HTN Pharmacology Flashcards
- Diuretics
1) Examples
2) Primarily goal?
1) Lasix
2) HCTZ
3) Spironolactone*
Includes loop diuretics, potassium-sparing diuretics, and thiazides (and thiazide-like diuretics)
*What is first line therapy for hypertension?
Diuretics
Are loop diuretics potassium sparing or wasting?
Aka “Potassium wasting diuretics”
HTN risk factor for?
CAD CVD Death from cardiovascular causes Stroke HF Kidney failure PVD
7 main categories of drugs used in HTN?
1) DIuretics
2) Adrenergic drugs (includes beta blockers)
3) Vasodilators
4) ACEI
5) Angiotensin II receptor blockers (ARBs)
6) Calcium channel blockers
7) Renin inhibitors
Which drug is NOT considered first light therapy for HTN (esp in those over 60)?
Beta blockers
Examples of ACE inhibitors?
Mechanism of action?
Block angiotensin II, lowering PVR and blood volume
**In addition to htn, then are diuretics used?
HF
**Common adverse effects of diuretics?
Decreased K levels + Na, Ca, Cl
Hypotension
Dehydration
**nursing considerations for diuretics?
BP, HR, K, Na
Teaching
**Lifespan considerations for diuretics?
Elderly –>
Which kind of diuretics are most commonly used for HTN?
Thiazides
Which drugs end in “pril”
ACE inhibitors
Lab values to focus on for all antihypertensives?
Renal: BUN, creatinine, GFR
Hepatic: (why??)
Electrolytes
Diagnostics important for antihypertensives?
For diuretics - only ECG
For all others: ECG, angiogram, stress test
What is considered “prehypertension”?
same as high normal
sys 120-139 and dias 80-89 or both
Antihypertensive lab tests according to lilley?
- Those pertaining to Fluid + electrolyte imbalances, heart function and tissue damage, kidney and liver fx
- Serum Na, K, cl, Mg and Ca
- Serum troponin
- Kidney fx
- Liver fx:
**because HTN leads to kidney, retinal, hepatic, heart and vascular damage…
What assessment tool might you use to determine vascular damage d/t hypertension?
Look at retina with opthalmascope
In which populations does extra caution need to be taken when administering antihypertensives?
Elderly + chronically ill –> at high risk for further compmprise of their physical condition if they suffer from uncontrolled or untreated HTN or the adverse effects of antihypertensives (such as dehydration, electrolyte imbalances, hypotension)
Why is it important to know if is beta1 or beta2 receptor blocker?
beta1 will only affect cardio system, less concern for respiratory effects
–> beta1 specific drug would be used to minimize impact on lungs, when issues such as restrictive airway problems would be exacerbated by bronchoconstrictive effects
What what BP and pulse should a phyisician be notified prior to administering a beta blocker?
BP
**Beta blocker baseline values to include in nursing considerations?
BP
HR (apical pulse)
* May cause bradycardia
Also from Lilley:
- Breath + heart sounds
Why is respiratory status very important assessment in use of ACE inhibitors?
AE: dry, hacking cough