Wk 13. Anti-Hypertension meds Flashcards
- What should the nurse check before administering antihypertensives?
Blood pressure and pulse
- Antihypertensive agents should be given for what period of time?
Lifelong
- What is the systolic blood pressure range for prehypertension?
120-139
- What side effect may occur with the coadministration of an antihypertensive drug with another antihypertensive drug or diuretic?
Hypotension
- Which drug classification is the first-line therapy for hypertension?
Thiazides.
- How do thiazide diuretics affect blood vessels?
Arteriole dilation.
- What are three effects of beta-blockers on the heart?
Decreased heart rate, AV block, decreased contractility
- Name two ways beta-blockers affect diabetic patients.
Block glycogenolysis. Mask symptoms of hypoglycemia.
- What hormone do beta1-blockers block?
Renin
- What is the suffix for beta-blockers?
“olol”
- Alpha1-blockers cause what? What disease may they be used for and why? Why are they seldom used?
Vasodilation of arterioles and veins. Benign prostatic hypertrophy, because it relaxes the smooth muscle of the prostatic capsule and bladder neck. Increased number of CV events.
- By what mechanism do alpha2-agonists decrease blood pressure? What side effects disappear over time?
Decrease sympathetic outflow from brainstem and decrease norepinephrine release. Dry mouth and sedation.
- Which alpha2-agonist is commonly-used for hypertension that starts during pregnancy?
Methyldopa (Aldomet).
- Direct-acting vasodilators may cause what two important adverse effects? What drug category is used to prevent this?
Reflex tachycardia and renin release. Treat with beta-blockers.
- Which calcium channel blockers should not be given with beta-blockers? Why?
Diltiazem and verapamil. Suppresses heart function in persons with heart disease.
- How does grapefruit juice affect calcium channel blocker serum levels? What are the effects?
Raise calcium channel blocker serum levels. Raise heart rates in dihydropyridines and decrease heart rates with verapamil or diltiazem.
- Direct renin inhibitors prevent what? Why is it used?
Renin from binding with the receptor. Hypertension.
- What is a common electrolyte disturbance caused by ACEIs?
Hyperkalemia
- The patient on an ACEI asks you whether he should use salt or salt substitute. What do you say?
Check to make sure that the salt substitute does not have potassium, which may increase potassium levels to an unsafe level.
- ACEIs cause vasodilation of which blood vessels? Which vasodilates the most?
Arterioles and veins. Arterioles.
- ACEIs and ARBs are the only hypertensive drugs contraindicated for what?
Pregnancy
- Why would a patient be encouraged to lie down prior to the first dose of an ACEI?
First dose hypotension
- What category of diuretics should a person on ACEIs avoid?
Potassium-sparing diuretics
- What is the suffix for ACE inhibitors (ACEIs)
“pril”
- What side effect of ACE inhibitors commonly leads to the discontinuation of these drugs?
Persistent, nonproductive cough
- How do ARBs work?
Block angiotensin II receptors.
- What is the suffix for angiotensin II receptor blockers (ARBs)?
“sartan”
- What are the adverse effects of angiotensin II receptor blockers (ARBs)?
Hypotension, fatigue, headache, dizziness, diarrhea, rare angioedema.
- How does spironolactone (Aldactone) work?
Blocks aldosterone receptors
- Spironolactone (Aldactone) may cause gynecomastia by interfering with what?
Steroid hormones like progesterone, androgens, corticosteroids
- Spironolactone (Aldactone) may cause what electrolyte disturbance?
Hyperkalemia
- How does blocking aldosterone affect the sodium stores of the body? How might this influence lithium?
Promotes sodium loss which lowers body sodium stores. Prevents excretion of lithium.
- Sodium nitroprusside (Nitropress) vasodilates which blood vessels?
Arterioles and veins
- Why is nitroprusside (Nitropress) used?
Emergency treatment of severely elevated blood pressure
- What blood levels are monitored with sodium nitroprusside (Nitropress) use?
Thiocyanate levels
