Lecture Week 6 Cardiovascular System Flashcards
what is the ending of ACE inhibitors?
-pril
what is the ending of Angiotensin II Receptor Blockers (ARBs)?
- tan
what is the ending of calcium channel blockers?
-pine
ACE inhibitor prototype and others
Captopril (Capoten)
Lisinopril, Enalopril, Ramipril
ACE inhibitor EPA
Captopril (Capoten)
Block enzyme that converts angiotensin I to angiotensin II
decreases vasoconstriction, & aldosterone
reduces retention of sodium and water
leads to vasodilation & retention of K+
ACE inhibitor therapeutic use
Captopril (Capoten)
treats hypertension and heart failure
ACE inhibitor ADRs
Captopril (Capoten)
Orthostatic hypotension
dry non productive COUGH
hyperkalemia
angioedema
taste distortions
rash
ACE inhibitors contraindications
Captopril (Capoten)
teratogenic
liver disease w elevated liver enzymes
avoid NSAIDs
ACE inhibitors interventions and education
Captopril (Capoten)
avoid salt substitutes because they contain potassium
monitor BP before, during, after
warn about cough
monitor K+ for hyperkalemia
potassium serum normal range
3.5-5
ARBs prototype and others
Losartan (Cozaar)
Valsartan (Diovan), Irbesartan (Avapro)
ARBs EPA
Losartan (Cozaar)
Blocks vasoconstricting and aldosterone-secreting effects of angiotensin II
Increases renal blood flow
Vasodilation and retention of K+
ARBs therapeutic use
Losartan (Cozaar)
treatment of HTN
losartan can prevent strokes
diabetic neuropathy and heart failure
ARBs contraindications
Losartan (Cozaar)
teratogenic
children younger than 6
NSAIDs increase risk for renal complications
ARBs ADRs
Losartan (Cozaar)
angioedema
dizziness
hypotension
headache
insomnia
ARBs interventions and client education
Losartan (Cozaar)
monitor BP before, during, after
monitor potassium
monitor for angioedema
aldosterone antagonist prototype and others
Eplerenone (Inspra)
Spironolactone (Aldactone)
aldosterone antagonist EPA
Eplerenone (Inspra)
blocks aldosterone receptors thereby blocking effects of aldosterone
causes excretion of Na+ and water and retention of K+
aldosterone antagonist therapeutic use
Eplerenone (Inspra)
HTN and symptoms of heart failure following MI
aldosterone antagonist contraindications
Eplerenone (Inspra)
avoid other potassium raising meds
do not take if serum potassium >5
avoid if breastfeeding
caution in children
NSAIDs decrease affects
can cause lithium toxicity
aldosterone antagonist ADRs
Eplerenone (Inspra)
hyperkalemia
aldosterone antagonist interventions and education
Eplerenone (Inspra)
monitor BP
periodic blood levels - potassium, BUN and creatinine
avoid salt substitutes
hyperkalemia symptoms
palpitations
muscle twitching
weakness
paresthesia
diarrhea
slow irregular heart rate
direct renin inhibitors prototype
Aliksiren (Tekturna)
direct renin inhibitors EPA
Aliksiren (Tekturna)
Binds with renin thereby inhibiting activation of angiotensin I
vasodilation and urinary excretion of sodium and water
direct renin inhibitors therapeutic use
Aliksiren (Tekturna)
hypertension
direct renin inhibitors ADRs
Aliksiren (Tekturna)
diarrhea
indigestion
abdominal pain
angioedema
dry cough and hyperkalemia possible but less common
direct renin inhibitors contraindications
Aliksiren (Tekturna)
teratogenic
less than 18 years old
serum potassium >5
use of ACE inhibitors and ARBs
increases blood levels of atorvastatin
direct renin inhibitors intervention and education
Aliksiren (Tekturna)
monitor BP
monitor signs and symptoms of hyperkalemia
fatty foods can interfere with absorption
periodic blood levels - potassium, BUN and creatinine
avoid salt substitutes
calcium channel blockers prototype and others
Nifedipine (Adalat) or (Procardia)
Amlodipine (Norvasc)
Verapamil (Calan)
Diltiazem (Cardizem)
calcium channel blockers EPA
Nifedipine (Adalat) or (Procardia)
hypertension type exert effects on peripheral arterioles
Block calcium channels in vascular smooth muscles cells of peripheral arteries, causes vasodilation and decreased BP
calcium channel blockers therapeutic use
Nifedipine (Adalat) or (Procardia)
HTN or stable angina
calcium channel blockers ADRs
Nifedipine (Adalat) or (Procardia)
Reflex tachycardia
angina
Vasodilatory effects: headache, dizziness, facial flushing, peripheral edema and arrhythmias
Gingival hyperplasia
calcium channel blockers contraindications or indications
Nifedipine (Adalat) or (Procardia)
avoid in children
avoid if 2nd or 3rd degree heart block
interacts with seizure meds
grapefruit juice increases levels -> hypotension
calcium channel blockers interventions and education
Nifedipine (Adalat) or (Procardia)
monitor BP and heart rate
hold if systolic under 90
fall risk
peripheral edema might call for diuretic
regular dental checkups
avoid grapefruit
Alpha 1 blockers prototype and others
Doxazosin (Cardura)
Prazosin (Minipress)
Alpha 1 blockers EPA
Doxazosin (Cardura)
Block alpha1 receptors to cause venous and arteriolar dilation
Alpha 1 blockers therapeutic use
Doxazosin (Cardura)
HTN and benign prostatic hypertrophy (BPH)
Alpha 1 blockers ADRs
Doxazosin (Cardura)
orthostatic hypotension; reflex tachycardia, headache, dizziness
Alpha 1 blockers contraindications and interactions
Doxazosin (Cardura)
avoid in children
avoid in liver disease
contraindicated with viagra
Alpha 1 blockers intervention and education
Doxazosin (Cardura)
carefully monitor BP when changing positions
risk for falls due to orthostatic changes
stand up slowly
beta blockers prototype and others
Atenolol (Tenformin)
Metoprolol (Lopressor), Carvedilol (Coreg)
Beta blockers EPA
Atenolol (Tenformin)
Block beta1 receptors
decrease in HR and contractility
cardiac output and suppresses reflex tachycardia
Block beta 1 in kidney blocks renin release
Beta blockers therapeutic use
Atenolol (Tenformin)
HTN, angina, dysrhythmias, MI, heart failure
Beta blockers ADRs
Atenolol (Tenformin)
Bradycardia
heart failure
Rebound excitation with sudden withdrawal
Beta blockers contraindications and interactions
Atenolol (Tenformin)
bradycardia
1st degree heart block
heart failure
children <6
asthma or COPD
Beta blockers interventions and education
Atenolol (Tenformin)
monitor BP and HR
hold if systolic <90 and HR <60
do not stop abruptly
monitor heart failure - SOB, edema, coughing while orthopneic
Direct Acting Vasodilators prototype
Hydralazine
Direct Acting Vasodilators EPA
Hydralazine
Acts directly on arterioles to relax smooth muscle leading to vasodilation
Stimulates SNS, affecting heart rate
Direct Acting Vasodilators therapeutic use
Hydralazine
moderate to severe HTN
hypertensive crisis
Direct Acting Vasodilators interventions
Hydralazine
monitor BP
do not stop abruptly