Hypertension Medications

Question 0

What are ACE (Angiotensin-Coverting Enzyme) inhibitors used for?

Answer 0

Lower blood pressure by preventing conversion of angiotensin I to angiotensin II.
Prevent vasoconstriction and sodium and water retention.

Question 1

Which class of hypertension medicines should you give the first dose at bedtime to minimize “first dose” syncope?

Answer 1

Your Alpha-Adrenergic Blockers.

Examples: doxazosin, prazosin, terazosin

Question 2

What are some nursing considerations when giving ACE inhibitors?

Answer 2

• Monitor client for first dose syncope, persistent dry cough, hyperkalemia
• Monitor client for manifestations of angioedema, for example swelling of facial features and tongue, which would result in the closing of their airway
• Contraindicated in renal artery stenosis and pregnancy
• Report changes in WBC count

Question 3

What are some examples of Beta-Adrenergic Blocking Agents?

Answer 3

End in “olol”

```
Acebutolol
Atenolol
Metoprolol
Lopressor
Nadolol
Propranolol
~~~

Question 4

Inhibits flow of calcium ions across the cell membrane of vascular tissue and cardiac cells.

Relaxes arterial smooth muscle, lowering peripheral resistance through vasodilation.

Answer 4

Calcium-Channel Blockers

Question 5

Examples of angiotensin-converting enzyme inhibitors (ACE)

Answer 5

End in “pril”

Benazepril
Captopril
Enalapril
Fosinopril
Lisinopril
Ramipril
Perindopril

Question 6

Prevents vasoconstriction and sodium and water retention

Answer 6

ACE inhibitors

Question 7

Block alpha-receptors in vascular smooth muscle.

Decrease vasomotor tone and vasoconstriction.

Reduce serum levels of low and very low density lipoprotein

Answer 7

Alpha-Adrenergic Blockers

Question 8

Which class of hypertension medications are good for diabetics?

Answer 8

ACE inhibitors

Question 9

Use is contraindicated in asthma, chronic lung disease, bradycardia, or heart block.

Answer 9

Beta-Adrenergic blocking agents

(This is because beta cells dilate the blood vessels so beta blockers will cause constriction, which can cause shortness of breath)

Question 10

May cause constipation.

Answer 10

Calcium-channel blockers

End in “pine”
With exception of diltiazem and verapamil

Question 11

Reduces blood pressure by preventing beta receptor stimulation in the heart, resulting in decreased heart rate and cardiac output.

Answer 11

Beta-Adrenergic Blocking Agents

End in “olol”

Question 12

Interferes with renin release by kidneys, decreasing the effects of angiotensin and aldosterone.

Answer 12

Beta-Adrenergic blocking agents

End with “olol”

Question 13

Stimulate the alpha2-receptors in the central nervous system to suppress sympathetic outflow to the heart and blood vessels.

Decreases cardiac output and vasodilation, reducing blood pressure.

Answer 13

Centrally acting sympatholytics

Ex: clonidine, guanfacine, methyldopa, reserpine

Question 14

Dry mouth and sedation are common adverse effects.

Answer 14

Centrally acting sympatholytics

Question 15

Reduces blood pressure by relaxing vascular smooth muscle and decreasing peripheral vascular resistance.

Often prescribed in combination with a diuretic or beta blocker because they can cause reflex tachycardia and fluid retention.

Answer 15

Vasodilators

Examples: hydralazine, minoxidil

Question 16

Hydrochlorothiazide

Answer 16

Thiazide diuretics

Question 17

Prevents tubular reabsorption of sodium, promoting sodium and water expiration and reducing blood volume.

Reduces systemic vascular resistance.

Answer 17

Thiazides diuretics

Example: hydrochlorothiazide

Question 18

Nursing considerations include:

• Monitoring client for hypokalemia
• Preferred treatment for systolic hypertension in older adults
• Effective in African-American clients

Answer 18

Thiazides diuretics

Question 19

Inhibits sodium and chloride reabsorption from the loop of Henle.

Acts on kidneys to increase flow of urine.

It may be used alone or in conjunction with other anti-hypertensives.

Answer 19

Loop Diuretics

Example: Furosemide (Lasix)

Question 20

While on these medications you should monitor client for hyponatremia, HYPOKALEMIA, or hypomagnesemia.

Answer 20

Loop Diuretics (Lasix)

Question 21

These receptor antagonist cause water and sodium excretions by the kidneys.

Answer 21

Potassium-Sparing diuretics

Example: spironolactone (Aldactone)

Question 22

With ACE inhibitors = hyperkalemia

Answer 22

Potassium-Sparing diuretics

Example: spironolactone (Aldactone)

Question 23

Inhibits 3-hydroxy-3-methylglutaryl coenzymes (HMG-CoA), a reductase, which results in less cholesterol biosynthesis.

Answer 23

Statins

Example:
Atorvastatin, fluvastatin, lovastatin, pravastatin

Question 24

What is it very important to monitor with a patient on statins?

Answer 24

Liver functions tests.

Avoid in clients with liver disease or heavy alcohol consumption, teach client to avoid alcohol while taking.

Question 25

Blocks vasoconstriction and promotes relaxation of blood vessels, thereby lowering blood pressure.

Answer 25

Angiotensin II receptor blockers (ARB’s)

End in “sartan”
Losartan
Valsartan

Question 26

Nursing considerations for a patient taking ARB’s

Answer 26

**Monitor client for manifestations of angioedema.
•Hyperkalemia
•contraindicated in pregnancy

Question 27

Potent vasodilator that dilate both arterial and venous smooth muscle. Dilation of veins reduces preload.

Answer 27

Nitrates

Example: nitroglycerin

Question 28

To reduce the oxygen demands on the heart, have client lie down when taking this medication for chest pain.

Answer 28

Nitrates

Example: nitroglycerin

Question 29

Causes the heart to be more forcefully and more slowly, improving cardiac output. (positive inotropic affect)

Answer 29

Cardiac glycosides

Example: digoxin

Question 30

Side effects such as drowsiness, fatigue, dizziness, visual disturbances, anorexia, nausea, or vomiting may indicate toxic levels ==> digtoxicity

Answer 30

Cardiac glycosides

Example: digoxin

Question 31

Administered to dissolve clots resulting in myocardial infarction or stroke, with quick restoration of circulation.

Answer 31

Thrombolytics (Clot Busters)

Example: Tissue plasminogen activator (t-PA)