exam 1 Flashcards
normal K level
3.5-5
RAAS
low bp makes liver release angiotensinogen
kidneys release renin
renin makes liver turn angiotensinogen into angiotensin I. Angiotensin I goes to lungs. ACE convert it to angiotensin II.
angiotensin II stimulates adrenal glands to release aldosterone.
aldosterone causes fluid retention while angiotensin II vasoconstricts
arterial baroreceptors
L ventricle, carotid sinus, aorta
sense BP and change it by altering HR
vascular autoregulation
maintains tissue perfusion by changing size of arterioles
primary htn
no known causer
secondary htn
has a cause of underlying issue
treat underlying issue
long term htn outcomes
stroke, vision change, increased cardiac work/enlargement of L ventricle
end stage renal disease
gangrene
hypertensive urgency
> 180/120
no signs of end organ damage
gradually reduce BP
hypertensive emergency
180/120
signs of end stage damage
stroke, chest pain, etc
aggressively lower BP
types of meds to treat HTN
diuretics, sympathetic nervous blockers, beta blockers, calcium channel blockers, vasodilators
types of diuretics
potassium sparing, thiazide, loop
thiazide diuretic
hydrochlorothiazide, metolazone
MOA: works on distal convoluted tubule to inhibit Na and K reabsorption
Route: PO
Side effects: hypokalemia
Nurse: check K levels, supplement if needed
loop diuretic
furosemide, bumetanide, torosemide
MOA: inhibits reabsorption of Na, K, CL in loop of henle
PO OR IV
side effects: hypokalemia, dehydration
nurse: monitor K levels, normally pt on KCl supplement
potassium sparing diuretic
spironalactone, triamterene
MOA: block aldosterone (increase NA and water excretion)
SE: hYPERkalemia and potentially endocrine effects
sympatholytics
beta blockers, alpha 2 agonist, alpha adrenergic blockers
block SNS which usually vasoconstricts
beta blockers
propranolol, carvedilol, metoprolol
MOA: increase nitric oxide and vasodilate
SE: rebount HTN, contraindicated w asthma
nurse:watch for low HR and BP
PO OR IV
alpha 2 agonist
clonidine and methyldopa
mOA: decrease sympathetic outflow, decrease receptor stimulation
PO OR TRANSDERMAL
side effects: rebound, could worsen liver disease
alpha adrenergic blocker
doxazosin
MOA: vasodilation and arterial dilation
SE: low BP and dizziness
RAAS blockers
ace inhibitor, angiotensin receptor blocker, renin inhibitor
ace inhibitor
catopril
lisinopril
enlapril
benzapril
rampiril
MOA: blocks ace, inhibits angiotensin II, vasodilation
choice for DM
SE: dry cough, BP drop, angioedema
nurse: use cautiously in pt with renal hx
risk for hyperkalemia,
PO
something that catopril can cause
neutropenia
angiotensin receptor blocker (ARB)
losartan, eprosartan, valsartan, olmesartan
MOA: blocks angiotensin after it is made. causes vasodilation
SE: angioedema
PO
renin inhibitor
aliskiren
directly inhibits renin which causes vasodilation, decrease in blood volume.
SE: GI issues, watch for hyperkalemia
nurse: know it takes several weeks
calcium channel blockers
nifedipine
amlodipine
nicardipine
diltiazem
verapimil
indicated for HTN and chest pain
po or IV
SE: peripheral edema, orthostatic hypotension
Nurse: best for elderly and african american
vasodilators
hydrazaline
moa:tells veins and arteries to relax
po is usually combo with others, also IV
SE: hypotension, tachy, swelling
