Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

pharm exam 2 > drug therapy for hypertension > Flashcards

drug therapy for hypertension Flashcards

1
Q

what is the function of the cardiac cycle

A

essential in delivery of O2 and nutrients to myocardium and tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the two cycles in the cardiac cycle

A

systolic and diastolic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the systolic cycle

A

the contraction of the ventricles of the heart that occurs between the first and second heart sounds of the cardiac cycle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the diastolic cycle

A

the part of the cardiac cycle during which the heart refills with blood after the emptying done during systole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is stroke volume

A

the amount of blood ejected from the left ventricle with each contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what three factors effect stroke volume

A

preload, after load, contractility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is preload

A

end diastolic volume: the amount of blood left in the left ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is after load

A

resistance to left ventricular ejection: the work the heart must overcome to eject blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is contractility

A

ability of heart muscle to contract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is cardiac output

A

the amount of blood pumped by the heart each minute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the equation for cardiac output

A

HR x SV = CO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what artery is the only artery that carries deoxygenated blood

A

pulmonary artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

cardiac conduction pathway

A

SA node -> AV node -> bundle of his -> right and left bundle branches -> purkinje fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

the SA node has what job in the heart

A

pacemaker; sets the pace of the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

functions of the AV node

A

receives messages from SA node; has the ability to slow conduction of the heart; the filter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

purkinje fibers cause what

A

the contraction or squeeze of the ventricles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

cardiac blood flow: arteries

A

carry oxygenated blood away from the heart, delivers it to the tissue in the body; high pressure system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

cardiac blood flow: veins

A

carries deoxygenated blood back to the heart; low pressure system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

coronary arteries are the arteries in the veins that feed what

A

the heart muscle with oxygenated and deoxygenated blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Right and left coronary arteries branch off at

A

base of the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

coronary arteries receive blood when

A

during diastole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

pulse pressure

A

systolic minus diastolic; represents the filling pressure of the coronary arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

electrocardiography; ECG or EKG

A

conduction of the patients heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

each part of the ECG/EKG

A

p wave, pr interval, qrs complex, st segment, t wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what Is the P wave

A

atrial depolarization; conduction of an electrical impulse through the atria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is the PR interval

A

tracks the atrial impulse through the AV node, bundle of his and Rt/Lt bundle branches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is the QRS complex

A

depolarization of the ventricles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what is the ST segment

A

end of ventricular conduction/ depolarization; beginning of ventricle depolarization; or rest when it rebuilds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is the T wave

A

ventricular recovery or depolarization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is the T wave

A

ventricular recovery or depolarization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what are the three components of the physiological regulation of blood pressure

A

vasomotor center, emotions, and hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is included in the vasomotor center

A

baroreceptors and chemoreceptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what are baroreceptors

A

they respond to increase or decrease in pressure or stretch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what are chemoreceptors

A

they respond to oxygen, carbon dioxide and pH changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

emotions effect blood pressure thru what system

A

sympathetic system; anger or stress will elevate BP: or parasympathetic; depression or lethargy will lower BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what hormones regulate Blood pressure

A

antidiuretic hormone (ADH) and renin-angiotensin aldosterone system (RAAS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

in hypertension/ high BP your body will do what with ADH

A

body will no excrete ADH, it will shut it down because it wants the body to increase urination to decrease vascular volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

three primary areas to look at when taking about blood pressure

A

blood volume, peripheral resistance/ diameter of arterioles, cardiac output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what could affect blood volume

A

fluid loss; dehydration -> low BP or fluid retention; aldosterone or ADH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what could affect peripheral resistance/ diameter of arterioles

A

sympathetic nervous system activity, renin/angiotension II, increase in viscosity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what could affect the cardiac output

A

stroke volume: preload, contractility, afterload; heart rate: sympathetic system activity, parasympathetic system activity, epinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

T/F hypertension increases the risk of cancer

A

false; HTN increase risk of MI, CHF, renal disease, CVA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

autoregulation of blood flow

A

ability of organ/body tissues to regulate own blood flow (heart, brain, kidneys)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

autoregulation occurs primarily by

A

nutritional needs of tissue; lack of O2 or cellular metabolism by-product accumulation(lactic acid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

important factors that the body releases

A

histamine, bradykinin, prostaglandins

46
Q

what does histamine do

A

the release dilates blood vessel -> lowers BP

47
Q

what does bradykinin do

A

potent peptide causing vasodilation -> lowers BP

48
Q

what does prostaglandins do

A

include both vasodilators and vasoconstrictors

49
Q

what is arterial blood pressure

A

the force exerted on arterial walls by blood flow

50
Q

what are the two main determinants of blood pressure

A

cardiac output (systolic) and peripheral vascular resistance (diastolic)

51
Q

Stroke volume is

A

the amount of blood ejected/ heart beat

52
Q

frank starlings law

A

the greater the volume of blood in the heart during diastole(resting state), the more forceful the cardiac contraction, the more blood the ventricle will pump

53
Q

if you increase urine output, that decrease blood volume resulting in what BP

A

a lower BP

54
Q

what is the response to hypotension

A

the SNS is stimulated, adrenal medulla secretes epinephrine and norepinephrine, angiotensin II and aldosterone are formed, kidneys retain fluid and BP is increased

55
Q

what is the response to hypertension

A

increased renal secretion (increase urine output), fluid loss decreases circulating volume, decrease cardiac output, decrease arterial BP, decrease BP

56
Q

what can cause hypotension

A

vomiting, diarrhea, excessive sweating

57
Q

s/sx hypotension

A

dizzy, light headed, dehydrated

58
Q

definition of hypertension

A

persistently high blood pressure (increase force in the arteries) that results from abnormalities in regulatory mechanisms

59
Q

hypertension considered over

A

systolic < 140
diastolic < 90

60
Q

prehypertension considered between

A

systolic 120-139
diastolic 80-89

61
Q

primary HTN is what % of cases

A

90%-95%

62
Q

secondary HTN may result from

A

renal (renal artery stenosis), endocrine, or CNS disorders or from medications

63
Q

danger of HTN

A

its can be asymptomatic for years

64
Q

hypertension increases the risk of

A

target organ damage, MI, CHF, renal disease, retinal damage, increased cardiac workload=CHF

65
Q

physiological BP regulation of ADH released in response to

A

increased blood osmolarity -> promotes reabsorption of water by kidneys -> decrease urine output -> increases circulating volume of Na+ and H2O -> loss of K+ in urine -> potent vasoconstrictor: synthetic vasopressin admin to treat DI and hypotensive crisis

66
Q

physiological BP regulation of renin-angiotensin- aldosterone system (RAAS)

A

renin -> angiotensinogen -> angiotensin I -> angiotensin converting enzyme (ACE) -> angiotensin II -> vasoconstriction -> aldosterone -> reabsorption or Na+ and H2O

67
Q

HTN goals for > 60

A

< 150/90

68
Q

HTN goals for <60 that have DM, CKD or with or without

A

<140/ 90

69
Q

nonpharmacolgical management/ stress management

A

lifestyle changes: reduce Na+, reduce fat & cholesterol, increase fruits & veggies, increase aerobic physical activity, discontinue tobacco products, maintain optimum weight, limit alcohol

70
Q

factors that affect HTN

A

age, ethnicity, CV disorders

71
Q

medication guidelines for HTN

A

start in the lowest available dose, if one med doesn’t work do not increase the dose if ineffective-> change med group, many its will require 2+ meds

72
Q

antihypertensive drug class medications

A

angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), calcium channel blockers, antiadrenergics, direct vasodilators, diuretics

73
Q

action of angiotensin-converting enzyme inhibitors (ACE)

A

inhibit the conversion of angiotensin I to angiotensin II

74
Q

examples of angiotensin-converting enzymes (ACE)

A

captopril, enalapril, lisinopril, ramipril: ends in PRIL

75
Q

side effects of ACE inhibitors

A

ACE cough, hyperkalemia(avoid K+ supplements, K+ salt substitutes), angioedema

76
Q

action of angiotensin II receptor blockers (ARBs)

A

selectivity bind to angiotensin II receptors in vascular smooth muscle and adrenal cortex

77
Q

examples of angiotensin II receptor blockers (ARBs)

A

losartan, valsartan, olmesartan: ending in SARTAN

78
Q

ARB side effects

A

orthostatic hypotension, angioedema, acute renal failure (monitor BUN, creatinine), hyperkalemia

79
Q

contraindications of ARB

A

hepatic or renal failure impairment

80
Q

action of calcium Chanel blockers

A

inhibit the movement of Ca2+ across the membrane of myocardial and arterial muscle cells= decrease in HR and causes vasodilation of the peripheral vasculature

81
Q

examples of calcium Chanel blockers

A

amlodipine, nicardipine, nifedipine: ending in DIPINE

82
Q

Ca2+ blocker side effects

A

flushed skin, muscle cramps, peripheral edema, dizziness, angioedema, sexual dysfunction

83
Q

contraindications of Ca2+ blockers

A

hepatic/ renal impairment, CHF/ heart block, pregnancy

84
Q

calcium channel blockers interferes with

A

macrolide antibiotics/ grapefruit juice

85
Q

action of antiadrenergic (sympatholytics)/ adrenergic receptor blockers

A

inhibit SNS = decrease HR, decrease force of myocardial contraction, CO and blood pressure

86
Q

examples of alpha 1 adrenergic receptor blocker

A

doxazosin, prazosin, terazosin: ending in OSIN

87
Q

alpha 1 adrenergic receptor blocker work in what way

A

dilate blood vessels and decreases peripheral vascular resistance (PVR)

88
Q

side effects of alpha 1 adrenergic receptor blocker

A

orthostatic hypotension, dizzy, increase of Na+/ fluid retention(may need diuretic Rx)

89
Q

action of alpha2 receptor agonists

A

inhibits norepinephrine = antiadrenergic effect = decreased CO, decreased HR, decreased PVR, decreased BP

90
Q

examples of alpha2 receptor agonists

A

clonidine, methyldopa, guanfacine

91
Q

action of beta adrenergic blockers (beta blockers)

A

decrease HR, decrease force of myocardial contraction, decrease CO and renin relaxes from the kidneys

92
Q

examples of beta adrenergic blockers (beta blockers)

A

atenolol, metoprolol, propranolol: ending in OLOL

93
Q

patients under 50 with cardio selective mediations are given what medication (asthma, PVD, DM)

A

beta adrenergic blockers (beta blockers)

94
Q

beta adrenergic blockers (beta blockers) treat

A

HTN, dysrrhythmias, HF, MI and narrow angle glaucoma

95
Q

side effects of beta adrenergic blockers (beta blockers)

A

hypotension, bradycardia, dizziness (use caution in patient with liver impairment)

96
Q

examples of alpha-beta adrenergic blockers

A

carvedilol, labetalol

97
Q

black box for all beta adrenergic blockers for patients with

A

CAD

98
Q

action of diuretics

A

reduction of blood volume through urinary excretion of H2O and electrolytes

99
Q

types of diuretics

A

thiazide and thiazide like diuretics, potassium-sparing diuretics, loop diuretics

100
Q

examples of thiazide diuretics

A

hydrochlorothiazide (HCTZ)

101
Q

action of thiazide diuretics

A

block Na+ reabsorption, increase K+ and H2O secretion

102
Q

action of potassium- sparing diuretics

A

excretion of Na+ and retention of K+

103
Q

example of potassium-sparing diuretics

A

spironolactone (blocks aldosterone)

104
Q

effects of spironolactone

A

can increase effects of digoxin, monitor hyperkalemia in patients also taking n ACE/ARB

105
Q

actions of loop diuretics

A

reabsorption of Na+ and Cl- in loop of henle

106
Q

example of loop diuretic

A

furosemide (can increase digoxin levels and can cause hypokalemia)

107
Q

episodes of Beverly elevated BP caused by

A

extension of malignant HTN, cerebral hemorrhage (brain bleed), dissecting aortic aneurysm, renal disease

108
Q

symptoms of hypertensive emergency

A

severe HA, N/V, visual disturbances, neurologic disturbances, disorientation, decrease level of consciousness

109
Q

direct acting vasodilators used in hypertensive emergencies because they

A

directly relax smooth muscles in the blood vessels = dilation and decreased PVR

110
Q

examples of direct acting vasodilators

A

hydralazine, nitroprusside (IV only)

111
Q

nursing implications for anti-HTN: monitor what

A

bradycardia, hypotension/orthostatic(falls risk), I&Os, heart healthy/Na+ restriction diet, electrolyte, telemetry monitoring, dietary supplement use

pharm exam 2 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions