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NUR 325 Fundamentals of Pathopharmacology > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What is the MOA of hydrochlorothiazide?

A

Inhibits resorption of
sodium/potassium/chloride resulting in water loss

Relaxes 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

Hypokalemia
Orthostatic hypotension
Hyperuricemia
Can 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

Hypokalemia
Dehydration
Hypotension
Ototoxicity

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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

Hyperkalemia

Deepened 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 
Hypotension
Dry, nonproductive, persistent cough
Dizziness
Rash
Angioedema
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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

Angioedema
Do not use if pregnant
Use 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 pressure
Headache
Peripheral edema
Abdominal 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 
Hypotension
Dizziness
Headache
Tachycardia
Edema
GI 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/lethargy
Bradycardia
Hypotension
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 bradycardia

Hold & 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
Q

MAO of Doxazosin (cardura)

A

Selective alpha-1 blockade

Venous AND arterial dilation

26
Q

Side Effects of Doxazosin (cardura)

A

hypotension, dizziness

27
Q

MOA of Ace Inhibitors- lisinopril, captopril

A

Blocks angiotensin-converting enzyme (ACE)
Inhibits production of Angiotensin-2 (powerful vasoconstrictor)
Inhibits aldosterone secretion- less water retention

28
Q

Side Effects of lisinopril/captopril

A

Dry, nonproductive, PERSISTENT cough- (largest complaint from patients often reason people switch)
Dizziness
Rash
Serious: ANGIOEDEMA

29
Q

Can you take lisinopril, captopril while pregnant?

A

NO

30
Q

Nursing Considerations for lisinopril/captopril

A

Renal insufficiency- use cautiously in patients with history of renal disease
Captopril can cause neutropenia- monitor WBC
Risk of hyperkalemia especially if patient on potassium supplements

31
Q

MOA of Losartan (cozaar)

A

blocks the action of angiotensin 2 AFTER it is formed
Causes vasodilation
Increased sodium and water excretion

32
Q

Side Effects of Losartan (cozaar)

A

(Well tolerated)

Some risk of angioedema

33
Q

Can you take Losartan while pregnant?

A

NO

Requires the use of contraception if of childbearing age

34
Q

Nursing Implications of Losartan (cozaar)

A

Use cautiously in patients with renal problems

35
Q

MOA of Aliskiren (tekturna)

A

Direct inhibition of renin

Induces vasodilation, decreases blood volume, decreases SNS, and inhibitors cardiac and vascular hypertrophy

36
Q

Side Effects of Aliskiren (tekturna)

A

relatively well tolerated
GI discomfort
When given with ACEi watch for hyperkalemia, especially in patients with diabetes

37
Q

Nursing Considerations of Aliskiren (tekturna)

A

Take several weeks to see full effect (half-life)

DO NOT take pregnant

38
Q

Calcium Channel Blockers

A

nifedipine (procardia)
nicardipine (cardene)
verapamil (calan)
diltiazem (cardizem)

39
Q

Side Effects of Calcium Channel Blockers

A

Orthostatic hypotension

Peripheral edema

40
Q

Nursing Implications for CCB

A

CCB are often best for elderly and African Americans

Diuretics can be given for peripheral edema

41
Q

MAO of Hydralazine (apresoline)

A

Vasodilators work directly on arterial and venous smooth muscles and cause relaxation
Direct vasodilation cause decreased systemic and peripheral vascular resistance

42
Q

Side Effects of Hydralazine (apresoline)

A

HYPOTENSION

Dizziness, headache, tachycardia, edema, dyspnea, GI upset

43
Q

MAO of Hydrochlorothiazide [HCTZ] (HydroDiruil)

A

-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
Q

Side Effects of Hydrochlorothiazide

A
  • 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
Q

Nursing Implications of Hydrochlorothiazide

A
  • Can give potassium supplements

- Encourage food rich in potassium

46
Q

MAO of Furosemide (Lasix)

A
  • 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
Q

Loop Diuretic

A

Furosemide (Lasix)

48
Q

Side Effects Furosemide

A 
-HYPOKALEMIA
And other electrolyte abnormalities
-Dehydration 
-Hypotension 
-Ototoxicity = difficulty hearing, usually transient with furosemide
49
Q

Nursing Implications of Furosemide

A
  • Monitor potassium levels!

- Patients typically receive KCL supplements with their Lasix doses

50
Q

Potassium-Sparing Diuretics

A

Spironolactone (Aldactone)

51
Q

MAO of Spironolactone (Aldactone)

A

Block the action of aldosterone (sodium & water retention)= potassium retention & excretion of sodium and water

52
Q

Side Effects of Spironolactone

A

Can see HYPERkalemia

Endocrine effects: deepened voice, impotence, irregular menstrual cycles, gynecomastia, hirsutism

53
Q

Nursing Implications of Spironolactone

A
  • 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

NUR 325 Fundamentals of Pathopharmacology (7 decks)

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