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CPCT > hypertension drugs > Flashcards

hypertension drugs Flashcards

1
Q

diuretics

A

increase urine output by inhibiting sodium and water reabsorption by the kidney.

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2
Q

diuretics examples

A

thiazide and thiazide-like diuretics
loop diuretics
potassium-sparing diuretics

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3
Q

diuretic implications

A
  • Give with food to prevent gastrointestinal upset.
  • Monitor intake and output (I&O) and weight to determine fluid loss.
  • Check for edema improvement in patients with heart failure and reduced blood pressure (BP) in hypertension.
  • Electrolyte imbalances may occur quickly.
  • Teach:
  • Take during waking hours to prevent excessive urination during sleeping hours.
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4
Q

Thiazide and Thiazide-Like Diuretics

A

Increase urine output by promoting sodium, chloride, and water excretion; cause loss of potassium, sodium, and magnesium; calcium saved; no immediate effect; most effective in normal kidney function.

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5
Q

Thiazide and Thiazide-Like Diuretics examples

A

Thiazide:
- hydrochlorothiazide (HydroDIURIL)
- chlorothiazide (Diuril)
Thiazide-like:
- chlorthalidone (Hygroton)
- indapamide (Lozol)
- metolazone (Zaroxolyn)

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6
Q

Thiazide and Thiazide-Like Diuretics implications

A
  • Hypercalcemia could be hazardous to the patient on digoxin.
  • Monitor potassium level for hypokalemia.
  • Blood glucose may increase in diabetics.
  • Teach:
  • Wear sunscreen and protective clothing to prevent photosensitivity.
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7
Q

loop diuretics

A

Act on ascending loop of Henle in the kidney to cause sodium and water loss; also causes loss of potassium, magnesium, and calcium.

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8
Q

loop diuretics examples

A
  • bumetanide (Bumex)
  • furosemide (Lasix)
  • torsemide (Demadex)
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9
Q

loop diuretics implications

A
  • Contraindicated if allergic to sulfonamides.
  • Monitor potassium level for hypokalemia.
  • Teach:
  • Take with food or milk to prevent gastrointestinal upset.
  • Use sunscreen to prevent photosensitivity.
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10
Q

Potassium-sparing Diuretics

A

Mild diuretic; can be used as combination therapy; promote sodium and water excretion and potassium retention by the kidney.

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11
Q

Potassium-sparing Diuretics examples

A
  • amiloride (Midamor)
  • spironolactone (Aldactone)
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12
Q

Potassium-sparing Diuretics implications

A
  • Check potassium level for hyperkalemia before administration.
  • Check BP before administration.
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13
Q

Sympatholytics (Beta Blockers)

A

Decrease sympathetic nervous system response, resulting in decreased BP, heart rate, contractility, cardiac output, and renin activity.

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14
Q

Sympatholytics (Beta Blockers) examples

A
  • atenolol (Tenormin)
  • metoprolol (Lopressor)
  • metoprolol extended-release (Toprol XL)
  • nadolol (Corgard)
  • propranolol (Inderal)
  • propranolol long-acting (Inderal LA)
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15
Q

Sympatholytics (Beta Blockers) implications

A
  • Check heart rate and BP before administration as causes bradycardia and orthostatic hypotension.
  • Check daily I&O and weight.
  • Monitor for bronchospasm.
  • Teach:
  • Rise slowly.
  • Do not stop the drug abruptly to avoid rebound hypertension, angina, or arrhythmias.
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16
Q

Alpha-1 Blockers

A

Block effects of the sympathetic nervous system on blood vessels’ smooth muscle, resulting in vasodilation and decreased BP.

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17
Q

Alpha-1 Blockers examples

A
  • prazosin (Minipress)
  • terazosin (Hytrin)
18
Q

Alpha-1 Blockers implications

A
  • Check heart rate and BP before administration; causes hypotension and tachycardia.
  • Teach:
  • Rise slowly.
19
Q

Combined Alpha and Beta Blockers

A

Block alpha-adrenergic receptors, causing vasodilation and reduced BP; decrease sympathetic nervous system response, resulting in decreased heart rate and contractility.

20
Q

Combined Alpha and Beta Blockers examples

A
  • carvedilol (Coreg)
  • labetalol (Normodyne)
21
Q

Combined Alpha and Beta Blockers implications

A
  • Check heart rate and BP before administration as causes bradycardia and hypotension.
  • Check daily I&O and weight.
  • Monitor edema, neck vein distention, and lung sounds.
  • Teach:
  • Rise slowly.
  • Do not stop the drug abruptly to avoid rebound hypertension, angina, or arrhythmias.
22
Q

Central-Acting Alpha2 Agonists

A

Block effects of sympathetic nervous system centrally.

23
Q

Central-Acting Alpha2 Agonists examples

A
  • clonidine (Catapres)
  • guanfacine hydrochloride (Tenex)
24
Q

Central-Acting Alpha2 Agonists implications

A
  • Check for decreased BP and edema.
  • Teach:
  • Rise slowly.
  • Do not stop the drug abruptly to avoid rebound hypertension, angina, or arrhythmias. Suggest gum or hard candy for dry mouth.
25
Q

Angiotensin-Converting Enzyme (ACE) Inhibitors

A

Block production of angiotensin II, a potent vasoconstrictor, reduces peripheral arterial resistance and BP.

26
Q

Angiotensin-Converting Enzyme (ACE) Inhibitors examples

A
  • benazepril hydrochloride (Lotensin)
  • captopril (Capoten)
  • enalapril maleate (Vasotec)
  • fosinopril (Monopril)
  • lisinopril (Prinivil, Zestril)
  • moexipril (Univasc)
  • perindopril (Aceon)
  • quinapril (Accupril)
  • ramipril (Altace)
  • trandolapril (Mavik)
27
Q

Angiotensin-Converting Enzyme (ACE) Inhibitors implications

A
  • Monitor patient for edema with heart failure, decreased BP with hypertension, and new-onset cough.
  • Teach:
  • Rise slowly.
  • Report new-onset cough.
  • Use sunscreen to prevent photosensitivity.
  • Understand angioedema can occur anytime during therapy.
  • Do not stop the drug abruptly to avoid rebound hypertension, angina, or arrhythmias.
28
Q

Angiotensin II Receptor Blocker (ARB)

A

Blocks angiotensin II receptors, causing vasodilation and reduction in BP.

29
Q

Angiotensin II Receptor Blocker (ARB) examples

A
  • candesartan (Atacand)
  • eprosartan (Teveten)
  • irbesartan (Avapro)
  • losartan (Cozaar)
  • olmesartan (Benicar)
  • telmisartan (Micardis)
  • valsartan (Diovan)
30
Q

Angiotensin II Receptor Blocker (ARB) implications

A
  • Monitor patient for edema with heart failure and decreased BP with hypertension.
  • Teach:
  • Report new-onset cough.
  • Use sunscreen to prevent photosensitivity.
31
Q

Aldosterone Receptor Antagonist

A

Blocks binding of aldosterone at receptor site reduces sodium reabsorption and then BP.

32
Q

Aldosterone Receptor Antagonist examples

A

eplerenone (Inspra)

33
Q

Aldosterone Receptor Antagonist implications

A

Monitor potassium for hyperkalemia before and during therapy.

34
Q

Calcium Channel Blocker (CCB)

A

It prevents the movement of extracellular calcium into the cell, causing vasodilation.

35
Q

Calcium Channel Blocker (CCB) examples

A
  • amlodipine (Norvasc)
  • diltiazem (Cardizem)
  • felodipine (Plendil)
  • isradipine (DynaCirc)
  • nicardipine hydrochloride (Cardene, Cardene SR)
  • nifedipine (Procardia)
  • nisoldipine (Solar)
  • verapamil (Calan SR, Isoptin SR)
36
Q

Calcium Channel Blocker (CCB) implications

A
  • Check BP (for hypotension), heart rate (for bradycardia), arrhythmias, and angina.
  • It might increase blood levels of digoxin.
37
Q

Direct Vasodilators

A

Relax smooth muscles of blood vessels, causing vasodilation and decreased BP.

38
Q

Direct Vasodilators examples

A
  • hydralazine (Apresoline)
  • minoxidil (Loniten)
39
Q

Direct Vasodilators implications

A
  • Monitor BP for hypotension/hypertension and increased heart rate.
  • Treat headache with acetaminophen.
  • Often given with diuretic to reduce edema resulting from water and sodium retention.
40
Q

Combination Agents examples

A
  • losartan (Cozaar) + hydrochlorothiazide (HydroDIURIL) = Hyzaar
  • telmisartan (Micardis) + hydrochlorothiazide (HydroDIURIL) = Micardis HCT

CPCT (21 decks)

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