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ABSN > HTN & HLD drug matrix > Flashcards

HTN & HLD drug matrix Flashcards

1
Q

hydrochlorothiazide MOA

A

works on distal convoluted tubule to inhibit resorption of Na/K+/Cl -> results in decreased cardiac output and increased water loss
also decreases PVR

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2
Q

hydrochlorothiazide side effects

A

hypokalemia + lyte abnormalities
-orthostatic hypotension
-hyperuricemia
-may worsen renal insufficiency
-can elevate levels of glucose, cholesterol & tags

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3
Q

hydrochlorothiazide nursing considerations

A

-watch out for pt’s w/ gout
-give K+ sups & encourage K+ rich foods (potatoes, spinach, kale, beans, tomatoes, banana, avocado)

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4
Q

Furosemide MOA

A

inhibit the kidney’s ability to reabsorb Na in the loop henle -> more Na in urine which water will follow and increase urine output
water pills

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5
Q

Furosemide side effects

A

hypokalemia + lyte abnormalities
-dehydration
-hypotension
-ototoxicity

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6
Q

Furosemide nursing consideration

A

-monitor K+ levels (usually give a sup)

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7
Q

Spironolactone MOA

A

block the action of aldosterone -> K+ retention & excretion of Na & H2O

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8
Q

Spironolactone side effects

A

-hyperkalemia
-endocrine effects (deepened voice, period and erectile, hirsutism)

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9
Q

Spironolactone nursing considerations

A

-usually given w/ other diuretics
-only given PO

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10
Q

metoprolol/propranolol/carvedilol MOA

A

-increases nitric oxide = vasodilation
-blocks stimulation of beta 1 receptors = decreases HR and contractility

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11
Q

metoprolol/propranolol/carvedilol side effects

A

bradycardia
hypotension
-fatigue/lethargy

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12
Q

metoprolol/propranolol/carvedilol nursing considerations

A

-can mask hypoglycemia
-wean when discontinuing to avoid rebound HTN
-hold & call if HR <60 or systolic is <100

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13
Q

propranolol/carvedilol additional nursing considerations

A

do not give to pt’s w/ lung conditions or asthma d/t blocking of beta 2 receptors in the lungs

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14
Q

clonidine MOA

A

decrease sympathetic outflow resulting in decreased stimulation of adrenergic receptors (alpha & beta)

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15
Q

clonidine side effects

A

-drowsiness (give at night, v common)
-rebound HTN
-may worsen pre existing liver disease

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16
Q

clonidine nursing consideration

A

wean when discontinuing

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17
Q

doxazosin MOA

A

selective alpha 1 blockage (directly blocks SNS & decreases PVR) -> venous & arterial dilation

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18
Q

doxazosin side effects

A

-hypotension
-dizzinesss

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19
Q

doxazosin nursing considerations

A

only use after other meds have failed

20
Q

captopril/lisinopril MOA

A

blocks ACE -> inhibits angiotensin 2 & aldosterone secretion (vasodilation & less water retention)

21
Q

captopril/lisinopril side effects

A

dry, non productive cough
angioedema w/ racial disparity
-first dose hypotension
-dizziness
-rash

22
Q

captopril/lisinopril nursing considerations

A

do not give to pregnant women
-renal insufficiency so use caution w/ renal disease
-hyperK+ risk (esp on K+ sups)
-often give w/ thiazide diuretics

23
Q

captopril additional nursing consideration

A

can cause neutropenia -> monitor WBC

24
Q

losartan MOA

A

blocks the action of angiotensin 2 after it is formed

25
Q

losartan side effects

A

usually well tolerated
-angioedema w/o racial disparities

26
Q

losartan nursing considerations

A

-do not give to pregnant women **requires contraception use*
-use cautiously w/ renal pts

27
Q

aliskiren MOA

A

direct inhibition of renin (induces vasodilation, decrease blood volume & SNS and inhibitors cardiac & vascular hypertrophy)

28
Q

aliskiren side effects

A

well tolerated
-GI discomfort
-hyperK+ when given w/ ACE (esp in DM pts)

29
Q

aliskiren nursing considerations

A

-do not give to pregnant women
-takes several weeks to see full effect due to half life

30
Q

nifedipine/nicardipine MOA

A

blocks calcium access to cells causing a decrease in contractility & conductivity of heart (vasodilation of smooth muscles & peripheral arterials)

31
Q

nifedipine/nicardipine side effects

A

peripheral edema
orthostatic hypotension
-bradycardia
-headache
-abdominal discomfort
-AV block

32
Q

nifedipine/nicardipine nursing considerations

A

best for elderly and African Americans
-can give diuretics for peripheral edema

33
Q

hydralazine MOA

A

vasodilator works directly on arterial and venous smooth muscles causing relaxation (decreases systemic & peripheral resistance)

34
Q

hydralazine side effects

A

-hypotension
-dizziness, headache, tachycardia, edema, dyspnea, GI upset

35
Q

hydralazine nursing considerations

A

can be given with isosorbide to treat heart failure in African Americans

36
Q

what drug class can you not give to pregnant women

A

-ACE
-ARBs
-Renin inhibitors

37
Q

what drug classes do you need to watch for renal pts

A

-ACEs
-ARBs
-Thiazide Diuretics

38
Q

statins MOA

A

inhibits HMG-CoA reductase -> less cholesterol is produced & more LDL receptors are produced to pull cholesterol out of the blood
(also stabilizes plaque & decreases inflammation)

39
Q

statins effect on levels

A

LDL: 21-63% decrease
HDL: 5-22% increase
TAGs: 6-43 decrease

40
Q

statins side effects

A

myopathy -> rhabdomyolysis (breakdown of muscle fibers & acute kidney failure)
-hepatotoxicity

41
Q

statin nursing considerations

A

-2 wks to take effect
-take w/ food
-avoid drugs & alcohol

42
Q

additional nursing considerations for simvastatin & rosuvastatin

A

take at night d/t short half life since chol is highest at night

43
Q

ezetimibe MOA

A

blocks absorption of cholesterol in the jejunum (dietary chol)

44
Q

ezetimibe nursing considerations

A

-not as effective as statins d/t dietary chol
-take w/ statin
-2nd line

45
Q

nursing considerations before giving HLD meds

A

-fasting lipid panel
-ALT levels
-CK levels (rhabdo)
-consider secondary causes

46
Q

what are other meds to treat HLD

A

-bile acid sequestrants
-niacin
-fibric acid derivative
-fish oil

47
Q

what drugs have a risk of hyperkalemia

A

-potassium sparing diuretics
-ACEs
-Renin Inhibitors

ABSN (90 decks)

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