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
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
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
4
Q
thiazide diuretics - nursing actions
A
- monitor potassium levels
- can give potassium supplements
- encourage food rich in potassium
5
Q
thiazide diuretics - drug
A
hydrochlorothiazide
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
7
Q
loop diuretics
A
- decreased fluid in the blood vessels = decreased cardiac output
- profound diuresis possible
- can be given PO or IV
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
9
Q
loop diuretics - side effects
A
- hypokalemia
- dehydration
- hypotension
- ototoxicity
10
Q
loop diuretics - nursing consideration
A
- monitor potassium levels
11
Q
hypokalemia
A
- low potassium
- loop and thiazide diuretics can cause potassium loss in the blood
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
13
Q
potassium-sparing duretics - drug
A
spironolactone
14
Q
potassium-sparing diuretics - MOA
A
- block the action of aldosterone (sodium and water retention
- potassium retention and excretion of sodium and water
15
Q
potassium-sparing diuretics - side effects
A
- endocrine effects
- deepened voice
- impotence
irregular menstrual cycles - gynecomastia
- hirsutism
16
Q
sympathyolytics
A
- sympathetic nervous system blockers
- decreased vasoconstriction
- decrease BP by decreasing peripheral vascular resistance
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
18
Q
beta blockers - MOA
A
- increases nitric oxide = vasodilation response
- blocks stimulation of beta 1 receptors = decreases HR and contractibility
19
Q
beta blockers - side effects
A
- fatigue/lethargy
- BRADYCARDIA
- HYPOTENSION
- can mask hypoglycemia
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
alpha-2 adrenergic agonist - nursing consideration
- do not discontinue abruptly
- rebound hypertension
26
alpha-2 adrenergic agonist - side effects
- drowsiness
- rebound HTN
- may worsen pre-existing liver disease
27
selective alpha-1 blockers - drug
doxazosin
28
selective alpha-1 blockers - MOA
- selective alpha-1 blockade
- venous and arterial dilation
29
selective alpha-1 blockers - side effects
- hypotension
- dizziness
30
ACE inhibitors
- 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
ACE inhibitors - drugs
captopril
lisinopril
32
ACE inhibitors - MOA
- blocks angiotensin-converting enzyme
- inhibits production of angiotensin-2
- inhibits aldosterone secretion (less water retention)
33
ACE inhibitors - side effects
- first dose hypotension
- dry, non productive, persistent cough
- dizziness
- rash
- angioedema
34
ACE inhibitors - nursing considerations
- renal insufficiency
- captopril can cause neutropenia
- risk of hyperkalemia
35
angiotensin receptor blockers (ARBs)
- do not use if pregnant
- given PO
36
angiotensin receptor blockers (ARBs) - drug
losartan
37
angiotensin receptor blockers (ARBs) - MOA
- blocks the action of angiotensin 2 AFTER it is formed
- causes vasodilation
- increased sodium and water excretion
38
angiotensin receptor blockers (ARBs) - side effects
- well tolerated
- some risk of angioedema
39
renin inhibitor - drug
aliskiren
40
renin inhibitor - MOA
- direct inhibition of renin
- induces vasodilation, decreases blood volume, decreases SNS, and inhibits cardiac and vascular hypertrophy
41
renin inhibitor - side effects
- relatively well tolerated
- GI discomfort
- when given with ACEi, watch for hyperkalemia
42
renin inhibitor - nursing consideration
- takes weeks to see full effect
- do not take while pregnant
- given PO
43
calcium channel blockers
- can be given PO or IV
- indicated for hypertension and chest pain
44
calcium channel blockers - drugs
- nifedipine
- nicardipine
- verapamil
- diltiazem
45
calcium channel blockers - side effects
- orthostatic hypotension
- peripheral edema
46
calcium channel blockers - nursing considerations
- best for elderly and African Americans
47
vasodilators - drug
hydralazine
48
vasodilators - MOA
- work directly on the arterial and venous smooth muscles and cause relaxation
49
vasodilators - side effects
- hypotension
- dizziness
- tachycardia
- edema
- dyspnea
- GI upset
