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561 Pharm > Treatment of Hypertension > Flashcards

Treatment of Hypertension Flashcards

1
Q

risks of HTN

A

stroke, heart failure, sexual dyfx, vision loss, heart attack, kidney disease/failure

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2
Q

risk factors for HTN

A

chronic alc
smoking
stress/anxiety
sedentary
genetic
sodium
caffeine
obesity
age

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3
Q

essential hypertension cause

A

unknown

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4
Q

secondary hypertension cause

A

concurrent medical condition
renal artery constriction
pheochromocytoma on adrenal glands
primary aldosteronism

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5
Q

BP equation

A

BP = CO x TPR
CO = SV x HR

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6
Q

BP categories

A

normal: <120/80
elevated: 120-129/80
HTN I: 130-139/80-89
HTN II: >140/>90
crisis: >180/120

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7
Q

stages of HTN med care

A
  1. lifestyle changes
  2. medication management
  3. multiple medications
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8
Q

non pharmacological treatment for HTN

A

dietary salt restriction
potassium supplementation
weight loss
DASH diet
aerobic exercise

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9
Q

Diuretic general MOA

A

act on kidneys to increase sodium and water excretion

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10
Q

types of diuretics and uses

A

thiazide: mild-mod HTN
loop: reduce edema NOT HTN
potassium sparing: weak anti HTN

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11
Q

diuretics site of action

A
  1. PCT: acetazolamide
  2. PCT/descending limb: osmotic diuretics
  3. ascending limb: loop diuretic
  4. DCT: thiazide type
  5. collecting duct: potassium sparing
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12
Q

thiazide MOA

A

inhibit sodium resorption in DCT

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13
Q

loop diuretics MOA and suffix

A

inhibit sodium and chloride reabsorption in loop
-semide

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14
Q

K+ sparing MOA and suffix

A

prevent K+ secretion
-one/-ene

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15
Q

side effects of diuretics

A

fluid loss: orthostatic HTN, mental changes, confusion, irritability
electrolyte imbalance: weakness/cardiac/GI/GLC metabolism/lipid metabolism disturbances; fatigue; hyponatremia/kalemia
hyperkalemia w K sparing

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16
Q

Renin angiotensin system function

A
  1. decreased BP
  2. kidney release Renin
  3. renin converts angiotensinogen to angiotensin I
  4. travels to lungs
  5. angiotensin converting NZ converts to angiotensin II vasoconstriction
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17
Q

effects of angiotensin II

3

A

vasoconstriction
release aldosterone increasing Na retention
stim ADH causing retention
induce thirst

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18
Q

ACE inhibitor MOA

A

inhibit ang II formation to decrease vasoconstriction/lower BP
limit aldosterone secretion to decrease retention

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19
Q

ACE inhibitor suffix

A

-pril

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20
Q

ACE inhibitor side effects

A

dry cough
hyperkalemia
acute kidney damage
angioedema
fetotoxic

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21
Q

angiotensin receptor blockers MOA

A

block ang II receptors to prevent vasoconstriction and aldosterone release

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22
Q

ARB suffix

A

-sartan

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23
Q

ARB side effects

A

less than ACE
fetotoxic
acute kidney damage
hyperkalemia

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24
Q

Calcium channel blocker MOA

A

block Ca entry into vascular cells and heart, causing influx of Ca into cells to activate calmodulin - MLCK - myosin binds actin and contracts
so blocking this reduces contraction

25
Q

CCBs side effects

A

dizziness
flushing
headache
fatigue
peripheral edema

26
Q

beta blocker MOA

A

bind beta 1 receptor on heart to block effects of NE and epi
decrease HR and CO for BP

27
Q

betablocker suffix

A

-olol

28
Q

non selective vs selective beta blockers

A

non selective can cause breathing issues bc active in lungs

29
Q

beta blocker side effects

A

bronchoconstriction
decreased HR/contractility
OH
depression
lethargy
decreased libido

30
Q

alpha blockers suffix

A

-osin

31
Q

alpha blockers MOA

A

block alpha 1 adrenergic receptor on vascular smooth muscle to decrease vascular resistance
causes reflex tachycardia needing beta blocker

32
Q

alpha 2 agonists drugs

A

clonidine
methyl-DOPA

33
Q

alpha 2 agonists MOA

A

stimulate alpha 2 receptors in brain to reduce sympathetic outflow
decrease HR, CO, vascular resistance

34
Q

alpha 2 agonists side effects

A

dry mouth
dizziness
sedation

35
Q

vasodilators drugs

A

hydralazine
minoxidil

36
Q

vasodilator MOA

A

directly relax arteriolar smooth muscle to vasodilate for lower BP
treat mod-servere HTN
activate K channels to increase efflux, hyper polarize smooth muscle to inhibit Ca influx and muscle contraction

37
Q

vasodilator side effects

A

reflex tachycardia
headache
OH

38
Q

renin inhibitors

A

like ACE/ARB
use when other drugs not working or in combo w others

39
Q

PT considerations for HTN

A

monitor BP for hyper/hypo
OH: monitor and be cautious w position changes
fatigue/dizzy: gradual progression of exercise and monitor intensity to prevent falls
exercise intensity: beta blockers blunt HR response to exercise
dehydration: diuretics, impact exercise tolerance/falls/hypotension
electrolyte imbalance: muscle weakness/cramp
pt education: side effects

40
Q

cardiac action potential

A

0: depolarization w Na channel opening influx
1: close fast Na channels for rapid repolarization
2: plateau w Ca influx and K efflux
3: repolarization K channels efflux open
4: rest

41
Q

Class I antiarrhythmics

A

block fast Na channels to increase AP duration, delay repolarization

42
Q

class I antiarrhythmics side effects

A

diarrhea, nausea, thrombocytopenia, torsades de pointes

43
Q

Class IB antiarrhythmics MOA

A

mild block of Na channels, accelerate repolarization
ventricular arrhythmics

44
Q

Class IB antiarrhythmics side effects

A

CNS effects, hypotension, nausea, tremor

45
Q

Class IC antiarrhythmics MOA

A

strong fast Na channel block
ventricular arrhythmias

46
Q

Class IC antiarrhythmics side effects

A

visual disturbances, dizziness, risk of proarrythmia, taste disturbance, constipation, headache

47
Q

Class II antiarrhythmia drugs

A

beta blockers
-olol
block beta adrenergic receptors reducing sympathetic effects
ventricular arrhythmias and atrial tachycardias

48
Q

Class III antiarrhythmics MOA

A

potassium channel blockers to delay repolarization

49
Q

Class III antiarrhythmics side effects

A

pulmonary toxicity, thyroid dysfunction, hepatotoxicity, corneal deposits

50
Q

Class IV antiarrhythmics MOA

A

block calcium channels in cardiac tissue
reduce HR by preventing next beat from firing as quickly
-one
-ilide

51
Q

adenosine

A

inhibit AV conduction short term, IV injection for SVT

52
Q

digoxin

A

reduce conduction through AV node
use to control atrial flutter/fib

53
Q

atropine

A

treat sinus bradycardia by blocking vagal effects on SA node

54
Q

PT considerations for pts with arrhythmias

A

monitor vitals
recognize side effects to avoid falls
pace/progression important bc decreased exercise tolerance
consider exercise type and avoid high CV load
pt education: side effects
knowledge of emergency procedures
coordinate w healthcare providers

55
Q

PT with Na channel blockers

A

monitor HR/rhythm, adapt intensity

56
Q

PT with beta blockers

A

use RPE to monitor exercise intensity bc blunted HR

57
Q

PT with K+ channel blockers

A

monitor EKG for torsades de pointes to respond to acute events

58
Q

PT with Ca channel blockers

A

monitor for OH, positional changes

561 Pharm (21 decks)

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