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HTN pharmacology Flashcards

1
Q

Hydrochlorothiazide (HydroDiuril) Classification

A

Thiazide diuretics

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2
Q

Hydrochlorothiazide [HCTZ] (HydroDiuril) MOA

A

Works on the distal convoluted tubule to inhibit reabsorption of Na/K and Cl which causes dec cardiac output and water loss; relaxes arterioles which dec peripheral vascular resistance (PVR); usually given PO

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3
Q

Hydrochlorothiazide [HCTZ] (HydroDiuril) Adverse reactions

A

Electrolyte and metabolic disturbance, hypokalemia; orthostatic hypotension; worsened renal insufficiency; hyperuricemia; elevated glucose, cholesterol, triglycerides

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4
Q

Hydrochlorothiazide [HCTZ] (HydroDiuril) Nursing considerations

A

Tell pt to eat potassium rich foods like bananas, avocado, spinach, watermelon, beans; watch gout pt bc hyperuricemia; will need to monitor K levels

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5
Q

Hypokalemia

A

Low potassium levels

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6
Q

Foods rich in vitamin K

A

bananas, avocado, watermelon, spinach, beans

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7
Q

Furosemide (Lasix) classification

A

Loop diuretic

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8
Q

Furosemide (Lasix) MOA

A

Inhibit kidneys ability to reabsorb sodium in the loop of henle; makes kidneys put more sodium in the urine which encourages peeing; often given PO

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9
Q

Furosemide (Lasix) Indications

A

HTN, fluid overload

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10
Q

Furosemide (Lasix) adverse effects

A

Hypokalemia, hyponatremia, low magnesium, dehydration, hypotension, ototoxicity—difficulty healing, usually transient with furosemide

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11
Q

Furosemide (Lasix) nursing considerations

A

Monitor potassium levels, may need potassium supplement; watch urine output and contact HCP if low output because profound amounts of urine are more common

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12
Q

Spironolactone (Aldactone) Classification

A

Potassium-sparing diuretic (aldosterone antagonist)

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13
Q

Spironolactone (Aldactone) MOA

A

Blocks aldosterone activity (sodium and water retention and secretion of sodium and water); does not mess with K much; small amount of diuretics; only given PO

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14
Q

Spironolactone (Aldactone) adverse effects

A

Hyperkalemia; endocrine effects—deeper voice, impotence, irregular menstrual cycles, gynecomastia, hirsutism

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15
Q

Spironolactone (Aldactone) nursing considerations

A

Warn pt of side effects; monitor K levels

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16
Q

Metoprolol [selective], propranolol and carvedilol [non-selective] classification

A

Beta adrenergic blockers

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17
Q

Beta blockers prefix

A

–olol

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18
Q

Metoprolol [selective], propranolol and carvedilol [non-selective] MOA

A

Increases nitric oxide which causes vasodilation and blocks stimulation of the beta 1 receptors which decreases HR and contractility (propranolol and carvedilol also block beta 2 which acts on the lungs)

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19
Q

Metoprolol [selective], propranolol and carvedilol [non-selective] adverse effects

A

Lethargy, fatigue, dec BP, bradycardia, can exacerbate lung issues (propranolol and carvedilol)

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20
Q

Metoprolol [selective], propranolol and carvedilol [non-selective] nursing considerations

A

Need to wean when discontinuing the med to avoid CVD event, watch asthma patients for propranolol and carvedilol, never give any beta blockers with HR under 60 or systolic BP under 100

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21
Q

Clonidine (catapres) classification

A

Alpha 2 adrenergic agonist (centrally acting sympatholytic)

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22
Q

Clonidine (Catapres) MOA

A

Decrease sympathetic outflow which decreases stimulation of adrenergic receptors (alpha and beta), which lowers BP; PO or transdermal

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23
Q

Clonidine (Catapres) adverse effects

A

Drowsiness, rebound HTN, worsened renal insufficiency

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24
Q

Clonidine (Catapres) nursing considerations

A

Give at night to combat drowsiness, gradually discontinue to avoid rebound HTN

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25
Q

doxazosin (Cordova) classification

A

Selective alpha 1 blocker

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26
Q

doxazosin (Cordova) MOA

A

Selective alpha 1 blockade—venous and arterial dilation

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27
Q

Doxazosin (Cordova) adverse effects

A

Hypotension, dizzy

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28
Q

captopril (Capoten), lisinopril (Zestril) classification

A

ACE inhibitors

28
Q

Doxazosin (Cordova) nursing considerations

A

Be careful getting up after taking

28
Q

captopril (Capoten), lisinopril (Zestril) MOA

A

Block ACE which inhibits the production of angiotensin II and inhibits aldosterone secretion (less water retention) and slows

29
Q

ACE inhibitor suffix

30
Q

captopril (Capoten), lisinopril (Zestril) adverse effects

A

First dose hypotension, DRY AND PERSISTENT COUGH, dizzy, rash, ANGIOEDEMA, neutropenia (captopril)

31
Q

captopril (Capoten), lisinopril (Zestril) nursing considerations

A

Be careful within first 6-8 hours bc hypotension, educate about not moving too fast, educate about angioedema, especially African Americans

32
Q

angioedema

A

swelling in the body tissues especially the larynx which is more common in African Americans

33
Q

Losartan (Cozaar) classification

A

Angiotensin receptor blocker (ARBs)

34
Q

Losartan (Cozaar) MOA

A

Blocks angiotensin 2 after is it formed, causing vasodilation, increased Na/water excretion; only give PO

35
Q

Angiotensin receptor blocker suffix

36
Q

Losartan (Cozaar) adverse effects

A

Well tolerated; worsened renal insufficiency, slight risk of angioedema

37
Q

Losartan (Cozaar) nursing considerations

A

Don’t take if pregnant, women of child-bearing age need to use contraceptive if taking, renal insufficient patients should monitor

38
Q

aliskiren (Tekturna) classification

A

renin inhibitor

39
Q

aliskiren (Tekturna) MOA

A

Inhibits renin which induces vasodilation, decreases blood volume, decreases SNS activity, inhibits cardiac and vascular hypertrophy; given PO

40
Q

aliskiren (Tekturna) adverse effects

A

Well-tolerated, GI discomfort, hyperkalemia

41
Q

aliskiren (Tekturna) nursing considerations

A

Takes several weeks for full effect, can’t take if pregnant; if you are diabetic watch for hyperkalemia

42
Q

nifedipine (Procardia), amlodipine (Norvasc), nicardipine (Cardene) classification

A

Calcium channel blocker

43
Q

Calcium channel blocker suffix

44
Q

nifedipine (Procardia), amlodipine (Norvasc), nicardipine (Cardene) MOA

A

Blocks calcium access to cells which causes vasodilation of smooth muscles and works on veins; decreases contractility and heart conductivity; PO or IV; for HTN and angina pectoris

45
Q

nifedipine (Procardia), amlodipine (Norvasc), nicardipine (Cardene) adverse effects

A

orthostatic hypotension, peripheral edema

46
Q

nifedipine (Procardia), amlodipine (Norvasc), nicardipine (Cardene) nursing considerations

A

Best choice for elderly and African Americans; diuretics may be given if edema occurs, be careful changing position

47
Q

Hydralazine (Apresdine) classification

A

Vasodilator

48
Q

Hydralazine (Apresdine) MOA

A

Works on atrial and venous smooth muscles to cause relaxation, decreases systemic and peripheral vascular resistance with direct vasodilation; IV or PO

49
Q

Hydralazine (Apresdine) adverse effects

A

Hypotension, dizzy, headache, tachycardia, edema, dyspnea, GI

50
Q

Hydralazine (Apresdine) nursing considerations

A

Be careful changing position, watch for swelling

51
Q

Diuretics characteristics

A

Least expensive, enhance effects of other hypertensives, often first-line, dec BP by dec CO (block Na and Cl reabsorption)

52
Q

MOA for all diuretics

A

Increase urinary output, dec circulatory volume, dec arterial resistance

53
Q

Normal potassium range

54
Q

What does hypokalemia cause

A

Cardiac rhythm problems bc K works with the heart

55
Q

Sympatholytics

A

hypertensive drugs that block the SNS (which usually vasoconstricts) so there is less vasoconstriction, less peripheral vascular resistance, and lower BP

56
Q

beta adrenergic blockers

A

block beta receptors; beta 1–in heart (cardioselective), beta 2–in lungs

57
Q

Characteristics of ACE inhibitors

A

safe and efficacious for heart failure and HTN

58
Q

Gynecomastia

A

Increased breast tissue in men

59
Q

Impotence

A

Erectile dysfunction

60
Q

Hirsutism

A

Excess hair growth around often around mouth and chin

61
Q

Contractility

A

The force with which the heart contracts

62
Q

Neutropenia

A

Very low WBC count

63
Q

Best choice for African Americans and elderly

A

Calcium channel blockers

64
Q

Preg women can’t take these…

A

ACE inhibitors, ARBs, renin inhibitors

65
Q

These drugs cause worsened renal insufficiency

A

ARBs, ACE inhibitors, thiazide

66
Q

These drugs worsen liver problems

A

Alpha 2 adrenergic agonists, HLD drugs

PATHO (32 decks)

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