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htn Flashcards

1
Q

What is the MOA of hydrochlorothiazide?

A

Inhibits resorption of sodium/potassium/chloride resulting in water lossRelaxes arterioles decreasing peripheral vascular resistance

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2
Q

When is hydrochlorothiazide used?

A

First line treatment for mild hypertension

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3
Q

What are side effects of thiazide diuretics?

A

HypokalemiaOrthostatic hypotensionHyperuricemiaCan elevate glucose & cholesterol

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4
Q

What is the MOA of furosemide?

A

Inhibit reabsorption of sodium in the loop of henle results in profound water loss (diuresis) & decreased cardiac output

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5
Q

When is furosemide used?

A

Treats hypertension due to fluid volume overload

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6
Q

What are side effects with furosemide?

A

HypokalemiaDehydrationHypotensionOtotoxicity

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7
Q

What is the normal potassium level?

A

3.5 - 5 mmol/L

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8
Q

What is the MOA of spironolactone?

A

Block the action of aldosterone resulting in potassium retention and excretion of sodium and water

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9
Q

When is spironolactone used?

A

Usually with other diuretics for increased effect with retention of potassium

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10
Q

What are side effects with spironolactone?

A

HyperkalemiaDeepened voice, impotence, hirsutism

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11
Q

What is the MOA of ACE inhibitors such as Captopril and Lisinopril?

A

Blocks angiotensin-converting enzyme thereby inhibiting production of angiotensin-2

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12
Q

What are side effects of lisinopril?

A

HypotensionDry, nonproductive, persistent coughDizzinessRashAngioedema

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13
Q

What is the MOA of losartan?

A

Blocks the action of angiotensin-2 after it is formed causing vasodilation and increased water & sodium secretion

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14
Q

What are side effects of angiotensin receptor blockers?

A

AngioedemaDo not use if pregnantUse with caution with renal problems

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15
Q

How are calcium channel blockers used to control blood pressure?

A

Blocking calcium channels causes vasodilation (the ipines)

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16
Q

What are the side effects with nifedipine?

A

Drop in blood pressureHeadachePeripheral edemaAbdominal discomfort

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17
Q

What is the MOA of hydralazine?

A

Relaxes smooth muscles of arteries and veins

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18
Q

What are side effects of hydralazine?

A

HypotensionDizzinessHeadacheTachycardiaEdemaGI upset

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19
Q

MAO of metoprolol, propranolol, carvedilol

A

Increases nitric oxide= vasodilation response Blocks stimulation of beta-1 receptors= Decreases HR and contractility

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20
Q

Side Effects of Beta-Blockers

A

Fatigue/lethargyBradycardiaHypotension Can mask hypoglycemia- prevents tachycardia, be careful with use in diabetics

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21
Q

Nursing Implications of Beta-Blockers

A

Recognize the RISK for hypotension and/or bradycardiaHold & contact provider if HR is less than 60 or a systolic BP less than 100

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22
Q

MAO of Clonidine (catapress)

A

Decrease sympathetic outflow resulting in decreased stimulation of adrenergic receptors (both alpha AND beta receptors) Main outcome: decreased blood pressure

23
Q

Side Effects of Clonidine

A

Drowsiness- most common Give at night to combat this Rebound HTN May worsen pre-existing liver disease

24
Q

Nursing Implications of Clonidine

A

Do not abruptly discontinue- rebound HTN

25
MAO of Doxazosin (cardura)
Selective alpha-1 blockade Venous AND arterial dilation
26
Side Effects of Doxazosin (cardura)
hypotension, dizziness
27
MOA of Ace Inhibitors- lisinopril, captopril
Blocks angiotensin-converting enzyme (ACE) Inhibits production of Angiotensin-2 (powerful vasoconstrictor) Inhibits aldosterone secretion- less water retention
28
Side Effects of lisinopril/captopril
Dry, nonproductive, PERSISTENT cough- (largest complaint from patients often reason people switch)Dizziness Rash Serious: ANGIOEDEMA
29
Can you take lisinopril, captopril while pregnant?
NO
30
Nursing Considerations for lisinopril/captopril
Renal insufficiency- use cautiously in patients with history of renal diseaseCaptopril can cause neutropenia- monitor WBC Risk of hyperkalemia especially if patient on potassium supplements
31
MOA of Losartan (cozaar)
blocks the action of angiotensin 2 AFTER it is formedCauses vasodilation Increased sodium and water excretion
32
Side Effects of Losartan (cozaar)
(Well tolerated)Some risk of angioedema
33
Can you take Losartan while pregnant?
NORequires the use of contraception if of childbearing age
34
Nursing Implications of Losartan (cozaar)
Use cautiously in patients with renal problems
35
MOA of Aliskiren (tekturna)
Direct inhibition of renin Induces vasodilation, decreases blood volume, decreases SNS, and inhibitors cardiac and vascular hypertrophy
36
Side Effects of Aliskiren (tekturna)
relatively well tolerated GI discomfort When given with ACEi watch for hyperkalemia, especially in patients with diabetes
37
Nursing Considerations of Aliskiren (tekturna)
Take several weeks to see full effect (half-life) DO NOT take pregnant
38
Calcium Channel Blockers
nifedipine (procardia)nicardipine (cardene)verapamil (calan)diltiazem (cardizem)
39
Side Effects of Calcium Channel Blockers
Orthostatic hypotension Peripheral edema
40
Nursing Implications for CCB
CCB are often best for elderly and African Americans Diuretics can be given for peripheral edema
41
MAO of Hydralazine (apresoline)
Vasodilators work directly on arterial and venous smooth muscles and cause relaxation Direct vasodilation cause decreased systemic and peripheral vascular resistance
42
Side Effects of Hydralazine (apresoline)
HYPOTENSION Dizziness, headache, tachycardia, edema, dyspnea, GI upset
43
MAO of Hydrochlorothiazide [HCTZ] (HydroDiruil)
-Works on the distal convoluted tubule to inhibit resorption of sodium/potassium/ & chloride = decreased cardiac output-Results in water loss Also relaxes arterioles = decreased peripheral vascular resistance (PVR)
44
Side Effects of Hydrochlorothiazide
-Electrolyte and metabolic disturbances-HYPOKALEMIA (low potassium) -Orthostatic hypotension -May worsen renal insufficiency -Hyperuricemia- watch out with gout patients -Can elevate levels of glucose, cholesterol, and triglycerides
45
Nursing Implications of Hydrochlorothiazide
-Can give potassium supplements -Encourage food rich in potassium
46
MAO of Furosemide (Lasix)
-Inhibit the kidneys ability to reabsorb sodium in the LOOP OF HENLE -Makes kidneys put more sodium in the urine-WATER FOLLOWS SODIUM= more peeing out
47
Loop Diuretic
Furosemide (Lasix)
48
Side Effects Furosemide
-HYPOKALEMIAAnd other electrolyte abnormalities-Dehydration -Hypotension -Ototoxicity = difficulty hearing, usually transient with furosemide
49
Nursing Implications of Furosemide
-Monitor potassium levels!-Patients typically receive KCL supplements with their Lasix doses
50
Potassium-Sparing Diuretics
Spironolactone (Aldactone)
51
MAO of Spironolactone (Aldactone)
Block the action of aldosterone (sodium & water retention)= potassium retention & excretion of sodium and water
52
Side Effects of Spironolactone
Can see HYPERkalemia Endocrine effects: deepened voice, impotence, irregular menstrual cycles, gynecomastia, hirsutism
53
Nursing Implications of Spironolactone
-Only given PO -Usually given in combination with other hypertensives/diuretics to get more effect with a lower chance of hypokalemia -Only provides small amount of diuresis and hypotensive effect

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