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NUR325 > Medications to Treat Hypertension > Flashcards

Medications to Treat Hypertension Flashcards

1
Q

general diuretics MOA

A
  • increased urinary output
  • decreased circulating volume
  • decreased arterial resistance
  • lower BP by decreasing cardiac output
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2
Q

thiazide diuretics - MOA

A
  • works on the distal convoluted tubule to inhibit resorption of sodium, potassium, chloride = decreased cardiac output
  • water loss
  • relaxes arterioles = decreased peripheral resistance
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3
Q

thiazide diuretics - side effects

A
  • electrolyte and metabolic disturbances
  • hypokalemia (low potassium)
  • orthostatic hypotension
  • may worsen renal insufficiency
  • hyperuricemia
  • can elevate levels of glucose, cholesterol, and triglycerides
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4
Q

thiazide diuretics - nursing actions

A
  • monitor potassium levels
  • can give potassium supplements
  • encourage food rich in potassium
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5
Q

thiazide diuretics - drug

A

hydrochlorothiazide

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6
Q

thiazide diuretics

A
  • first line management of mild hypertension
  • can be used alone or in combination with other anti-hypertensives
  • usually given PO
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7
Q

loop diuretics

A
  • decreased fluid in the blood vessels = decreased cardiac output
  • profound diuresis possible
  • can be given PO or IV
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8
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 = more peeing out
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9
Q

loop diuretics - side effects

A
  • hypokalemia
  • dehydration
  • hypotension
  • ototoxicity
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10
Q

loop diuretics - nursing consideration

A
  • monitor potassium levels
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11
Q

hypokalemia

A
  • low potassium
  • loop and thiazide diuretics can cause potassium loss in the blood
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12
Q

potassium-sparing diuretics

A
  • only given PO
  • usually given in combination with other hypertensives/diuretics to get more effect
  • only provides a small amount of diuresis and hypotensive effect
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13
Q

potassium-sparing duretics - drug

A

spironolactone

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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

potassium-sparing diuretics - side effects

A
  • endocrine effects
  • deepened voice
  • impotence
    irregular menstrual cycles
  • gynecomastia
  • hirsutism
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16
Q

sympathyolytics

A
  • sympathetic nervous system blockers
  • decreased vasoconstriction
  • decrease BP by decreasing peripheral vascular resistance
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17
Q

beta adrenergic blockers (Beta-Blockers)

A
  • can be given PO or IV
  • beta 1 receptors are found in the heart
  • used to treat many cardiovascular diseases
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18
Q

beta blockers - MOA

A
  • increases nitric oxide = vasodilation response
  • blocks stimulation of beta 1 receptors = decreases HR and contractibility
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19
Q

beta blockers - side effects

A
  • fatigue/lethargy
  • BRADYCARDIA
  • HYPOTENSION
  • can mask hypoglycemia
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20
Q

beta blockers - nursing considerations

A
  • wean when discontinuing
  • possible REBOUND HTN if discontinued abruptly
  • non selective- do not use in patients with asthma or breathing problems
  • recognize risk for hypotension and/or bradycardia
21
Q

beta blockers - drugs

A
  • metoprolol (selective)
  • propranolol (non-selective)
  • carvedilol (alpha and beta blockers)
22
Q

alpha-2 adrenergic agonist - drug

A

clonidine

23
Q

alpha-2 adrenergic agonist

A
  • not first line treatment
  • can be given PO or transdermal
24
Q

alpha-2 adrenergic agonist - MOA

A
  • decreases sympathetic outflow resulting in decreased stimulation of adrenergic receptors
  • decreased blood pressure
25
Q

alpha-2 adrenergic agonist - nursing consideration

A
  • do not discontinue abruptly
  • rebound hypertension
26
Q

alpha-2 adrenergic agonist - side effects

A
  • drowsiness
  • rebound HTN
  • may worsen pre-existing liver disease
27
Q

selective alpha-1 blockers - drug

A

doxazosin

28
Q

selective alpha-1 blockers - MOA

A
  • selective alpha-1 blockade
  • venous and arterial dilation
29
Q

selective alpha-1 blockers - side effects

A
  • hypotension
  • dizziness
30
Q

ACE inhibitors

A
  • first line therapy for hypertension and heart failure
  • slows progression of left ventricular hypertrophy associated with HTN
  • drug of choice for DM
  • not safe during pregnancy
  • often given with thiazide diuretics
  • given PO
31
Q

ACE inhibitors - drugs

A

captopril
lisinopril

32
Q

ACE inhibitors - MOA

A
  • blocks angiotensin-converting enzyme
  • inhibits production of angiotensin-2
  • inhibits aldosterone secretion (less water retention)
33
Q

ACE inhibitors - side effects

A
  • first dose hypotension
  • dry, non productive, persistent cough
  • dizziness
  • rash
  • angioedema
34
Q

ACE inhibitors - nursing considerations

A
  • renal insufficiency
  • captopril can cause neutropenia
  • risk of hyperkalemia
35
Q

angiotensin receptor blockers (ARBs)

A
  • do not use if pregnant
  • given PO
36
Q

angiotensin receptor blockers (ARBs) - drug

A

losartan

37
Q

angiotensin receptor blockers (ARBs) - MOA

A
  • blocks the action of angiotensin 2 AFTER it is formed
  • causes vasodilation
  • increased sodium and water excretion
38
Q

angiotensin receptor blockers (ARBs) - side effects

A
  • well tolerated
  • some risk of angioedema
39
Q

renin inhibitor - drug

A

aliskiren

40
Q

renin inhibitor - MOA

A
  • direct inhibition of renin
  • induces vasodilation, decreases blood volume, decreases SNS, and inhibits cardiac and vascular hypertrophy
41
Q

renin inhibitor - side effects

A
  • relatively well tolerated
  • GI discomfort
  • when given with ACEi, watch for hyperkalemia
42
Q

renin inhibitor - nursing consideration

A
  • takes weeks to see full effect
  • do not take while pregnant
  • given PO
43
Q

calcium channel blockers

A
  • can be given PO or IV
  • indicated for hypertension and chest pain
44
Q

calcium channel blockers - drugs

A
  • nifedipine
  • nicardipine
  • verapamil
  • diltiazem
45
Q

calcium channel blockers - side effects

A
  • orthostatic hypotension
  • peripheral edema
46
Q

calcium channel blockers - nursing considerations

A
  • best for elderly and African Americans
47
Q

vasodilators - drug

A

hydralazine

48
Q

vasodilators - MOA

A
  • work directly on the arterial and venous smooth muscles and cause relaxation
49
Q

vasodilators - side effects

A
  • hypotension
  • dizziness
  • tachycardia
  • edema
  • dyspnea
  • GI upset

NUR325 (18 decks)

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