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Pharmacology > Week 10 Antihypertensives > Flashcards

Week 10 Antihypertensives Flashcards

1
Q

hypertension that has no know causes

A

essential hypertension

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2
Q

hypertension that has a known cause

A

secondary hypertension

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3
Q

pressure in the cardiovascular system is determined by….

A

HR, Stroke Volume, and total peripheral resistance

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4
Q

Prototype drug of Ace inhibitors

A

captopril

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5
Q

Prototype drug of angiotensin II receptor blockers

A

losartan

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6
Q

Prototype drug of calcium channel blockers

A

diltiazem

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7
Q

what class does captopril belong to

A

ACE inhibitors

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8
Q

what class does Diltiazem belong to

A

Angiotensin II blockers

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9
Q

what class does losartan belong to

A

calcium channel blockers

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10
Q

Therapeutic Action: ACE inhibitors

A
  • Block the conversion of angiotensin I to angiotension II
  • Decrease in blood pressure and decrease in aldosterone
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11
Q

Indications: ACE inhibitors

A
  • HTN, HF, diabetic neuropathy, left ventricular dysfunction after MI
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12
Q

pharmacokinetics: ACE inhibitors

A
  • metabolized in liver, excreted in urine
  • cross placenta/ breastmilk
  • oral med; well absorbed & widely distributed
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13
Q

adverse effects: ACE inhibitors

A
  • unrelenting, nonproductive cough
  • effects of vasodilation and alterations in blood flow
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14
Q

contradictions: ACE inhibitors

A
  • impaired renal function, Heart failure, salt/fluid volume depletion, pregnancy/ lactation
  • allergy to med
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15
Q

Drug-drug interaction: ACE inhibitors

A
  • Risk for decreased antihypertensive effects if taken w/ NSAIDs
  • DO NOT combine w/ other RAAS altering drugs> ACE inhibitors, ect
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16
Q

nursing consideration: ACE inhibitors

A
  • Assess HR, BP, ECG, perfusion, electrolytes, renal function tests
  • encourage pt to implement lifestyle changes
  • Administer on an empty stomach
  • monitor pts closely for a drop in fluid volume to detect and treat hypotension
17
Q

Therapeutic actions: Angiotensin II receptor blocker

A
  • Selectively blocks the binding of angiotensin II to specific tissue receptors in vascular smooth muscle
  • Blocks vasoconstriction and the release of aldosterone associated with the RAAS
18
Q

Indications: Angiotensin II receptor blocker

A
  • Alone as part of combination therapy for HTN
  • Diabetic neuropathy in pts w/ type 2 diabetes and hypertension
19
Q

pharmacokinetics: Angiotensin II receptor blocker

A
  • Metabolized in liver, excreted in urine & feces
  • crosses placenta, unknown about breastmilk
  • oral med; well absorbed
20
Q

Adverse effect: Angiotensin II receptor blocker

A
  • adverse effects related to effects of decreased BP; dizziness, fainting, fever, muscle pain, diarrhea, abdominal pain, headache
  • associated w/ renal failure
21
Q

contradictions: Angiotensin II receptor blocker

A
  • Allergy
  • pregnancy/ lactation
  • renal/ hepatic dysfunction
  • hypovolemia; blocking compensatory mechanisms could lead to more complications
22
Q

drug-drug interactions: Angiotensin II receptor blocker

A
  • loss of effectiveness if taken in combination w/ phenobarbital, indomethacin, rifamycin, ketoconazole, fluconazole, or diltiazem
  • DO NOT combine w/ other RAAS altering drugs
23
Q

Nursing considerations: Angiotensin II receptor blocker

A
  • Assess HR, BP, ECG, perfusion, electrolytes, renal function tests
  • encourage pt to implement lifestyle changes
  • Administer w/out regard to meals
  • ensure females who are pregnant/ breastfeeding or may be pregnant do not start taking med
  • monitor pt for drop in fluid volume/ excessive hypotension
24
Q

Therapeutic actions: Calcium channel blockers

A
  • Inhibit the mov’t of calcium ions across the membranes of myocardial and arterial muscle cells, altering the action potential and blocking muscle cell contraction
  • decreased BP, cardiac workload, and myocardial oxygen consumption
25
Q

indication: Calcium channel blockers

A
  • Essential HTN in the extended- release form
26
Q

pharmacokinetics: Calcium channel blockers

A
  • Metabolized in liver, excreted in urine
  • crosses the placenta/ detected in breastmilk
  • oral med; well absorbed
27
Q

adverse effects: Calcium channel blockers

A

-mostly related to the effect on cardiac output and smooth muscle; dizziness, bradycardia, AV block, flushing, n/v, peripheral edema

28
Q

contradictions: Calcium channel blockers

A
  • Heart block; could be exacerbated by slowing effect
  • allergy
  • renal/hepatic dysfunction
  • pregnancy/ lactation
29
Q

drug-drug interactions: Calcium channel blockers

A
  • Increase in serum levels and toxicity of cyclosporine is possible if taken w/ diltiazem
30
Q

nursing considerations: Calcium channel blockers

A

-Assess for contradictions, cautions, and adverse effects
- Assess HR, BP, ECG, perfusion, electrolytes, renal function tests
- encourage pt to implement lifestyle changes
- avoid grapefruit juice; can increase to toxic levels
- Monitor pts BP closely if the pt is also taking nitrates; increased risk of hypotensive episode

31
Q

children considerations

A
  • Institute lifestyle changes before drug therapy if possible
  • Treatment should be done carefully, long-term effects of antihypertensive agents are unknown
  • Safety and efficacy of ACE inhibitors and ARBs have not been established in children
  • Calcium channel blockers may be a first consideration if drug therapy is needed
32
Q

adult considerations

A
  • Stress the importance of other measures to help lower BP (wt loss, diet, exercise, smoking cessation)
  • Evaulate the interacting effects of other drugs they are taking
  • Saftey precautions in hot weather or with conditions that cause fluid depletion(v/d)
  • ACE inhibitors and ARBs should NOT be used during pregnancy
33
Q

older adult considerations

A
  • More susceptible to toxic effects
  • Careful attention to drug-drug interactions
  • more likely to have underlying conditions that impact metabolism and excretion
34
Q

ace inhibitor suffix

A

“pril”

35
Q

angiotensin II receptor blocker suffixes

A

“artans”

Pharmacology (13 decks)

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