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NUR 325 PATHO > Hypertension Medications (Exam 1) > Flashcards

Hypertension Medications (Exam 1) Flashcards

1
Q

Diuretics

A

Potassium-Sparing: Mild

Thiazide (thiazide-like): Mild

Loop: Moderate to profound

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2
Q

General Diuretics

A

MOA: Increasing urinary output, Decreasing circulating volume, Decreasing arterial resistance

-Lower BP by decreasing CARDIAC OUTPUT. (Block Sodium and Chloride reabsorption)

-Can enhance effects of other anti-hypertensives

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3
Q

Cardiac Output

A

Amount of blood the heart is pumping out. Calculated by HR x SV

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4
Q

Thiaziaide (Thiaziade like) Diuretics

A

Hydrocholorothiazide [HCTZ] (HydroDiuril)

-1st line management of mild hypertension

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5
Q

Thiazaide Diuretics: MOA

A

-Works on the distal convoluted tubule to inhibit resorption of sodium/potassium/ and chloride = decreases Cardiac Output

-Results in water loss

-Also relaxes arterioles = decreased in (PVR)

-Can be used alone or in combination with other anti-hypertensives

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6
Q

Thiazide Diuretics: Side Effects

A

-Electrolyte and Metabolic disturbances. HYPOKALEMIA (low potassium)

-Orthostatic Hypotension

-May worsen renal insufficiency

-Hyperuricemia — watch out with gout patients

-Can elevate levels of glucose, cholesterol, and triglycerides

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7
Q

Thiazide Diuretics: Nursing Actions

A

Monitory Potassium Levels

HYPOKALEMIA (low potassium) can lead to issue with our cardiac rhythms

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8
Q

Loop Diuretic Medication

A

Furosemide

(very strong)

(PO or IV)

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9
Q

Loop Diuretics: MOA

A

-Inhibit the kidneys ability to reabsorb sodium in the LOOP OF HENLE

-Makes kidneys put more sodium in the urine. (Water follows sodium so you pee more)

-Decreases fluid in the blood vessels—-decreases cardiac output—-decrease blood pressure

-PROFOUND DIURESIS POSSIBLE

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10
Q

Loop Diuretic: Side effects

A

-HYPOKALEMIA

-Other electrolyte abnormalities

-Dehydration (Strong Medication)

-Hypotension

-Otooxicity — Causing hearing problems

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11
Q

Loop Diuretics: Nursing Considerations

A

-Monitor potassium levels. Patients typically receive KCL supplements with their Lasix doses

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12
Q

Hypokalemia

A

-Low Potassium (Normal 3.5-5)

-Loop and Thiazide diuretics can cause potassium loss in the blood

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13
Q

Potassium-Sparing Diuretics (Aldosterone Antagonist)

A

-Spironolactone

-Spare potassium

-ONLY given PO

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14
Q

Potassium-Sparing Diuretics: MOA

A

-Block the action of aldosterone (Sodium and water retention) = potassium retention and excretion of sodium and water

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15
Q

P-S Diuretics: Side Effect

A

-HYPERkalemia

-Endocrine effects: Deepened voice, impotence, irregular menstrual cycles, gynecomastia, hirsutism

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16
Q

5 classes of types of medications that treat hypertension

A

Diuretics

Sympathetic Nervous system blockers

Beta Blockers

Calcium Channel Blockers

Vasodilators

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17
Q

Sympatholytics

A

Alpha-adrengic blockers

Centrally acting alpha 2 agonists

Beta adrenergic blockers

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18
Q

Sympatholytics

A

-Sympathetic nervous system blockers

-SNS usually VASOCONSTRICTS, when it is BLOCKED = decreased vasoconstriction

-Decrease blood pressure by decreasing PERIPHERAL VASCULAR RESISTANCE

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19
Q

Beta adrenergic blockers (Beta-Blockers) (Sympatholytic)

A

-Metoprolol

-Propranolol

-Carvedilol

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20
Q

Beta Adrenergic Blockers

A

-Block 2 types of receptors

-Beta 1 receptors found in the heart (Cardioselective beta receptors) (One Heart)

-Beta 2 receptors: Found in lungs (focus on beta 1) (Two Lungs)

-OLOL = Beta Blocker

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21
Q

Which Beta Blocker is non-selective?

A

Propanolol

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22
Q

Which beta blocker blocks both alpha receptors and beta blockers?

A

Carvedilol

23
Q

Which beta blockers only works on Beta 1 receptors in the heart?

A

Metoprolol (Selective)

24
Q

Beta-Blockers: MOA

A

Works by decreasing force, rate, and rennin secretion.

-Increases nitric oxide = vasodilation response

-Blocks stimulation of beta-1 receptors = decreases HR and contractility

25
Q

Beta-Blockers: Side Effects

A

-Fatigue/Lethargy
-Bradycardia
-Hypotension
-Mask hyopglycemia —– prevents tachycardia which is a common sign of DM

26
Q

Beta Blockers: Nursing Considerations

A

-Wean patients off

-Possible rebound HTN if discontinued abruptly—-critical rise in BP, high risk for CVA

-If non selective beta blocker——do not use with patients who have asthma or other breathing conditions

-RECONGIZE THE RISK FOR HYPOTENSION AND BRADYCARDIA. MEASURE HR AND BP EVERYTIME BEFORE GIVING MED

27
Q

Alpha-2 Adrenergic Agonist

A

clonidine

Typically not first-line treatment because of high side effects.

28
Q

A2AA’s: MOA

A

Decrease sympathetic outflow resulting in decreased stimulation of adrenergic receptors (both alpha AND beta receptors)

Can be given PO or Transdermal (patch)

29
Q

A2AA: Side effects

A

-Drowsiness—-most common. (given at night)

-Rebound HTN

-Pre-existing liver disease

30
Q

Selective Alpha-1 Blockers

A

doxazosin

31
Q

Selective Alpha 1 Blocker: MOA

A

-Directly blocking sympathic NS. Blocking A1 receptors

32
Q

SA1 Blocker: Side effect

A

-Hypotension

-Dizziness

33
Q

RAAS Blockers

A

-ACE inhibitors

-ARB’s

-Renin inhibitor

34
Q

Where do ACE inhibitors work?

A

Between Angiotensin I and Angiotensin II

35
Q

What does ARBS block?

A

ATII receptor

36
Q

When is the RASS system activated?

A

Loss of blood volume

Drop of BP

37
Q

ACE Inhibitors

A

-captopril

-lisinopril

Safe medication and first line therapy for HTN and HF

-Ends with -pril

ACE-pril

38
Q

ACE inhibitors: MOA

A

-Block angiotensin-converting enzyme

-Inhibits production of Angiotensin-2 (powerful vasoconstrictor)

-Inhibits aldosterone secretion—less water retention

-Slows progression of left ventricular hypertrophy associated with HTN

-Drug choice for DM— has some renal protective effects

39
Q

ACE inhibitor: side effects

A

-First dose hypotension—common, 15-20% drop in 6-8 hours

-Dry non productive and persistent cough—largest complaint from patients

-ANGIODEMA—rare but more common in blacks (Swelling of face)

-DO NOT USE IF PREGNANT

-Do not take if you are driving or during something active. Take at night

40
Q

ACE Inhibitors: Nursing Considerations

A

-Renal insufficincy—-use cautiously in patients with history of renal disease

-Captopril can cause neutropenia—monitor WBC

41
Q

Angiotensin Receptor Blockers

A

-ARBS

-Iosartan

-SARTAN suffix

42
Q

ARBS: MOA

A

-Block the action of angiotensin 2 after it is formed

-Causes vasodilation

-Increased sodium and water excretion

-Does not affect the HR or Cardiac issues

43
Q

ARBS: Side Effects

A

-Well tolerated

-Some risk of angioedema. No racial disparity like ACEi

-Do not use in someone who is pregnant and should be prescribe a contraceptive if in childbearing age

44
Q

Renin Inhibitor

A

aliskiren

45
Q

Renin Inhibitor: MOA

A

-Direct inhibition of Renin

-Induces vasodilation, decrease blood volume, decrease SNS, and inhibitors cardiac and vascular hypertrophy

46
Q

Renin Inhibitor: Side effects

A

-GI discomfort

-When given with ACEi watch for hyperkalemia, especially in patients with diabetes

47
Q

Renin inhibitor: Nursing considerations

A

-Takes several weeks to see fell effect (half-life)

-Do NOT take pregnant

48
Q

Calcium Channel Blockers

A

nifedipine
nicardipine

verapamil
diltiazem
(More common for heart rythym disorders)

-Block Ca channels which cause Vasodilation of Smooth muscle. Arterial vasodilation

49
Q

What is given when trying to treat for crisis refractive HTN IV

A

Calcium channel blocker (Nicardipine)

50
Q

Calcium Channel Blockers: Side Effects

A

-Orthostatic Hypotension

-Peripheral edema

51
Q

Calcium Channel Blocker: Nursing Considerations

A

-CCB are best for elderly and AA’s

-Diurectics with to adress edma that comes along with

52
Q

Vasodilators

A

Hydralazine

53
Q

Vasodilators: MOA

A

Work directly on arterial and venous smooth muscles and cause relaxation

-Direct vasodilation cause decreased systemic and pheripheral vascular resistance

PO and IV (Emergnecy)

54
Q

Vasodilators: Side Effect

A

Hypotension

dizziness, headache, tachy, edema, dyspnea.

NUR 325 PATHO (44 decks)

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