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NUE 325: Pathopharm I > Hypertension Medications > Flashcards

Hypertension Medications Flashcards

1
Q

general diuretics MOA

A
  • inc urinary output
  • dec circulating vol
  • dec arterial resistance
  • lower BP to decrease cardiac output*
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2
Q

diuretics extra info

A
  • can enhance effects of other hypertensives
  • least expensive
  • typically first line therapy for many
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3
Q

hydroclorothiazide class

A

thiazide diuretic

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4
Q

hydroclorothiazide moa

A

inhibits absorption of Na/K/Cl in distal convoluted tubules
- increases water loss which decreases cardiac output
relaxes arterioles
- dec peripheral resistance

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5
Q

hydroclorothiazide side effects

A
  • electrolyte and metabolic disturbances
  • hypokalemia
  • orthostatic hypotension
  • may worsen renal insufficiencies
  • hyperuricemia
  • can elevate levels of glucose, cholesterol, and triglycerides
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6
Q

furosemide class

A

loop diuretic

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7
Q

furosemide moa

A

inhibits kidneys ability to reabsorb Na in loop of Henle
- Na goes into urine and water follows
- dec fluid in bv so dec cardiac output
- IV or PO

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8
Q

furosemide side effects

A
  • hypokalemia
  • dehydration
  • hypotension
  • ototoxicity
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9
Q

furosemide nursing considerations

A
  • monitor K levels
  • monitor output levels bc should have high output
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10
Q

hypokalemia

A

low K (below 3.5)
- normal range: 3.5-5.0
- thiazide and loop diuretic common side effect

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11
Q

why is hypokalemia problematic

A

K is needed for proper contractions of heart, w/out enough K, there is a disruption to proper cardiac function

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12
Q

spironolactone class

A

potassium sparing diuretic

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13
Q

spironolactone moa

A

block action of aldosterone
- K retention, Na water excreted

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14
Q

spironolactone side effects

A

hyperkalemia which can cause endocrine effects like
- deepened voice, impotence irregular menstrual cycles, gynecomastia, hirsutism

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15
Q

spironolactone nursing info

A
  • only given PO
  • usually given in combo with other HTN meds/diuretics to get more results and lower risk of hypokalemia
  • small dieresis and hypotensive
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16
Q

sympatholytics general info

A

SNS blockers
- SNS usually vasoconstrictors so when blocked vasoconstriction is lessened
- dec peripheral vascular resistance

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17
Q

beta blockers medications

A
  • metoprolol (selective)
  • propranolol (non selective)
  • carvedilol (alpha and beta blockers)
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18
Q

beta blocker types

A
  • beta 1 receptors; found in the heart called cardioselective beta receptors
  • beta 2 receptors: found in the lungs
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19
Q

beta blocker moa

A
  • inc nitric oxide –> vasodilation response
  • block 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
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21
Q

beta blockers nursing considerations

A
  • wean when discontinuing
  • possibility of rebound HTN
  • do not use non selective blockers for pt with chronic lung problems like asthma
  • recognize risk for hypotension/bradycardia
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22
Q

beta blockers general info

A
  • PO/IV
  • end in -olol
  • primarily treats HTN but also prescribed for cardiovascular disease
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23
Q

beta blocker is short for

A
  • beta adrenergic blocker
24
Q

centrally acting sympatholytic are aka

A

alpha-2 adrenergic agonist

25
Q

centrally acting sympatholytic drug

A

clonidine

26
Q

clonidine moa

A

dec sympathetic outflow –> decreases stimulation of adrenergic receptors
- blocks both alpha and beta receptors which decreases bp

27
Q

clonidine side effects

A
  • drowsiness
  • rebound HTN
  • may worsen pre existing liver disease
28
Q

clonidine nursing indications

A
  • HTN
  • PO or transdermal patch
  • do not abruptly discontinue –> rebound HTN
29
Q

doxazosin class

A

selective alpha-1 blockers

30
Q

doxazosin moa

A

selective alpha-1 blockade
- venous and arterial dilation

31
Q

doxazosin side effects

A

hypotension and dizziness

32
Q

doxazosin nursing info

A
  • not first line treatment
  • tamsulosin (flomax) is also an alpha 1 block out but only used to treat BPH (benign prostate hypertrophy)
33
Q

captopril and lisinopril class

A

ace inhibitors

34
Q

captopril and lisinopril moa

A

blocks angiotensin converting enzyme
- inhibits production of angiotensin-2 (powerful vasoconstrictor)
- inhibits aldosterone secretion –> less water retention

35
Q

captopril and lisinopril side effects

A
  • first does hypotension
  • dry, persistent, cough
  • dizziness
  • rash
  • serious: angioedema
36
Q

captopril and lisinopril nursing consideration

A
  • not appropriate for pregnant women
  • use caution if pt has renal insufficiency
  • captopril can cause neutropenia
  • risk of hyperkalemia
  • often given in conjunction with thiazide diuretics
37
Q

captopril and lisinopril other nursing info

A
  • slows progression of LV hypertrophy
  • ends in -pril
  • drug of choice for DM so has some renal protective effects
  • safe first line therapy for hypertension and heart failure
38
Q

losartan class

A

angiotensin receptor blocker (arb)

39
Q

losartan moa

A

blocks action of angiotensin 2 AFTER it is formed
- causes vasodilation
- inc Na and water excretion

40
Q

losartan side effects

A

generally well tolerated
- some have risk of angioedema

41
Q

losartan nursing considerations

A
  • do not use if pregnant
  • use contraceptive if using
  • use caution if renal problems
  • only give PO
  • ends in -sartan
42
Q

losartan indications

A
  • HTN
  • heart failure
  • stroke progression
43
Q

aliskiren class

A

renin inhibitor

44
Q

aliskiren moa

A

direct inhibitor of renin which
- induces vasodilation, dec blood vol, decreases SNS, and inhibitors of cardiac/vascular hypertrophy

45
Q

aliskiren side effects

A

relatively well tolerated
- GI discomfort
- when given ACEi, watch for hyperkalemia especially if DM

46
Q

aliskiren nursing considerations

A
  • takes several weeks for full effect
  • do not take if pregnant
  • give PO
47
Q

calcium channel blocker drugs

A

nifedipine
nicardipine
verapamil
diltiazem

48
Q

ca channel moa

A

block ca access to cells causes
- dec contractility
- dec conductivity of heart
–> which decreases demand of o2

49
Q

ca channel side effects

A
  • hypotension, orthostatic hypotension
  • bradycardia
  • may precipitate AV block
  • headache
  • abdominal discomfort
  • peripheral edema
50
Q

ca channel indications

A

HTN and chest pain (angina pectoris)
- dilt and verapamil: heart rhythm disorders
- nicardipine: refractive hypotension

51
Q

ca channel nursing considerations

A
  • best for elderly or blacks
  • diuretics can be give for peripheral edema
  • PO or IV
52
Q

hydralazine class

A

vasodilator

53
Q

hydralazine moa

A

work directly on arterial and venous smooth muscle and cause relaxation

54
Q

hydralazine side effects

A

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

55
Q

hydralazine nursing considerations

A
  • treatment for HTN
  • PO usually w other hypertensive agents
  • IV in emergency or PO not tolerated

NUE 325: Pathopharm I (23 decks)

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