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Physiology & Pharmacology > Hypertension Medications and Diuretics > Flashcards

Hypertension Medications and Diuretics Flashcards

1
Q

Chlorothiazide Drug Class

A

Thiazide Diuretic

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2
Q

Chlorothiazide (Diuril) Indication

A

Hypertension

Edema

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3
Q

Chlorothiazide (Diuril) MOA

A

Reduces blood volume

Prevents reabsorption of sodium in the distal tubule. (This allows a greater urine output since water will follow salt)

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4
Q

Chlorothiazide Side Effects

A

Hypokalemia, hyperglycemia, orthostatic hypertension,

hyperuricemia, dehydration

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5
Q

Chlorothiazide Nursing Considerations

A

Nocturia if taken at night

Check potassium levels before administration- if levels are less than 3.5, mEq/L then hold

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6
Q

Chlorothiazide Drug to Drug interactions

A

Potential for Digoxin toxicity
and
Lithium toxicity

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7
Q

furosemide (Lasix)

Drug Classification

A

Loop Diuretic

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8
Q

Furosemide (Lasix) Indications

A

Hypertension
Heart Failure
Conditions where reducing volume is a goal

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9
Q

furosemide (Lasix) MOA

A

Reduces blood volume by preventing the reabsorption of sodium and chloride in the ascending loop of Henle and thereby the reabsorption of water- this promotes rapid diuresis

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10
Q

furosemide (Lasix) Side Effects

A

Hypokalemia
Hypotension
Digoxin Toxicity
Ototoxicity

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11
Q

furosemide (Lasix) Nursing Considerations

A

Oral or IV

Assess serum potassium level prior to and after administration. Do not administer if  K+  level  < 3.5 mEq/L

May need to provide K supplementation

Causes profound diuresis!
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12
Q

Drug to drug effects of Furosemide (Lasix)

A

digoxin – hypokalemia is dangerous with digoxin

Nitrates/other antihypertensive – increased hypotensive effects

Other ototoxic drugs (aminoglycoside antibiotics)

lithium – lithium toxicity

NSAIDS can attenuate the diuretic effect of furosemide

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13
Q

Spironolactone (Aldactone) Drug Class

A

Potassium Sparing Diuretic

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14
Q

Spironolactone (Aldactone)

A

Hypertension
Edema
Heart Failure

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15
Q

Spironolactone (Aldactone) MOA

A

Aldosterone reception blocker
Promotes excretion of sodium and chloride
Promotes renal retention of K+
Prevent the reabsorption of sodium from the collecting tubule and duct

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16
Q

Spironolactone (Aldactone) Side Effects

A

Hyperkalemia

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17
Q

Spironolactone (Aldactone) Nursing Considerations

A

Assess K+ levels Prior to administration

Hold if >5.5 m Eq/L

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18
Q

Spironolactone (Aldactone) Drug to Drug Interactions

A

Potassium supplements and salt substitutes (KCl) are contraindicated

ACE inhibitors or ARBs may exacerbate the tendency for hyperkalemia

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19
Q

Lisinopril (Zestril) Drug Class

A

ACE Inhibitor

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20
Q

Lisinopril (Zestril) indication

A

Hypertension
Heart Failure
Myocardial Infarction

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21
Q

Lisinopril (Zestril) MOA

A

Blocks ACE 1 to ACE 2

Increase levels of bradykinin

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22
Q

Lisinopril (Zestril) Side Effects

A

Hypotension
Hyperkalemia
Allergic Reactions
Cough

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23
Q

Lisinopril (Zestril) Nursing Considerations

A

Assess HR and BP prior to administration

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24
Q

Drug to Drug Interactions

A

Diuretics
Intensify hypotension

Antihypertensive agents
Intensify hypotension

Drugs that raise potassium
Increased risk of hyperkalemia

Lithium
Lithium toxicity

NSAIDS
Reduce efficacy of ACE inhibitors

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25
Q

Valsartan (Diovan) Drug Class

A

Angiotensin Receptor Blocker

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26
Q

Valsartan (Diovan) Indications

A

Hypertension
Heart Failure
Myocardial Infarction

27
Q

Valsartan (Diovan) MOA

A

Blocks access of angiotensin II to its receptors, thus causing decreased blood pressure and lowering blood volume

28
Q

Valsartan (Diovan) Side Effects

A

Hypotension
Hyperkalemia
Avoid in Pregnancy

29
Q

Valsartan (Diovan) Nursing Considerations

A

Assess HR and BP prior to administration

Monitor Kidney function

30
Q

Valsartan (Diovan) Drug to Drug Interactions

A

Antihypertensive drugs intensify hypotension

31
Q

Metoprolol (Lopressor) Drug Classification

A

Beta Adrenergic Blocker

32
Q

Metoprolol (Lopressor)

A

Hypertension
Angina pectoris
Heart failure
Cardiac Dysrhythmias

33
Q

Metoprolol (Lopressor) MOA

A

Reduces heart rate

Reduces force of contraction

Reduces conduction through the AV node

Reduces secretion of renin by the kidney

34
Q

Metoprolol (Lopressor) Side Effects

A

Cardiac - heart failure, AV block, and sinus arrest., bradycardia

Hypotension can occur secondary to reduced cardiac output

In patients with asthma, blocking beta2 receptors in the lung can cause bronchospasm.

35
Q

Metoprolol (Lopressor) Nursing Considerations

A

Assess apical BP and HR prior to administration. Notify HCP if < 60 bpm

Bradycardia

Hypotension

Hold if pt. report SOB

36
Q

Metoprolol (Lopressor) Side Effects

A

Cardiac - heart failure, AV block, and sinus arrest., bradycardia

Hypotension can occur secondary to reduced cardiac output

In patients with asthma, blocking beta2 receptors in the lung can cause bronchospasm.

37
Q

Metoprolol (Lopressor) Drug to Drug Interactions

A

Calcium Channel Blockers
Intensifies cardiac effects of beta blockers

Insulin
Prevents compensatory glycogenolysis in response to insulin induced hypoglycemia; diabetic patients may need to reduce insulin dosing

38
Q

amlodipine (Norvasc) Drug Class

A

Calcium Channel Blocker

39
Q

amlodipine (Norvasc) Indications

A

Hypertension

Edema

40
Q

amlodipine (Norvasc) MOA

A

Selective blockade of calcium channels in VSM

Promote vasodilation

41
Q

amlodipine (Norvasc) Side Effects

A

Peripheral and facial edema

Flushing

Dizziness

Headache

42
Q

Amlodipine (Norvasc) Nursing Considerations

A

Assess HR and BP prior to administration

Increased risk of digoxin toxicity

do not crush/chew

43
Q

Amlodipine (Norvasc) Drug to Drug Interactions

A

Beta-adrenergic Blockers

Decrease the cardiac effects

44
Q

atorvastatin (Lipitor) Drug Classification

A

Statin

45
Q

atorvastatin (Lipitor) Indications

A

Hypercholesterolemia

Prevention of cardiovascular events
MI, stroke, angina

Diabetes
ADA: Diabetic pts > 40 y.o. with more than one risk factor for cardiovascular disease, regardless of lipid levels

All pts with known CV disease regardless of lipid levels

46
Q

atorvastatin (Lipitor) MOA

A

Reduce cholesterol synthesis in liver

Increase LDL receptors (most important)

Decrease LDLs

Increase HDLs

Decrease triglycerides

Anti-inflammatory
47
Q

atorvastatin (Lipitor)

A

Myopathy

Rhabdomyolysis

Hepatotoxicity

48
Q

atorvastatin (Lipitor) Nursing Considerations

A

Timing:
Results within 2 weeks; maximal 4-6 weeks

If drug is stopped, serum cholesterol returns to pretreatment levels (lifelong treatment)

49
Q

cholestyramine (Questran) Drug Class

A

BILE ACID SEQUESTRANTS

50
Q

cholestyramine (Questran) Indications

A

Increased LDL levels

51
Q

Cholestyramine MOA

A

Absorb bile acids in the intestine

New bile acids must be synthesized

52
Q

Cholestyramine Side Effects

A

GI symptoms constipation, bloating, indigestion, nausea

53
Q

Cholestyramine Nursing Considerations

A

Take oral medications 1 hour before or 4 hours after the bile acid sequestrant

54
Q

ezetimibe (Zetia) Drug Class

A

Cholesterol Absorption Inhibitors

55
Q

ezetimibe (Zetia) Indications

A

Lowers total cholesterol, LDLs, TG and raises HDLs

Used as adjunct to diet modification

56
Q

ezetimibe (Zetia) MOA

A

Acts in GI tract to inhibits cholesterol absorption

Blocks absorption of dietary cholesterol and cholesterol secreted in bile

57
Q

ezetimibe (Zetia) Side Effects

A

Myopathy

Hepatitis

Pancreatitis

Thrombocytopenia

58
Q

ezetimibe (Zetia) Nursing Considerations

A

do not give to patients in hepatic failure

59
Q

fenofibrate (TriCor) Drug Class

A

Fibrates

60
Q

Fenofibrate (TriCor) Indications

A

Hypercholesterolemia

Low HDL

High TG

61
Q

Fenofibrate (TriCor) MOA

A

Lower LDL

Lowers TG

Increases HDL

62
Q

Fenofibrate (TriCor) Side Effects

A

gallstones

myopathy

hepatotoxicity

63
Q

Fenofibrate Nursing Considerations

A

Because of overlapping adverse effects, the combo of a statin and a fibric acid derivative should be used with great caution

Physiology & Pharmacology (13 decks)

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