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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
Valsartan (Diovan) Drug Class
Angiotensin Receptor Blocker
26
Valsartan (Diovan) Indications
Hypertension Heart Failure Myocardial Infarction
27
Valsartan (Diovan) MOA
Blocks access of angiotensin II to its receptors, thus causing decreased blood pressure and lowering blood volume
28
Valsartan (Diovan) Side Effects
Hypotension Hyperkalemia Avoid in Pregnancy
29
Valsartan (Diovan) Nursing Considerations
Assess HR and BP prior to administration | Monitor Kidney function
30
Valsartan (Diovan) Drug to Drug Interactions
Antihypertensive drugs intensify hypotension
31
Metoprolol (Lopressor) Drug Classification
Beta Adrenergic Blocker
32
Metoprolol (Lopressor)
Hypertension Angina pectoris Heart failure Cardiac Dysrhythmias
33
Metoprolol (Lopressor) MOA
Reduces heart rate Reduces force of contraction Reduces conduction through the AV node Reduces secretion of renin by the kidney
34
Metoprolol (Lopressor) Side Effects
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
Metoprolol (Lopressor) Nursing Considerations
Assess apical BP and HR prior to administration. Notify HCP if < 60 bpm   Bradycardia Hypotension Hold if pt. report SOB
36
Metoprolol (Lopressor) Side Effects
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
Metoprolol (Lopressor) Drug to Drug Interactions
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
amlodipine (Norvasc) Drug Class
Calcium Channel Blocker
39
amlodipine (Norvasc) Indications
Hypertension | Edema
40
amlodipine (Norvasc) MOA
Selective blockade of calcium channels in VSM Promote vasodilation
41
amlodipine (Norvasc) Side Effects
Peripheral and facial edema Flushing Dizziness Headache
42
Amlodipine (Norvasc) Nursing Considerations
Assess HR and BP prior to administration Increased risk of digoxin toxicity   do not crush/chew
43
Amlodipine (Norvasc) Drug to Drug Interactions
Beta-adrenergic Blockers | Decrease the cardiac effects
44
atorvastatin (Lipitor) Drug Classification
Statin
45
atorvastatin (Lipitor) Indications
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
atorvastatin (Lipitor) MOA
Reduce cholesterol synthesis in liver   Increase LDL receptors (most important) Decrease LDLs ``` Increase HDLs   Decrease triglycerides   Anti-inflammatory   ```
47
atorvastatin (Lipitor)
Myopathy Rhabdomyolysis   Hepatotoxicity
48
atorvastatin (Lipitor) Nursing Considerations
Timing: Results within 2 weeks; maximal 4-6 weeks If drug is stopped, serum cholesterol returns to pretreatment levels (lifelong treatment)  
49
cholestyramine (Questran) Drug Class
BILE ACID SEQUESTRANTS
50
cholestyramine (Questran) Indications
Increased LDL levels
51
Cholestyramine MOA
Absorb bile acids in the intestine New bile acids must be synthesized
52
Cholestyramine Side Effects
GI symptoms constipation, bloating, indigestion, nausea
53
Cholestyramine Nursing Considerations
Take oral medications 1 hour before or 4 hours after the bile acid sequestrant
54
ezetimibe (Zetia) Drug Class
Cholesterol Absorption Inhibitors
55
ezetimibe (Zetia) Indications
Lowers total cholesterol, LDLs, TG and raises HDLs   Used as adjunct to diet modification
56
ezetimibe (Zetia) MOA
Acts in GI tract to inhibits cholesterol absorption   Blocks absorption of dietary cholesterol and cholesterol secreted in bile
57
ezetimibe (Zetia) Side Effects
Myopathy Hepatitis Pancreatitis Thrombocytopenia
58
ezetimibe (Zetia) Nursing Considerations
do not give to patients in hepatic failure
59
fenofibrate (TriCor) Drug Class
Fibrates
60
Fenofibrate (TriCor) Indications
Hypercholesterolemia Low HDL High TG
61
Fenofibrate (TriCor) MOA
Lower LDL Lowers TG Increases HDL
62
Fenofibrate (TriCor) Side Effects
gallstones myopathy hepatotoxicity
63
Fenofibrate Nursing Considerations
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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