Test 3 Blood Pressure shi Flashcards
Which drugs affect the RAAS system?
ACE inhibitors
ARBs
Renin Inhibitors
What do ACE inhibitors end in ?
- pril
Except enaprilat
How do ACE inhibitors work
Act in the lungs to prevent ACE from converting angiotensin 1 to angiotensin 2
Leads to decrease in BP
Results in increase potassium and loss of sodium and fluid
Contraindications of ACE
Allergies
Impaired renal fx
Acute heart failure exacerbation
Salt/ volume depletion
Preg and lact
Black box warning for ACE
Angioedema
Fetal tox
Adverse effects of ACE inhibitors
Dizziness
Orthostatic Hypotension
GI
COUGH
Headache (angioedema
Hyperkalemia
What drugs are ACE inhibitors?
Benazepril
Captopril
Enalapril
Lisinopril
Captopril
What are ACE’s used for?
Hypertension
Heart failure
Left ventricular dysfx
Diabetic nephropathy
Which ACE has shortest half life?
Captopril
Used in prevention of ventricular remodeling after MI
Which ACE is available in both oral and parenteral?
Enalapril
IV route does not require cardiac monitoring
Improves pt chances of survival after MI
What do ARB’s end in?
-sartan
Examples of ARB’s
Azilsartan
Candesartan
Irbesartan
Losartan
Olmesartan
Telmisartan
Valsartan
How do ARB work?
Bind with angiotensin 2 in vascular smooth muscle and in adrenal cortex to block vasoconstriction and release of aldosterone
Lowers BP
Adverse affects of ARB’s
L- Low BP
O- Other (fatigue, headache, dizziness)
S- Swelling
A- Allergic Reactioin
R- Raised Potassium
T- Teratogenic
A- Acute kidney injury
N- Nasal congestion
Hyperkalemia
Hypoglycemia
Chest pain
Indications of ARB’s
Hypertension
Adjunctive drugs for treatment of HF
May be used alone or combination with other drugs liike diuretics
Contraindications of ARB’s
Allergy
Preg/ Lac
Drug interactions of ARB’s
NSAIDS- Decreased effectiveness
K+ containing drugs- risk for hyperkalemia
Lithium
What do renin inhibitors do?
Directly inhibits renin, leading to decreased plasma renin activity and inhibiting the conversion of angiotensinogen to angiotensin 1
What drug is a renin inhibitor?
Aliskiren
Adverse effect of renin inhibitor
Risk for hyperkalemia
Angioedema
Renal impairment
What should you monitor renin inhibitors for?
Potassium
Renal fx
What do calcium channel blockers end in?
-pine
most of them end in this but not all
What do calcium channel blockers do?
Decrease BP
Cardiac Work Load
Myocardial Oxygen Consumption
How do Calcium Channel Blockers work?
Inhibit movement of calcium ions across the membranes which alter action potential and block muscle cell contraction
Decreased heart contractibility
Decreased HR
Vasodilation
Adverse effects of Calcium Channel Blockers
Lowered BP
Bradycardia
Headache
AV Block
Abdominal discomfort
Peripheral edema
Hypotension
Calcium Channel Blocker examples
Amlodapine
Diltiazem
Felodipine
Verapamil
What are calcium channel blockers used for?
Angina
Hypertension
Dysrhythmias
Raynauds disease
Calcium channel blocker interactions
NO GRAPEFRUIT JUICE
Vasodilator indications
Severe hypertension
Refractory Hypertension
Hypertensive emergencies
What are the kinds of vasodilators?
Hydralazine
Minoxidil
Nitroglycerin
Nitroprusside
Calcium Channel Blockers too
How do vasodilators work?
Act. directly on smooth muscle to cause muscle relaxation, leading to vasodilation and drop in BP
Vasodilator side effects? (Nitroprusside)
Retrosternal pressure, palpitations, cyanide toxicity, diaphoresis, nausea, vomitting, hypotension
What is midodrine and what’s it used for?
BP raising agent
Used in treating orthostatic hypotension
Contraindications of Midodrine
Supine hypotension
Pheochromocytoma
Drug interactions of midoprine
Cardiac glycosides(digoxin)
Beta blockers
Alpha adrenergic agents
Corticosteroids
