Chapter 42 Antihypertensive Flashcards
What is preload?
Volume of blood in ventricles at the end of disatole
What is after load?
Resistance left ventricle must overcome to circulate blood
Usually when a patient who just got hypertension, what will we give?
Thaizide diuretic
Notes
Things that are effected of blood pressure
- kidneys
- catecholamines
- baroreceptors in aorta and carotid sinus
- vasomotor center in medulla
- hormones
Brain natriuretic peptide ( BNP )
Heart failure
Who are the highest risk of getting hypertension?
Older African American men
What’s the biggest thing to watch out with hypertension who takes antihypertensive medications?
Orthostatic hypotension
What are some things to change not pharmacological for treatment of hypertension?
Also start least invasive to most invasive
No salt
Exercise
Stress reduction techniques
Decrease alcohol ingestion
Smoking cessation
Asian Americans usually have a great response to what?
Compared to?
Hypertensive medications
African Americans
Usually patients in the hospital will have the following
Hypertension
Obesity
High cholesterol
What are the 3 actions of beta blockers?
Heart rate
Force of contraction
Rate of AV conduction
What are the 6 side effects of beta blockers?
Bradycardia
Lethargy
GI disturbance
CHF
BP decreased
Depression
Sympatholytics side effects (3)
Erectile dysfunction
Bronchospams
Abnormal blood glucose
Patients who are on beta blockers, it is possible they are going to have what?
Respiratory depression
Usually beta receptors come cardioselective
Which is more Side effects
Cardiosleve or nonselective?
Nonselective
It bothers everything
Beta blockers usually do what?
Like how do they work?
Decrease heart rate
Decrease oxygen
Peripheral edema can occur
People who should watch out for beta blockers are (2)
Diabetics and repository illness
If a patient has a pulse of 60, do you hold the medication or give of a beta blocker?
HOLDb
What are the 4 things centrally acting alpha agonists do?
Methyldopa
Clonidine
Guanfacine
Side effects
Rebound hypertension
Edema
Weight gain
Orthostatic hypotension
Stimulate alpha 2 receptors
Decrease cardiac output
Decrease epinephrine, dopamine
Increase vagus activity
Patients who are taking alpha adrenergic blockers we should 100% watch out for?
Orthostatic hypotension
What is direct acting arteriolar ?
Hydrazine, minoxidil, nitroprusside
Side effects (2)
Long acting nitroglycerin
More permanent vasodilator
Lupus like symptoms
Muscle pain!!
What does ace inhibitors?
Work on the angiotension and stops the angiotension hormone and causes vasodsiltion
What are the 3 ace inhibitors side effects!!
First dose hypotension
Hyperkalemia
Angioedema
Ace inhibitors normally have a cough, dry cough!
But if it isn’t painful, they should just tolerate it
What disease process affects renal function?
So patients with ___ on ace inhibitor in order to help promote renal function, renal protective
Diabetes
Do you take ACE on an empty stomach?
Yes
What is an ARBS?
It does the same thing as ACE just doesn’t cause a cough
What are the 3 side effects of arbs?
First dose hypotension
Orthostatic hypotension
Hyperkalemia
What does calcium channel blockers?
Changes the calcium from going back to your cells
What are the 3 big things of calcium Channel blockers?
Bradycardia
peripheral edema
Constipation
