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Pharm 201 > Chapter 23 > Flashcards

Chapter 23 Flashcards

1
Q

Primary HTN

A

idiopathic

no known cause

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2
Q

Secondary HTN

A

caused by another disease

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3
Q

Peripheral Resistance

A

Friction in arteries as blood flows through vascular system
Autonomic nervous system plays a roll
greater resistance means greater BP

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4
Q

Blood Volume medications

A

Medications that affect blood volume may lower or raise B/P

ex: aldosterone

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5
Q

Vasomotor center

A

Reacts to information from baroreceptors & chemoreceptors to raise or lower blood pressure

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6
Q

Primary Antihypertensive Agents

A 
Diuretics
ACE inhibitors
Angiotensin II receptor blockers
Beta blockers
Ca channel blockers
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7
Q

Diuretics action

A

Decrease BP by inhibiting sodium & water retention by kidneys this decreases fluid volume

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8
Q

Negative effects of diuretics

A

Cause loss of electrolytes
Increase urine flow
Reduce blood volume and cardiac workload
Reduce edema and pulmonary congestion

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9
Q

Types of diuretics

A

Thiazide & thiazide-like (HCTZ)
Potassium-sparing (Spironolactone)
Loop (Lasix)

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10
Q

Thiazide & thiazide-like diuretics

A

1st line Tx
Relatively safe & inexpensive
Primary adverse effect: potassium loss

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11
Q

Potassium-sparing diuretics

A

Modest diuresis

Primary adverse effect: potassium retention Concurrent use with ACE or ARB increases risk of hyperkalemia

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12
Q

Loop diuretics

A

Produce most diuresis

Adverse effects: dehydration, potassium loss

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13
Q

SNS Neurotransmitters

A

Alpha 1, 2

Beta 1, 2

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14
Q

Alpha 1

A

1—receptors in Arteriole smooth muscle (vasoconstrict to increase BP)

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15
Q

Alpha 2

A

receptors in Brain—inhibits (regulates) CNS output of epinephrine

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16
Q

Beta 1

A

receptors in Heart rate & strength of contraction, Kidneys

Release renin

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17
Q

Beta 2

A

receptors in skeletal muscle, bronchioles of Lungs (bronchodilation),

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18
Q

Ca channel blockers for HTN

A

Safe & well tolerated, hold for HR < 60, BP < 90/60
Treat constipation
Good for elderly and african americans
not use as monotherapy

pine

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19
Q

Verapamil

A

Ca2+ blocker
Non-selective- both blood vessels & cardiac arterioles
Block ca channels on myocardium & vascular smooth muscles, AV node

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20
Q

Verapamil side effects

A

HA, low BP, constipation, dysrhythmias, CHF, bradycardia, tachycardia, edema in feet & hands
constipation

21
Q

Verapamil effects

A

↑ blood flow to the heart
↓ impulses through the AV node—
↓ workload of heart & slow heart rate; HTN, angina, dysrhythmias, atrial fibrillation

22
Q

Diltiazem

A

Ca2+ blocker

blocks Ca+ channels in myocardium, relaxes coronary vessels & periphery-not in bowel Non-selective

23
Q

Diltiazem uses

A

Atrial fibrillation, HTN, Angina, Vasospasm

24
Q

Diltiazem side effects

A

vasodilation-HA, dizziness, dysrhythmias, peripheral edema, brady or tachycardia
Stevens-Johnson syndrome
Less constipation

25
Q

DIPINES

A

Peripheral vessel calcium channel blockers

Block the myocardial & coronary arteries & peripheral vascular calcium channels

26
Q

DIPINES side effects

A

BP < 90/60, dizziness, SOB
Vasodilation, crackles, HA, dysrhythmias,
peripheral edema, wt. gain, brady or tachycardia
*Serious, life threatening  BP

27
Q

ACE Inhibitors action

A

reduces levels of Angiotension II (a vasoconstrictor) & aldosterone
lowers peripheral resistance & ↓ blood volume
Reduces afterload
Used in DM PT’s

28
Q

ACE inhibitors side effects

A 
postural hypotension, hyperkalemia, 
renal failure
Angioedema
Cough
Electrolyte imbalance
29
Q

ACE inhibitors and African Americans

A

↑ risk for angioedema, can be fatal

30
Q

Angiotension II Receptor Blockers-ARBs

A

“sartan”
Often combined with other drugs for management HTN
Used when PT can not use ACE inhibitor

31
Q

ARBs action

A

Block receptors for angiotension II

Cause arteriolar dilation & increased sodium excretion

32
Q

ARBs side effects

A

hypotension, rare angioedema

33
Q

Adrenergic Antagonists

A

Betas work best for HTN

34
Q

Beta–Adrenergic Blockers action

A

decrease heart rate and contractility
↓ conduction velocity through AV node
Blockade of Beta 1-receptors in kidney which inhibits secretion of renin & formation of angiotension II

35
Q

Beta–Adrenergic Blockers Indications

A

First-line drug for hypertension

Angina, Dysrhythmias, Heart failure, Myocardial infarction

36
Q

Beta–Adrenergic Blockers considerations

A

Non-compliance-impotence & ↓ libido

37
Q

Beta–Adrenergic Blockers

A

Selective (effect beta 1 only) and Non-selective effect beta 1 & 2)
poor response in African Americans

38
Q

“Olols, alols, ilols”

A

Beta blockers

39
Q

Alpha 1- Adrenergic Blockers

A

“zosin”

Block sympathetic receptors in arterioles causing vasodilatation

40
Q

Alpha 1- Adrenergic Blockers adverse effects

A

bradycardia, bronchoconstriction, fatigue, activity intolerance, dizziness, nausea, decreased libido
Taper off to prevent rebound HTN

41
Q

Alpha 1- Adrenergic Blockers nursing considerations

A

do not give within 4 hours of viagra

42
Q

Alpha 2- Adrenergic Agonists action

A

decreases heart rate, BP & dilates arterioles

43
Q

Alpha 2- Adrenergic Agonists adverse effects

A

sedation, dizziness, other CNS effects, nasal stuffiness

44
Q

Vasodilators action

A

relaxes smooth muscles of blood vessels

Vasodilatation drops BP & increases water & sodium retention (leading to peripheral edema)

45
Q

Vasodilators side effects

A

reflex tachycardia, sodium & water retention, dizziness, palpitations, CVA, BP hypotension

46
Q

Calcium Channel Blockers “pine” uses

A

Used to treat HTN, Angina pectoris, dysrhythmias

47
Q

Calcium Channel Blockers “pine” action

A

inhibit Ca+ from entering cell, limiting muscular contraction
Relax arterial smooth muscle, ↓ peripheral resistance,
↓ BP
↓ automaticity in the SA node & slows myocardial (AV) conduction velocity
↓ heart rate & prolongs refractory period

48
Q

Calcium Channel Blockers “pine” indications

A

safe & well tolerated
Not used as monotherapy
Useful for elderly & African American

49
Q

ACE Inhibitors considerations

A

if tx is not working, check kidney function

Pharm 201 (24 decks)

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