Brainscape's Knowledge GenomeTM

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


See full index

NURS 306 > Chapter 22: Antihypertensive Drugs > Flashcards

Chapter 22: Antihypertensive Drugs Flashcards

1
Q

Normal Blood Pressure

A

<120 mm Hg systolic and

<80 mm Hg diastolic

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

Pre-hypertension

A

120-139 mm Hg systolic or

80-89 mm Hg diastolic

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

Hypertension Stage 1

A

140-159 mm Hg systolic or

90-99 mm Hg diastolic

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

Hypertension Stage 2

A

Greater than or equal to 160 mm Hg systolic or Greater than or equal to 100 mm Hg diastolic

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

Types of Hypertension

A
  1. Primary
  2. Secondary
  3. Isolated Systolic
  4. Malignant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Risk Factors for Hypertension

A

Modifiable (lack of exercise, smoking, diet, weight) and Unmodifiable (age, gender, genetics)

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

Hypertension can cause

A

Endothelial injury and tissue ischemia to the vessel walls → inflammation

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

Hypertension is a

A

silent disease

signs and symptoms occur due to: specific for the organs or tissues affected.

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

Complications of hypertension

A
  • cerebrovascular accident -stroke
  • myocardial infarction -heart attack
  • renal failure
  • aortic dissection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Lifestyle changes that can prevent hypertension

A
  • weight reduction
  • moderate alcohol intake
  • regular physical activity
  • stress reduction (biofeedback, relaxation)
  • smoking cessation
  • change in diet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Seven Main Categories of Antihypertensive Drugs:

A
  1. diuretics
  2. adrenergic drugs
  3. vasodilators
  4. angiotensin-converting enzyme (ACE) inhibitors
  5. angiotensin receptor blockers (ARB’s)
  6. calcium channel blockers (CCBs)
  7. indirect renin inhibitors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

secondary hypertension

A

high blood pressure caused by another disease such as renal, pulmonary, endocrine or vascular disease

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

2 divisions of the autonomic nervous system

A

parasympathetic and sympathetic nervous system

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

Stimulation of the ANS is controlled by

A

the neutrotransmitters acetylcholine and norepinephrine.

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

Receptors in the PSNS are called

A

muscarinic or cholinergic receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Receptors in the SNS are called

A

adrenergic or noradrenergic receptors (ex. alpha or beta receptors)

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

Physiologic activity at muscarinic receptors are stimulated by and inhibited by ….

A

stimulated by acetylcholine and cholinergic agonist drugs.

inhibited by cholinergic antagonists drugs.

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

Physiologic activity at adrenergic receptors are stimulate by and inhibited by..

A

stimulated by norepinephrine, epinephrine, and adrenergic agonists.
inhibited by antiadrenergics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Adrenergic drugs

A

drugs that stimulate the SNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Five specific adrenergic drug subcategories

A
  1. adrenergic neuron blocks (central and peripheral)
  2. the alpha2 receptor agonists (central)
  3. the alpha1 receptor blockers (peripheral)
  4. the beta receptor blockers (peripheral)
  5. combination alpha 1 and beta receptor blockers (peripheral)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Each of these subcategories of drugs can be described as

A

having central action (in the brain) or peripheral action (at the heart and blood vessels)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Stimulation of the SNS leads to

A
  • an increase in heart rate and force of contraction
  • the constriction of blood vessels
  • the release of renin from the kidneys
    resulting in hypertension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Alpha2 receptor agonists

A

-centrally acting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Mechanism of Action: Alpha2 receptor agonists

A
  • Stimulate alpha2-adrenergic receptors in the brain,
  • Decreases sympathetic outflow from the CNS
  • Decrease norepinephrine production,
  • Stimulate alpha2-adrenergic receptors → reduce renin activity in the kidneys,
  • Result in decreased BP.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Uses for alpha2 receptor agonists

A

-hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Clonidine

A

useful in the management of withdrawal symptoms in opioid-dependent persons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the alpha2 receptor agonists?

A

clonidine and methyldopa (HTN in pregnancy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Mechanisms of Action: Alpha1 receptor blockers

A
  • Block alpha1 receptors (cause vasodilation of arteries and veins),
  • Reduce peripheral vascular resistance,
  • Result in decreased BP.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Uses for alpha1 receptor blockers

A
  • HTN
  • relief of BPH symptoms
  • congestive heart failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the alpha1 receptor blockers?

A

doxazosin, terazosin

prazosin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Mechanism of Action: beta receptor blockers

A
  • Block beta1 receptors,
  • Reduce heart rate,
  • Reduce secretion of renin (reduces secretion of AT2),
  • Result in decreased BP.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Uses for beta receptor blockers

A

angina and conduction problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the beta receptor blockers?

A

atenolol, propranolol, metoprolol, nebivolol, nadolol, sotalol

34
Q

Mechanism of Action: dual alpha1 and beta blockers

A
  • Block beta1 receptors
  • Reduce heart rate,
  • Reduce secretion of renin (reduces secretion of AT2).
  • Block alpha1 receptors (cause vasodilation of arteries and veins),
  • Result in  BP.
35
Q

What happens when you block alpha1 receptors?

A

causes vasodilation of arteries and veins

36
Q

Uses for dual alpha1 and beta blockers?

A
  • hypertension

- congestive heart failure

37
Q

What are the dual alpha1 and beta blockers?

A

carvedilol, labetalol

38
Q

What are the most common adverse effects of adrenergic drugs?

A
  • bradycardia w/ reflexive tachycardia
  • orthostatic hypotension
  • dry mouth
  • drowsiness, sedation
  • constipation
  • depression
  • edema
  • sexual dysfunction
  • fatigue
39
Q

What are other adverse effects of adrenergic drugs?

A

headaches, sleep disturbances, nausea, rash, cardiac disturbances (palpitations), others

40
Q

methyldopa

A

alpha2-adrenergic receptor drug used to treat hypertension in pregnancy

41
Q

Mechanism of Action: ACE inhibitors

A

-Inhibit angiotensin converting enzyme (ACE)
-Converts Angiotensin I to Angiotensin II
-Prevent the breakdown of bradykinin
(vasodilating substance)

42
Q

What are the effects of ACE inhibitors?

A

decreased afterload, vasodilation = decreased BP

43
Q

Uses for ACE inhibitors

A

-hypertension, congestive heart failure
-post myocardial infarction (cardioprotective)
-renal protective effects in patients with diabetes
+

44
Q

ACE inhibitors: Drugs

A

captopril, benazepril, enalapril, fosinopril, lisinopril, quinapril, moexipril

45
Q

ACE inhibitors are the drugs of choice in

A
  • hypertensive patients with congestive heart failure

- diabetic patients

46
Q

Prodrugs

A
  • a drug that is inactive in its given form and must be metabolized to its active from in the body.
  • generally by the liver, to be effective
47
Q

Captopril and lisinopril

A

are NOT prodrugs.

-can be used if a patient has liver dysfunction, unlike other ACE inhibitors that are prodrugs.

48
Q

Adverse Effects of ACE inhibitors

A
  • Fatigue
  • Dizziness
  • Headache
  • Mood changes
  • Impaired taste
  • Possible hyperkalemia
  • Dry, nonproductive cough, which reverses when therapy is stopped
  • Angioedema: rare but potentially fatal
49
Q

Mechanism of Action: Angiotensin II Receptor Blockers (ARBs)

A

Block vasoconstriction and release of aldosterone =  BP

50
Q

Uses of ARBs

A
  • hypertension
  • adjunctive drugs for the treatment of congestive heart failure
  • adjunctive drugs for patients with diabetes (to protect their kidneys)
51
Q

What are the Angiotensin II Receptor Blockers (ARBs)?

A

iosartan, valsartan, irbesartan, candesartan, olmesartan, telmisartan

52
Q

Mechanism of Action: Calcium Channel Blockers

A
  • Block binding of calcium to its receptors, preventing muscle contraction
  • Smooth muscle relaxation, preventing muscle contraction
53
Q

Use of Calcium Channel Blockers results in

A
  • decreased peripheral smooth muscle tone
  • decreased systemic vascular resistance
  • decreased blood pressure
54
Q

Uses for Calcium Channel Blockers

A
  • angina
  • hypertension
  • dysrhythmias
55
Q

What are the calcium channel blockers?

A

amlodipine, nifedipine, felodipine, diltiazem, verapamil

56
Q

Adverse effects of calcium channel blockers

A
  • Constipation**
  • Dizziness
  • Facial flushing
  • Dry mouth
  • Headache
  • Edema of ankles and feet**
  • fatigue**
  • erectile dysfunction **

**most likely to occurfursing i

57
Q

Mechanism of Action: Vasodilators

A
  • Directly relax arteriolar and/or venous smooth muscle

- Results in decreased BP

58
Q

Uses for Vasodilators

A

treats hypertension

59
Q

What are the vasodilators?

A

diazoxide, hydralazine HCl, minoxidil, sodium nitroprusside

60
Q

Before giving antihypertensive drugs, what should the nurse do?

A
  • before beginning therapy, obtain a thorough health history and head-to-toe physical examination
  • assess for contraindications to specific antihypertensive drugs
  • assess for conditions that require cautious use of these drugs
61
Q

What should the nurse educate and instruct the patients to do when it comes to doses of antihypertensive drugs?

A
  • educate patients about the importance of not missing a dose and taking the medications exactly as prescribed
  • instruct patients to check with physician for instructions on what do do if dose is missed
62
Q

If a dose is missed, the patient should

A

never double up on doses

63
Q

During antihypertensive drug therapy, the nurse should

A

-monitor BP; instruct patients to keep a journal of regular BP checks

64
Q

Why should a nurse inform patients that antihypertensive drugs should not be stopped abruptly?

A

because it may cause a rebound hypertensive crisis and perhaps lead to a stroke

65
Q

During antihypertensive drug therapy, the nurse should

A
  • monitor BP; instruct patients to keep a journal of regular BP checks
  • monitor for adverse effects and for toxic effects
  • monitor for therapeutic effects
66
Q

The nurse should always administer IV forms of antihypertensive drugs

A

with extreme caution and using an IV pump

67
Q

The nurse should remind patients that

A

medication is only one part of therapy.

68
Q

Because medications are only one part of the treatment, the nurse should encourage and instruct the patient to

A
  • watch their diet, stress level, weight and alcohol intake
  • instruct patients to avoid smoking and eating food high in sodium
  • encourage supervised exercise
69
Q

Why should the nurse teach patients to change positions slowly?

A

to avoid syncope from postural hypotension

70
Q

The nurse should instruct the patient to report any

A
  • shortness of breath
  • difficulty breathing
  • swelling of the feet, ankles, face or around the eyes
  • weight gain or loss
  • chest pain
  • palpitations
  • excessive fatigue
71
Q

Male patients may not be aware that taking antihypertensive drugs can cause

A

impotence (inability to achieve an erection or orgasm) which may influence compliance with the drug therapy

72
Q

If patients are experiencing serious adverse effects or if they believe the dose or medications needs to be changed, they should…

A

contact their physician immediately

73
Q

Factors that may aggravate low blood pressure, leading to fainting and injury include

A
  • hot tubs, showers, or baths
  • hot weather
  • prolonged sitting or standing
  • physical exercise
  • alcohol ingestion
74
Q

Patients should not take any other medications, including over-the-counter drugs without

A

first getting the approval of their physician

75
Q

there will be questions on statistics “lifes simple 7”

A

….

76
Q

Theories for Hypertension

A

Sympathetic Nervous System, Renin Angiotensin Aldosterone System, defect in renal sodium excretion, interaction involving insulin resistance

77
Q

Primary hypertension

A

no known cause. Based on lifestyle.

78
Q

Isolated systolic hypertension

A

systolic BP increases while diastolic remains normal.

common in the elderly

79
Q

malignant hypertension

A

very rare, but can be deadly

increase in systolic BP

80
Q

any changes to the preload, afterload and contractility of the heart can

A

effect BP

81
Q

Uses for Beta blockers

A

HTN, congestive heart failure, migraines

82
Q

Adverse Effects of ARB’s

A
  • upper respiratory infections
  • headache
  • may cause occasional dizziness, inability to sleep, diarrhea, dyspnea, heartburn, nasal congestion, back pain, fatigue
  • hyperkalemia less likely to occur than in ACE
  • first dose hypotension
  • angioedema

NURS 306 (26 decks)

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