Lecture Week 6 Cardiovascular System

Question 1

what is the ending of ACE inhibitors?

Answer 1

-pril

Question 2

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

Answer 2

• tan

Question 3

what is the ending of calcium channel blockers?

Answer 3

-pine

Question 4

ACE inhibitor prototype and others

Answer 4

Captopril (Capoten)

Lisinopril, Enalopril, Ramipril

Question 5

ACE inhibitor EPA

Captopril (Capoten)

Answer 5

Block enzyme that converts angiotensin I to angiotensin II

decreases vasoconstriction, & aldosterone

reduces retention of sodium and water

leads to vasodilation & retention of K+

Question 6

ACE inhibitor therapeutic use

Captopril (Capoten)

Answer 6

treats hypertension and heart failure

Question 7

ACE inhibitor ADRs

Captopril (Capoten)

Answer 7

Orthostatic hypotension
dry non productive COUGH
hyperkalemia
angioedema
taste distortions
rash

Question 8

ACE inhibitors contraindications

Captopril (Capoten)

Answer 8

teratogenic
liver disease w elevated liver enzymes
avoid NSAIDs

Question 9

ACE inhibitors interventions and education

Captopril (Capoten)

Answer 9

avoid salt substitutes because they contain potassium
monitor BP before, during, after
warn about cough
monitor K+ for hyperkalemia

Question 10

potassium serum normal range

Answer 10

3.5-5

Question 11

ARBs prototype and others

Answer 11

Losartan (Cozaar)

Valsartan (Diovan), Irbesartan (Avapro)

Question 12

ARBs EPA

Losartan (Cozaar)

Answer 12

Blocks vasoconstricting and aldosterone-secreting effects of angiotensin II

Increases renal blood flow

Vasodilation and retention of K+

Question 13

ARBs therapeutic use

Losartan (Cozaar)

Answer 13

treatment of HTN

losartan can prevent strokes

diabetic neuropathy and heart failure

Question 14

ARBs contraindications

Losartan (Cozaar)

Answer 14

teratogenic
children younger than 6
NSAIDs increase risk for renal complications

Question 15

ARBs ADRs

Losartan (Cozaar)

Answer 15

angioedema
dizziness
hypotension
headache
insomnia

Question 16

ARBs interventions and client education

Losartan (Cozaar)

Answer 16

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

Question 17

aldosterone antagonist prototype and others

Answer 17

Eplerenone (Inspra)

Spironolactone (Aldactone)

Question 18

aldosterone antagonist EPA

Eplerenone (Inspra)

Answer 18

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

Question 19

aldosterone antagonist therapeutic use

Eplerenone (Inspra)

Answer 19

HTN and symptoms of heart failure following MI

Question 20

aldosterone antagonist contraindications

Eplerenone (Inspra)

Answer 20

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

Question 21

aldosterone antagonist ADRs

Eplerenone (Inspra)

Answer 21

hyperkalemia

Question 22

aldosterone antagonist interventions and education

Eplerenone (Inspra)

Answer 22

monitor BP
periodic blood levels - potassium, BUN and creatinine
avoid salt substitutes

Question 23

hyperkalemia symptoms

Answer 23

palpitations
muscle twitching
weakness
paresthesia
diarrhea
slow irregular heart rate

Question 24

direct renin inhibitors prototype

Answer 24

Aliksiren (Tekturna)

Question 25

direct renin inhibitors EPA Aliksiren (Tekturna)

Answer 25

Binds with renin thereby inhibiting activation of angiotensin I vasodilation and urinary excretion of sodium and water

Question 26

direct renin inhibitors therapeutic use Aliksiren (Tekturna)

Answer 26

hypertension

Question 27

direct renin inhibitors ADRs Aliksiren (Tekturna)

Answer 27

diarrhea indigestion abdominal pain angioedema dry cough and hyperkalemia possible but less common

Question 28

direct renin inhibitors contraindications Aliksiren (Tekturna)

Answer 28

teratogenic less than 18 years old serum potassium >5 use of ACE inhibitors and ARBs increases blood levels of atorvastatin

Question 29

direct renin inhibitors intervention and education Aliksiren (Tekturna)

Answer 29

monitor BP monitor signs and symptoms of hyperkalemia fatty foods can interfere with absorption periodic blood levels - potassium, BUN and creatinine avoid salt substitutes

Question 30

calcium channel blockers prototype and others

Answer 30

Nifedipine (Adalat) or (Procardia) Amlodipine (Norvasc) Verapamil (Calan) Diltiazem (Cardizem)

Question 31

calcium channel blockers EPA Nifedipine (Adalat) or (Procardia)

Answer 31

hypertension type exert effects on peripheral arterioles Block calcium channels in vascular smooth muscles cells of peripheral arteries, causes vasodilation and decreased BP

Question 32

calcium channel blockers therapeutic use Nifedipine (Adalat) or (Procardia)

Answer 32

HTN or stable angina

Question 33

calcium channel blockers ADRs Nifedipine (Adalat) or (Procardia)

Answer 33

Reflex tachycardia angina Vasodilatory effects: headache, dizziness, facial flushing, peripheral edema and arrhythmias Gingival hyperplasia

Question 34

calcium channel blockers contraindications or indications Nifedipine (Adalat) or (Procardia)

Answer 34

avoid in children avoid if 2nd or 3rd degree heart block interacts with seizure meds grapefruit juice increases levels -> hypotension

Question 35

calcium channel blockers interventions and education Nifedipine (Adalat) or (Procardia)

Answer 35

monitor BP and heart rate hold if systolic under 90 fall risk peripheral edema might call for diuretic regular dental checkups avoid grapefruit

Question 36

Alpha 1 blockers prototype and others

Answer 36

Doxazosin (Cardura) Prazosin (Minipress)

Question 37

Alpha 1 blockers EPA Doxazosin (Cardura)

Answer 37

Block alpha1 receptors to cause venous and arteriolar dilation

Question 38

Alpha 1 blockers therapeutic use Doxazosin (Cardura)

Answer 38

HTN and benign prostatic hypertrophy (BPH)

Question 38

Alpha 1 blockers ADRs Doxazosin (Cardura)

Answer 38

orthostatic hypotension; reflex tachycardia, headache, dizziness

Question 39

Alpha 1 blockers contraindications and interactions Doxazosin (Cardura)

Answer 39

avoid in children avoid in liver disease contraindicated with viagra

Question 40

Alpha 1 blockers intervention and education Doxazosin (Cardura)

Answer 40

carefully monitor BP when changing positions risk for falls due to orthostatic changes stand up slowly

Question 41

beta blockers prototype and others

Answer 41

Atenolol (Tenformin) Metoprolol (Lopressor), Carvedilol (Coreg)

Question 42

Beta blockers EPA Atenolol (Tenformin)

Answer 42

Block beta1 receptors decrease in HR and contractility cardiac output and suppresses reflex tachycardia Block beta 1 in kidney blocks renin release

Question 43

Beta blockers therapeutic use Atenolol (Tenformin)

Answer 43

HTN, angina, dysrhythmias, MI, heart failure

Question 44

Beta blockers ADRs Atenolol (Tenformin)

Answer 44

Bradycardia heart failure Rebound excitation with sudden withdrawal

Question 45

Beta blockers contraindications and interactions Atenolol (Tenformin)

Answer 45

bradycardia 1st degree heart block heart failure children <6 asthma or COPD

Question 46

Beta blockers interventions and education Atenolol (Tenformin)

Answer 46

monitor BP and HR hold if systolic <90 and HR <60 do not stop abruptly monitor heart failure - SOB, edema, coughing while orthopneic

Question 47

Direct Acting Vasodilators prototype

Answer 47

Hydralazine

Question 48

Direct Acting Vasodilators EPA Hydralazine

Answer 48

Acts directly on arterioles to relax smooth muscle leading to vasodilation **Stimulates SNS, affecting heart rate**

Question 49

Direct Acting Vasodilators therapeutic use Hydralazine

Answer 49

moderate to severe HTN hypertensive crisis

Question 50

Direct Acting Vasodilators interventions Hydralazine

Answer 50

monitor BP do not stop abruptly