Lecture Week 6 Cardiovascular System Flashcards by Isabel Ostroski

what is the ending of ACE inhibitors?

-pril

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what is the ending of Angiotensin II Receptor Blockers (ARBs)?

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what is the ending of calcium channel blockers?

-pine

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ACE inhibitor prototype and others

Captopril (Capoten)

Lisinopril, Enalopril, Ramipril

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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+

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ACE inhibitor therapeutic use

Captopril (Capoten)

treats hypertension and heart failure

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ACE inhibitor ADRs

Captopril (Capoten)

Orthostatic hypotension
dry non productive COUGH
hyperkalemia
angioedema
taste distortions
rash

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ACE inhibitors contraindications

Captopril (Capoten)

teratogenic
liver disease w elevated liver enzymes
avoid NSAIDs

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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

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potassium serum normal range

3.5-5

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ARBs prototype and others

Losartan (Cozaar)

Valsartan (Diovan), Irbesartan (Avapro)

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ARBs EPA

Losartan (Cozaar)

Blocks vasoconstricting and aldosterone-secreting effects of angiotensin II

Increases renal blood flow

Vasodilation and retention of K+

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ARBs therapeutic use

Losartan (Cozaar)

treatment of HTN

losartan can prevent strokes

diabetic neuropathy and heart failure

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ARBs contraindications

Losartan (Cozaar)

teratogenic
children younger than 6
NSAIDs increase risk for renal complications

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ARBs ADRs

Losartan (Cozaar)

angioedema
dizziness
hypotension
headache
insomnia

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ARBs interventions and client education

Losartan (Cozaar)

monitor BP before, during, after
monitor potassium
monitor for angioedema

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aldosterone antagonist prototype and others

Eplerenone (Inspra)

Spironolactone (Aldactone)

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aldosterone antagonist EPA

Eplerenone (Inspra)

blocks aldosterone receptors thereby blocking effects of aldosterone
causes excretion of Na+ and water and retention of K+

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aldosterone antagonist therapeutic use

Eplerenone (Inspra)

HTN and symptoms of heart failure following MI

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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

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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