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NURS 200 > HTN Drugs > Flashcards

HTN Drugs Flashcards

1
Q

Diuretics

Indications

A

hypertension, HF

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2
Q

Diuretics

Mechanism of action

A

reduce blood volume

lower BP

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3
Q

Diuretics

Adverse affects

A

Hyponatremia (low sodium in blood)

Hypokalemia (low potassium)

Hyperkalemia (high potassium)

Nocturia (urination at night)

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4
Q

Diuretics

Assessment

A

○ Obtain complete health hx
○ Obtain baseline VS and weight
○ Assess for pulmonary and peripheral edema (Auscultate lungs)
○ Obtain blood and urine samples

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5
Q

Diuretics

Planning

A

○ Pt to exhibit reduction in systolic and diastolic BP while maintaining normal electrolyte levels
○ Provide drug education regarding drug action, precautions, and possible adverse effects
○ Pt to report dizziness, headaches, hypotension

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6
Q

Diuretics

Interventions

A

monitor for…

  • signs of hyperglycemia
  • liver and kidney function
  • signs of hypersensitivity to drug
  • alcohol and caffeine use (hypotensive effect of thiazides)
  • hearing and vision (loop diuretics are ototoxic)
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7
Q

Calcium Channel Blockers

Indications

A

Used for HTN, variant/vasospastic angina, Raynaud’s phenomenon and hypertrophic cardiomyopathy

heart and BV

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8
Q

Calcium Channel Blockers

3 categories

A

Arteriole selective drugs (nifedipine)

Cardioselective drugs (diltiazen)

Non-selective drugs (Verapamil)

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9
Q

Arteriole selective drugs

A

CCB

relax arterial smooth muscle

indicated for hypertension, angina, Raynaud’s

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10
Q

Cardioselective drugs

A

CCB

decreases HR and force of contraction

indicated for hypertension, angina dysrhythmias

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11
Q

Non-selective drugs

A

CCB

affect arterial smooth muscle and heart

indicated for hypertension, angina, certain dysrhythmias

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12
Q

Calcium Channel Blockers

Adverse effects

A 
●	Dizziness, flushing, hypotension
●	Reflex tachycardia (w/ nifedipine)
●	Peripheral edema
●	Dysrhythmias
●	Exacerbation of heart failure
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13
Q

Nifedipine (Adalat)

Therapeutic effects/uses:

A

CCB
○ Hypertension
○ Chronic stable or variant angina

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14
Q

Nifedipine (Adalat)

Mechanisms of action

A

○ Selectively blocks calcium channels in vascular smooth muscle, causing vasodilation which reduces resistance and BP

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15
Q

Nifedipine (Adalat)

Adverse effects

A

○ Hypotension
○ Dizziness
○ Headache
○ Peripheral edema

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16
Q

Nifedipine (Adalat)

Serious adverse effects

A 
○	Hepatotoxicity
○	Paradoxical angina (inadequate delivery of O2 to myocardium)
○	Severe hypotension
○	Exacerbation of heart failure
○	Confusion
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17
Q

Nifedipine (Adalat)

Assessment

A

○ Obtain baseline ECG
○ Assess for pulmonary and peripheral edema
○ Assess neurological status and LOC

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18
Q

Nifedipine (Adalat)

Planning

A

○ Pt to exhibit reduced systolic and diastolic BP

○ Provide education

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19
Q

Nifedipine (Adalat)

Interventions

A
  • Vs, ECG, S/S orthostatic hypotension
20
Q

ACE inhibitors

Indications

A

HTN, HF

21
Q

ACE inhibitors

Mechanism of action

A

Reduce production of angiotensin II

  • Promotes vasodilation, reducing peripheral resistance and BP
  • Reduces secretion of ADH and aldosterone, increasing urine output, decreasing blood volume and decreasing blood pressure
  • Enhances effects of diuretics
22
Q

ACE inhibitors

Adverse effects

A

○ Persistent cough (bradykinin builds up to cause irritation due to vasodilation)
○ Postural hypotension
○ Hyperkalemia
○ Angioedema

23
Q

ACE inhibitors

Assessment

A

obtain blood and urine samples for lab testing

24
Q

ACE inhibitors

Planning

A

Pt to maintain normal electrolyte levels throughout duration of therapy (K+ is at risk)

25
Q

ACE inhibitors

A

○ When giving first dose, monitor pt for “first-dose phenomenon” syncope
○ Observe for angioedema at start of therapy
○ Monitor for blood dyscrasias
○ Monitor:
- S/S infection or bruising
- Liver and kidney function
- K+ levels

26
Q

Angiotensin II receptor blockers

indications

A

HTN and HF

27
Q

ARBs

Mechanism of action

A
  • block receptors for angiotensin II in arteriolar smooth muscle and in the adrenal gland
  • causes BP to fall
  • arteriolar dilation and increases sodium excretion by the kidneys
    (different from ACE inhibitors because it blocks the action of angiotensin II after it is formed)
28
Q

ARBs

Adverse effects

A

○ Orthostatic hypotension, hypotension
○ First-dose phenomenon
○ Dizziness, headaches
○ Hyperkalemia

29
Q

Beta 1 adrenergic antagonists (beta blockers):

Indications

A

Hypertension, dysrhythmias, angina

30
Q

Beta Blockers

Mechanism of action

A
  • Block beta1 receptors decreased CO
  • Can be non-specific as well and block beta2 and/or alpha1 receptors
  • Block sympathetic response to low blood glucose
31
Q

Cardio selective beta blockers

A
  • decreases HR and affect myocardial conduction and contractility (decreases oxygen demand)
32
Q

Nonspecific beta blockers

A
  • decreases HR and affect myocardial conduction and contractility (decreases oxygen demand)

AND

  • act on respiratory system and BV, producing vasoconstriction and bronchoconstriction
33
Q

Beta blockers

Adverse affects

A

○ Bradycardia, dysthymias
○ Hypotension
○ Bronchospasm
○ Hypoglycemia b/c it blocks body’s normal response to adjust to blood sugar, inhibits release of glucose, blocks release of insulin

34
Q

Beta Blockers

Assessment/Planning

A

○ Obtain baseline CO and urinary output

○ Assess for presence of respiratory disease (as beta blockers can affect beta 2 receptors)

35
Q

Beta Blockers

Interventions

A

monitor

  • VS, pulse, dysrhythmias
  • Signs of pulmonary edema
  • Adverse effects including orthostatic hypotension, fatigue, weakness, drowsiness
  • Signs of hypoglycemia
  • Fluid intake and output, body weight
36
Q

Alpha 1 adrenergic antagonists

Indications

A

HTN

37
Q

Alpha 1 adrenergic antagonists

Mechanism of action

A

Block alpha1 receptors -> vasodilation

38
Q

Alpha 1 adrenergic antagonists

Adverse effects

A
  • orthostatic hypotension
  • Tachycardia, palpitations
  • Dizziness, headaches, flushing
  • Nausea, vomiting
39
Q

Direct-acting Vasodilators

Indications

A

HTN

40
Q

Direct-acting vasodilators

Mechanism of action

A

Relax arterial smooth muscle directly causing vasodilation

41
Q

Direct-acting vasodilators

Adverse effects

A
  • Hypotension
  • Reflex tachycardia
  • Dizziness, headache, flushing
42
Q

Prototype drug Hydralazine (Apresoline)

Therapeutic effects/uses

A
  • Moderate to severe hypertension
  • Hypertensive emergencies
  • Acute heart failure
43
Q

Prototype drug Hydralazine (Apresoline)

Mechanism of action

A

Causes peripheral vasodilation of arterioles, reducing peripheral resistance and pressure

44
Q

Prototype drug Hydralazine (Apresoline)

Serious adverse effects

A
  • Lupus-like syndrome

- Blood dyscrasias

45
Q

Prototype drug Hydralazine (Apresoline)

Assessment/Planning

A
  • Obtain baseline ECG
  • Auscultate heart and chest sounds
  • Assess LOC and neuro status
  • Obtain blood and urine sample
46
Q

Prototype drug Hydralazine (Apresoline)

Interventions

A
  • Monitoring BP
  • Monitoring dizziness, LOC
  • Monitor any signs of angina
  • Evaluate for lifestyle changes that may occur
47
Q

HTN emergency

A
  • Life-threatening conditions present when diastolic pressure over 120 mmHg
  • Fast-acting direct vasodilators such as Nitroprusside sodium are used
  • Mechanism of action: donates nitric oxide, a direct vasodilator
  • Adverse effects: hypotension, flushing, dizziness, headache

NURS 200 (18 decks)

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