Drugs Flashcards by Jenny Burns

Drugs that can increase blood pressure

Birth control, nicotine, steroids, appetite, suppressants, tricyclic anti depressants (Effexor) , cyclosporine (sandimmune) , nasal decongestant, NSAIDs herbs(dig flox glov, lo a statin red yeast)

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What do ace inhibitors do?

Stop the enzyme, angiotensin converting enzyme from converting angiotensin, one to angiotensin two

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What are diuretics

First line treatment for hypertension in heart failure, because I reduce extra cellular fluid volume

Inexpensive
Take early in the day
Monitor wait

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Oh, what are the classes of diuretics?

Thiazide diuretic
Loop diuretics
Potassium sparing

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What are thiazide diuretic?

Inhibit, sodium reabsorption and distal tubes of kidneys

HCTZ MACROZIDE, Cholorthalidone, indapamide Lozol, metolozone zaroxolyn

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Other thiazide diuretics information

How does therapy HCTZ greater than 50, has increased risk of hypokalemia increase uric acid levels and serious cardiovascular outcomes using combination verse, pushing hard does

Watch with patients with hyper lipidemia and get out

Potential for cross sensitivity to sulfa

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What are loop diuretics

Inhibit reabsorption of sodium in ascending loop of Henle

Potential for crossing certificate with sulfur

Furosemide, torsemide, bumetanide

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What are potassium sparing diuretics?

Often used in combination with thiazide to help reverse, low, potassium affect

Triamterene, Spira lactone, eplerenone inspra

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Pharmacodynamics of ace inhibitors

Prevent angiotensin, one to converting to angiotensin two

Can lower vascular resistance with a decreasing cardiac output, a globular filtration rate

Does not Produce reflux tachycardia

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What do ace inhibitors do for the kidneys and heart?

Reduce cardiovascular and stroke, risk, reduction, heart failure, and slowing renal disease

Improves oxygenation to the heart
Reduces effects of diabetes on the kidneys. It protects the kidneys.

Improves insulin sensitivity does not affect glucose metabolism. Maria’s serum, lipid levels.

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Who do you use ace inhibitors for?

Young Caucasian patients
Patients with angina decreases pulmonary vascular resistance
Diabetic patients prevents or slows neuropathy
Heart failure patients

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What patients are not good with ace inhibitors

African-Americans, unless combined with a diuretic
African-Americans in Asians are 3 to 4 times greater risk of developing angioedema

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Ace inhibitors contraindications and side effects

Dry cough, hypotension, Angoedema, hyperkalemia, pancreatitis, jaundice, rush

Contra indicated in pregnancy

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Ace inhibitor monitoring

Orthostatic hypertension, within one hour of those and one starting each dosage change

Do not double dose of phone is messed
Hypotension is most common side effect
Call common with older agents
fall risk
Renal failure
Can cause hyperkalemia when paired with HCTZ

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Ace and angioedema

Call 911
Paleness or flushing of the face
Swelling of the face eyes lips are tongue
Difficulty breathing
Hoarseness, difficulty swallowing
Caused by histamine release

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Ace drugs

-PRIL

Lisinopril 10-40 daily
Lotensin 10-40
Capotes 25-100 DAILY OR BID
Monopril 10-40

what do ARBS DO?

Angiotensin II receptor blockers

Prevent binding of angiotensin II, receptor’s in kidney brain, heart and artery walls

Can help protect Denise and heart, but is not as well as An ACe

Expensive
Avoiding pregnancy

ARB drugs

-ARTAN
losartan cozaar 25-100 daily BID
VALSARTAN Diovan 80-320 daily
Omesartan benicar 20-40 daily

What are calcium channel blockers

Active vasodilators, lowering calcium influx into smooth muscles, which facilitates myocardial, relaxation

What are the two classes of calcium channel blockers?

Type one Non-dihydropyridines -affect conduction through the AV node

type two dihydropyridines do not affect conduction through the AV node

Type two calcium channel blockers

Dihydropyridines
-IPINE, IDINE
Procardia
Amlodipine
felodipine

Type one calcium channel blockers

-
Cardizem, verapamil

Calcium channel blocking agents monitoring

Constipation?
Verapamil has strong negative inotropic effect we can swap force of the muscle contraction and should be avoided in patients with CHF
Using CCb/ace combination decreases purple demon by 50% versus those on CCB alone

Avoid NSAIDs alcohol being in Jacuzzi
Gerd can get worse

What are the three types of beta blockers?

Nonspecific beta agonist
Selective beta agonist
Intrinsic Sympathomimetic activityISA

Relevance of ISA

Able to simulate beta adrenergic receptors agonist effect, and to oppose the stimulating effects of catecholamines antagonist effect in a competitive way, can increase blood pressure Pindolol acebutolol

Beta blocker faCT’s

More effective in African-American, an older patients, but use of caution with the elderly Beta blockers may not be properly withdrawn, increases beta, receptors sensitivity No longer first line hypertension, drug choice

IS a faCT’s

Imposed am I patience cardioselective agents are preferred without ISA Some are used as antiarrhythmics Drugs with ISA may help avoid a decrease in CO and HR may be preferred for patients who experience bradycardia with other beta blockers

Beta blocker drugs

Atenolol 25 to 100 mg daily Bisoprolol 2.5 to 10 mg. Meta-pro. Lol 50 to 100 today or BID. Propranolol 40 to 160 mg b.i.d. 60 to 180 mg b.i.d. Meta-pro. Lol succinate 50 to 100 mg Q day to be ID.

What are alpha one blockers

Usually used in patients with BPH causes relaxation of smooth muscle Given at night because of orthostatic hypotension when you getting out of bed -osin

What are essential alpha-2 receptor agonist?

Simulate alpha-2 receptors in the brain, to decrease her for assistance and CO Clonidine 0.1 to 0.8 mg b.i.d. Tid Catapres one patch weekly 0.1 to 0.3.

What are direct vasodilators?

Classes are too smooth, muscle relaxation, lowering blood pressure Hydralazine 25 to 100 mg b.i.d. Minoxidil 2.5 to 80 mg Q day to be ID.

Special population considerations

Pediatric Decisions based on a child’s age, and go ranges of systolic and diastolic falls into percentiles Complications of hypertension children are seizures in heart failure Hypertension in children may persistent adulthood Medication management, same as adult Geriatric Tones study showed older patients with hypertension blood pressure can be reduced by Lil sodium diet and weight loss. Many were able to DC meds or reduce number meds.

Geriatric population considerations

Old people are very sensitive to medication that causes sympathetic inhibition in our group rate, a risk of becoming volume depleted than younger people

Special population considerations African-Americans

High hypertension, risk factors, low circulating renin levels with excess levels of angio tension two Endothelial dysfunction as a result of reduce bradykinin nitric oxide Abnormal, sympathetic, nervous system activation Higher levels of intracellular, calcium stores

Hypertension and diabetic population

Hypertension increases cardiovascular risk for diabetes patients Their blood pressure to be low 140/90 All patient should be encouraged to modify their lifestyle to limit sodium intake lose weight and exercise for 150 minutes a week All major antihypertensive drug classes are you spell diabetic patient Ace And Arbs I recommended for the kidney protection

Commonly use medication for hypertensive emergency’s

Direct vasodilators, such as hydralazine Nitrates Calcium channel blockers nicardipine Sympathy, plegic agents labetalol Alpha one blockers phentolamine Ace inhibitors enalapril