Final Exam Flashcards - Blood Pressure
Blood Pressure
-Blood pressure is necessary to circulate blood, oxygen, and nutrients to body organs and to remove CO2 and waste products
Hypertension
- Blood pressure is above normal
- Normal BP is 120/80
Formula For Determining BP
BP = CO x PR
Pharmacotherapy of Hypertension: Diuretics
- Diuretics cause diuresis (increased production of urine) which causes elimination of water, sodium and other electrolytes
- Diuresis lowers BP by lowering blood volume
- Called water pills
Types of Diuretics
- Thiazides
- Loop diuretics
- Potassium sparing diuretics
Thiazide Diuretics
- Act at the distal tubule
- Blocks the Na/Cl co-transporter which interferes with with calcium transport into arterioles, decreasing vasoconstriction
Thiazide diuretics ADR’s
- Hypokalemia
- Hyponatremia
- Hypomagnesia
- Hypochloremia
- Hypotension
- Hyperuricemia
- Hyperglycemia
- Photosensitivity
- N/V
- Dehydration
Loop diuretics
- Act at the ascending loop of henle
- MOST POTENT
- Block the NA/K co-transporter
Loop Diuretics ADR’s
- Dehydration
- Hypotension
- Photosensitivity
- Hypokalemia
- Hyperuricemia
- Allergic reaction
Potassium Sparing Diuretics
- Inhibit sodium reabsorption while avoiding potassium loss
- Less effective than loop and thiazide diuretics
Potassium Sparing Diuretics ADR’s
- Hyperkalemia
- N/V
- Diarrhea
- Hypotension
- Fatigue
- Unpleasant aftertaste
Potassium Sparing/Aldosterone Antagonists
- Aldosterone causes sodium and water reabsorption
- Spironolactone and eplerenone are aldosterone antagonists so they decrease Na reabsorption and inhibit K elimination
Angiotensin Converting Enzyme (ACE)
- Converts angiotensin I to angiotensin II
- Increased angiotensin II increases BP
Angiotensin-Converting Enzyme Inhibitors (ACEI’s)
- Common Ending: “Pril.”
- Inhibit the activity of ACE, which reduced angiotensin II and aldosterone levels
- Decrease Na reabsorption in the renal tubules
- CONTRAINDICATED IN PREGNANCY
ACE Inhibitors ADR’s
- Dry cough
- Hyperkalemia
- Light-headedness
- Hypotension
- Diarrhea
- N/V
- Skin rashes
- Airway obstruction
Angiotensin II Receptor Blockers (ARB’s)
- Common ending: “sartan”
- Inhibit angiotensin II-stimulated growth of smooth muscle, reducing ventricular and arterial hypertrophy
Angiotensin II Receptor Blockers (ARB’s) ADR’s
- Dizziness
- Fatigue
- Hyperkalemia
- Abdominal pain
- Dry mouth
- Constipation
- Impotence
- Muscle cramps
- CONTRAINDICATED IN PREGNANCY
B-Adrenergic Blockers
- Common Ending: “olol”
- Lower BP by decreasing heart rate and peripheral resistance
- May be selective or non-selective
B-Adrenergic blockers ADR’s
- Dizziness
- Fatigue
- Exercise intolerance
- Bradycardia
- Hypotension
- Heart block
- Palpitations
- Hypoglycemia
- Congestive heart failure
- CONTRAINDICATED IN PEOPLE WITH ASTHMA AND DIABETES
Calcium Channel Blockers (CCB’s)
- Lower BP by relaxing blood vessels
- Diltiazem and verapamil also decrease heart rate and force of contractions
Different Calcium Channel Blockers
- Dihydropyridines
- diltiazem
- verapamil
Calcium Channel Blockers ADR’s
-Hypotension (all)
Dihydropyridines
- Dizziness
- Flushing
- Headache
- Peripheral edema
Nondihydropyridines
- Heart block and failure
- Bradycardia
- Constipation
A1-Adrenergic Antagonists
- Common ending: “zosin”
- Dilate blood vessels
A1-Adrenergic Antagonists ADR’s
- Postural Hypotension
- Dizziness
- Reflex tachycardia
- Weakness
- Fatigue
- Headache
Central Acting A2 Agonists
- Methyldopa mimics autoinhibitory NE effect and sympathetic activity is reduced, blood vessels dilate, etc.
- Clonidine inhibits NE release from the CNS and peripheral sites
A2 Agonists ADR’s
- Orthostatic hypotension
- Sedation
- Dry mouth
- Impotence
- Constipation
Direct Vasodilators
- Hydralazine and minoxidil lower BP by relaxing vascular smooth muscle
- Hydralazine is recommended for hypertensive emergencies
Direct Vasodilators ADR’s
- Orthostatic hypotension
- Headache
- GI upset
- Sodium and fluid retention
- Palpitations and arrhythmias
Direct Renin Inhibitors
Blocks the conversion of angiotensinogen to angiotensin I
Direct Renin Inhibitors ADR’s
- Diarrhea
- Hyperkalemia
- Headache
- Dizziness
- Aggravation of gout
- Acute renal failure
- CONTRAINDICATED IN PREGNANCY
