Antihypertensives

Question 1

What is normal vs. hypertensive blood pressures?

Answer 1

Normal BP = 90-119/60-80

HTN BP = 140-159/81-100

Question 2

What are NONpharmacological interventions to lower BP?

Answer 2

Restrict salty foods intake (No more than 2g)
Restrict alcohol intake
Exercise
Stress Reduction
Weight reduction (about 10mmHg lost with each lb lost)

Question 3

What are some important points about Metoprolol (Lopressor/Toprol)?

Answer 3

Is a beta-blocker
Should not be used in the THIRD TRIMESTER of pregnancy
Is a CNS DEPRESSANT
Bronchodilater (So contraindications = Asthma, bronchospasm and COPD)
Check VS (specifically BP) before giving

Question 4

What are some important points with Methyldopa (Aldomet)?

Answer 4

Is an Alpha 2 AGONIST
Alpha 2 = Suppresses alpha 1 (so vasoDIALATES and slows HR and heart contractility)
Causes Na and water retention in HIGH doses (so normally used with a diuretic)
Can also treat pregnant induced HTN
Extra point: Clonidine (Catapress) is also a part of this group

Question 5

What are some important points with Prazosin (minipress)?

Answer 5

Is an Alpha Adrenergic Blocker (Alpha 1 blocker)
Alpha 1 = Sympathomimetic hormone (so blocking this causes parasympathetic effects)
Used for Benign prostate hyperplasia (BPH)
Causes CNS Depression (SE: Orthostatic hypotension, insomnia, vertigo, N/V/D, palpitations)
Monitor VS (Sudden drop in BP and sudden rise in HR should be reported)

Question 6

What are some important points with Valsartan (Diovan)?

Answer 6

Is an ARB
Similar to ACE Inhibitor EXCEPT:
Does NOT cause dry cough
IS TERATOGENIC (so DO NOT use in pregnancy)
Is K SPARING (So Hyperkalemia should be monitored)
INCREASES: Creatinine, bilirubin, AST and ALT (AST and ALT are both part of LFT’s and check liver function)
- So can cause renal and hepatic failure

Question 7

What are similar points between all anti-hypertensives?

Answer 7

Orthostatic HYPOtension
- So slowly switch between positions
Vasodialation
Hyper/hypokalemia
Dizziness, HA and N/V
Should be used with caution with renal and hepatic Dx
Should CLOSELY monitor BP (and watch 4 sudden drop in BP)
Increased CNS depressant effects w/ other CNS depressants
Increased hypotensive effects w/ other antihyertensives

Question 8

What are some important points with ACE Inhibitors?

Answer 8

Common root = -pril
Common SE = dry cough (bc it inhibits branokinen)
PROTECTS the kidneys (in DIABETICS ONLY)
Is K SPARRING (so HYPERkalemia should be monitored)

Question 9

What are the 2 groups of Calcium Channel Blockers? What are the difference between the two?

Answer 9

Group 1 = Verapamil and Diltiazem

 - ONLY lowers BP
 - Used for: Angina, HTN, Afib, and cardiac dysrhythmias

Group 2 = Amlodipine and Nifedipine

 - Lower BOTH HR and BP
 - Used for: Angina and HTN (EX: Good 4 pt's w/ tachycardia and HTN)
 - Reflex Tachycardia: Body tries to increase BP as a response to sudden decrease in HR (usually goes away after a while)