Chapter 9.1 Flashcards
List the problems resulting from untreated, sustained high blood pressure.
to cardiovascular problems (stroke, heart failure), renal disease, and blindness
secondary hypertension
the elevated blood pressure can be attributed to some specific abnormality such as chronic kidney disease, renal artery stenosis, certain drugs, catecholamine-producing tumors, endocrine disorders, or cerebral damage
essential hypertension
there is no clear, readily discernible cause of the elevated blood pressure
State the mechanism of action of diuretics.
act on kidneys and decrease fluid in vascular system
hydrochlorothiazide
type of thiazide
furosemide
loop diuretics
spironolactone
potassium sparing agents
List the common adverse effects of diuretics.
orthostatic hypotension, weakness, mood changes and fatigue
cardioselective beta blocker
Beta 1 subtype on the heart are the cardioselective
nonselective beta blocker
bind to Beta 1 and 2 receptors.
atenolol, metoprolol are cardioselective or nonselective
cardioselective
propranolol are cardioselective or nonselective
nonselective
List the common adverse effects of beta blockers.
orthostatic hypotension, bronchoconstriction, depression, lethargic
Doxazosin mechanism of action
block alpha 1 receptors on arterioles causing vasodilation
Clonidine mechanism of action
Work at the brain stem and turns down the volume of the outgoing sympathetic activity
clonidine adverse effects
dry mouth, dizziness, and sedation
Doxazosin adverse effects
cardiac disease, orthostatic hypotension and tachycardia
Name two examples of vasodilator drugs.
hydralazine and minoxidil
List the common adverse effects of vasodilators.
tachycardia, orthostatic hypotension, dizziness, HA, and edema
State the reason that systemic heat (e.g., in a large whirlpool) should be avoided or cautiously used for patients taking vasodilator drugs.
The hot water will cause vasodilation and the combination could dramatically lower blood pressure
ACE inhibitors
inhibits the enzyme that converts angiotensin 1 to angiotensin 2
lisinopril
ACE inhibitor
losartan
ang II receptor blocker
List the common adverse effects of antihypertensive agents affecting the renin-angiotensin system.
dry cough, allergic reaction like rash, nausea and dizziness
List the common adverse effects of calcium channel blockers.
orthostatic hypotension, altered heart rate swelling in ankles
angiotensin receptor blockers
block angiotensin II receptors. Prevent detrimental effect on heart vasculature
Direct renin inhibitors
inhibits renin’s ability to convert angiotensinogen to Angiotensin I
State the relationship of the following terms that describe the renin-angiotensin system: angiotensinogen, renin, angiotensin I, converting enzyme, angiotensin II, aldosterone, vasoconstriction, vascular remodeling and occlusion. (from slides and pp. 13-14 of the assigned reading)
Look back at notes because it is long
State the common management strategy used when a patient develops a persistent, dry cough when using an ACE inhibitor.
Resolved by changing to a different RAS drug
diltiazem, verapamil, and amlodipine are what type of drugs
calcium channel blockers
State the reason that calcium channel blockers to not interfere with skeletal muscle strength in dosing usually used to manage hypertension.
Calcium channel blockers will limit entry of calcium in heart and vascular cells but skeletal muscle cells function normally
Identify non-pharmacologic treatment in the management of hypertension
changes in lifestyle including lowering sodium intake, decreasing use of alcohol and tobacco, decreasing body weight, regular exercise.
Identify the special concerns for physical therapists when treating a patient who is using antihypertensive medications.
We should be aware when patients change posture suddenly or engage in other activities that may lower blood pressure
State the overwhelming reason that blood pressure is not controlled in patients using non-pharmacologic and pharmacologic treatment.
Nonadherence!
