Chapter 9.1

Question 1

List the problems resulting from untreated, sustained high blood pressure.

Answer 1

to cardiovascular problems (stroke, heart failure), renal disease, and blindness

Question 2

secondary hypertension

Answer 2

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

Question 3

essential hypertension

Answer 3

there is no clear, readily discernible cause of the elevated blood pressure

Question 4

State the mechanism of action of diuretics.

Answer 4

act on kidneys and decrease fluid in vascular system

Question 5

hydrochlorothiazide

Answer 5

type of thiazide

Question 6

furosemide

Answer 6

loop diuretics

Question 7

spironolactone

Answer 7

potassium sparing agents

Question 8

List the common adverse effects of diuretics.

Answer 8

orthostatic hypotension, weakness, mood changes and fatigue

Question 9

cardioselective beta blocker

Answer 9

Beta 1 subtype on the heart are the cardioselective

Question 10

nonselective beta blocker

Answer 10

bind to Beta 1 and 2 receptors.

Question 11

atenolol, metoprolol are cardioselective or nonselective

Answer 11

cardioselective

Question 12

propranolol are cardioselective or nonselective

Answer 12

nonselective

Question 13

List the common adverse effects of beta blockers.

Answer 13

orthostatic hypotension, bronchoconstriction, depression, lethargic

Question 14

Doxazosin mechanism of action

Answer 14

block alpha 1 receptors on arterioles causing vasodilation

Question 15

Clonidine mechanism of action

Answer 15

Work at the brain stem and turns down the volume of the outgoing sympathetic activity

Question 16

clonidine adverse effects

Answer 16

dry mouth, dizziness, and sedation

Question 17

Doxazosin adverse effects

Answer 17

cardiac disease, orthostatic hypotension and tachycardia

Question 18

Name two examples of vasodilator drugs.

Answer 18

hydralazine and minoxidil

Question 19

List the common adverse effects of vasodilators.

Answer 19

tachycardia, orthostatic hypotension, dizziness, HA, and edema

Question 20

State the reason that systemic heat (e.g., in a large whirlpool) should be avoided or cautiously used for patients taking vasodilator drugs.

Answer 20

The hot water will cause vasodilation and the combination could dramatically lower blood pressure

Question 21

ACE inhibitors

Answer 21

inhibits the enzyme that converts angiotensin 1 to angiotensin 2

Question 22

lisinopril

Answer 22

ACE inhibitor

Question 23

losartan

Answer 23

ang II receptor blocker

Question 24

List the common adverse effects of antihypertensive agents affecting the renin-angiotensin system.

Answer 24

dry cough, allergic reaction like rash, nausea and dizziness

Question 25

List the common adverse effects of calcium channel blockers.

Answer 25

orthostatic hypotension, altered heart rate swelling in ankles

Question 26

angiotensin receptor blockers

Answer 26

block angiotensin II receptors. Prevent detrimental effect on heart vasculature

Question 27

Direct renin inhibitors

Answer 27

inhibits renin’s ability to convert angiotensinogen to Angiotensin I

Question 28

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)

Answer 28

Look back at notes because it is long

Question 29

State the common management strategy used when a patient develops a persistent, dry cough when using an ACE inhibitor.

Answer 29

Resolved by changing to a different RAS drug

Question 30

diltiazem, verapamil, and amlodipine are what type of drugs

Answer 30

calcium channel blockers

Question 31

State the reason that calcium channel blockers to not interfere with skeletal muscle strength in dosing usually used to manage hypertension.

Answer 31

Calcium channel blockers will limit entry of calcium in heart and vascular cells but skeletal muscle cells function normally

Question 32

Identify non-pharmacologic treatment in the management of hypertension

Answer 32

changes in lifestyle including lowering sodium intake, decreasing use of alcohol and tobacco, decreasing body weight, regular exercise.

Question 33

Identify the special concerns for physical therapists when treating a patient who is using antihypertensive medications.

Answer 33

We should be aware when patients change posture suddenly or engage in other activities that may lower blood pressure

Question 34

State the overwhelming reason that blood pressure is not controlled in patients using non-pharmacologic and pharmacologic treatment.

Answer 34

Nonadherence!