Chapter 23- Antihypertension Meds

Question 1

beta blockers

Answer 1

“olol”

• decrease heart rate and contractility; reduces cardiac output and lowers systemic blood pressure
• slow heart rate and cause bronchoconstriction
• decreases glucose levels
• decreases cardiac oxygen demand
• FIRST LINE drugs
• has REBOUND effect if stopped abruptly
• do not discontinue abruptly

Question 2

calcium channel blockers

Answer 2

“pine”

• blocks Ca2+, inhibits muscular contraction; lower resistance and decrease blood pressure
• do not give with GRAPEFRUIT juice
• watch for liver failure
• use daily weights to watch for lower extremity edema

Question 3

ace inhibitors

Answer 3

“pril”

• block effects of angiotensin II, decreasing blood pressure through two mechanisms; lowering peripheral resistance and decreasing blood volume
• DRY COUGH is main adverse effect
• most serious adverse effect is ANGIOEDEMA (swelling of everything)
• can cause HYPERKALEMIA
• DO NOT GIVE WITH PREGNANCY
• careful for orthostatic hypotension
• contraindication is RENAL STENOSIS
• NSAIDs decrease efficacy

Question 4

ARBs (second generation ace inhibitor)

Answer 4

“sartan”

• block receptors from angiotensin II in arteriolar smooth muscle and in adrenal gland; causes blood pressure to fall
• most side effects are related to hypotension
• takes 3-6 weeks for full effect
• watch POTASSIUM levels

Question 5

alpha blockers

Answer 5

• blocks sympathetic receptors in arterioles, causing vessels to dilate
• causes orthostatic hypotension
• dizziness, nausea, nervousness, fatigue (common side effects)
• will find an increased heart rate with weight gain

Question 6

arterial blood pressure=

Answer 6

cardiac output X systemic vascular resistance

Question 7

cardiac output=

Answer 7

heart rate X stroke volume

Question 8

drug interactions for antihypertensives

Answer 8

ALCOHOL

Question 9

nursing focus/teaching for antihypertensives

Answer 9

• slow position change (orthostatic hypotension)
• watch for weight gain (renin)
• 2 weeks to see therapeutic results

Question 10

contraindications for beta blockers

Answer 10

• diabetes

- asthma and COPD (because of bronchoconstriction)

Question 11

drug interaction with ARBs

Answer 11

-phenobarbital (reduces efficacy)

Question 12

direct vasodilators

Answer 12

• treatment of moderate to severe hypertension
• reduces PVR and CO
• NEVER used as first line treatment
• MANY ADVERSE EFFECTS

Question 13

diuretics

Answer 13

• reduce BP by reducing CO
• urinate more causing lowered blood pressure
• very often FIRST line treatment
• inexpensive, few adverse effects
• watch for ELECTROLYTE imbalance