodilation
What is the mechanism of action for nitrates and nitrites?
Vasodilation of coronary arteries
Drugs with the suffix -trate are in which classification?
Nitrates/Nitrites
Along with nitroglycerine
Beta Blockers are used to treat ____ angina
Exertional
Beta blockers
_____ _____ should be used with caution in patients with bronchial asthma as they can cause bronchoconstriction
What is the primary nursing diagnosis with use of antihypertensive drugs?
Ineffective peripheral tissue perfusion related to the impact of the hypertensive disease process and/or possible severe hypotensive adverse affects associated with antihypertensive drug therapy