TOPIC 10 Flashcards
- can cause fluid loss through
urination, thus decreasing blood volume
and lowering blood pressure.
-Before giving monitor bp & hr
DIURETICS
- Corticosteroids
- oral contraceptives
- estrogen
- erythropoiesis
- sibutramine
DRUDS ASS W/ HTN
- Cushing syndrome
- hyperthyroidism
- chronic renal impairment
- pheochromocytoma
- arteriosclerosis
Diseases associated with elevated BP
- First line drugs for hypertension because the produce few adverse effects and are very effective at controlling mild to moderate hypertension
Diuretics
- Widely used in the treatment of hypertension and heart failure
Diuretics
most commonly used diuretic
Furosemide lasix
- Has been the mainstay for the pharmacotherapy of hypertension for a decade
Thiazide & like drugs
- Most prescribed diuretics for hypertension.
- Produces few adverse effects and is effective at producing a 10-20 mm Hg reduction in blood pressure
HYDROCHLOROTHIAZIDE (hydroDIURIL)
- Are inexpensive and most are available in generic formulations
- Safe drugs, with urinary potassium loss being the primary adverse effects hence monito K level
Thiazide
- Beneficial when clients are at risk of developing hypokalemia owing to their medical condition or to the used of thiazide or loop diuretics
- Produce only a modest diuresis
Potassium Sparring Diuretics
- Cause more diuresis and thus greater reduction in blood pressure, than the thiazide or potassium sparing diuretics
- Are not ideal agents for HTN maintenance therapy.
- Often reserved for more serious cases of hypertension
Loop diuretics
most commonly used k sparring diuretic
spironolactone (aldactone)
widespread use loop diuretics; prototype for heart failure
Furosemide (lasix)
used to treat angina pectoris, dysrythmias, and HTN
CCB
first approved in the treatment of ANGINA in 1980
CCB
- not used as monotherapy for htn
- promotes vasodilation
CBB
for mild to moderate HTN: CCB
AMLODIPINE (Norvasc)
stage 1 and 2, HTN, and ANGINA : CCB
FELODIPINE (plendil)
for essential HTN: CCB
NICARDIPINE ( cardene)
Are selective for calcium channels in arterioles
Nifedipine (Procardia)
Generally prescribed for HTN and variant or vasospastic angina
Nifedipine (Procardia)
Acts by selectively blocking calcium channel in myocardial and vascular smooth muscle
Nifedipine (Procardia)
Affect channels in both arterioles and the myocardium
Verapamil (Calan)
- For HTN, and angina pectoris
- Is featured as a prototype antidysrhythmic
Verapamil (Calan)
For antianginal
Diltiazem (Cardizem)
Flushed skin
headache
dizziness
Peripheral edema, edema
lightheadedness
Nausea and diarrhea
ADVERSE EFFECTS OF CCB FOR HTN
Hepatotoxicity
MI
Confusion
Mood changes
SERIOUS ADVERSE EFFECT OF CCB
Heart rate increases owing to the rapid fall in blood pressure created by the drug CCBs
REFLEX TACHYCARDIA
CCB contraindication
- Sinus sick syndrome
- 3rd degree AV block w/o pace maker
key homeostatic mechanism controlling blood pressure and fluid balance
Renin angiotensin system
Is approved to treat hypertension since 1980
Angiotensin Converting Enzyme (ACE)
- Key agents in the treatment of HTN
- block the effects of angiotensin Il, decreasing the blood pressure through two mechanisms:
1. lowering peripheral resistance
2. decreasing blood volume.
ACE inhibitors
Have become primary drugs for the treatment of heart failure and myocardial infarction.
ACE inhibitors
Persistent cough and postural HTN
Hyperkalemia- major concern for diabetics
Headache
orthostatic hypotension
rash
SIDE EFFECTS OF ACE INHIBITORS
- Development of angioedema- most often develop within hours or days after beginning ACE inhibitor therapy.
- Renal failure
*Angioedema & renal failure - first phenomenon
SERIOUS ADVERSE EFFECTS OF ACE INHIBITORS
life-threatening effect of ACE inhibitors
angioedema and can cause asphyxia
- paroxysm of dry cough
- stridor
symptoms of angioedema:
ACE is contraindicated
pregnancy
