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Pharmacology > 39. Antihypertensives > Flashcards

39. Antihypertensives Flashcards

1
Q

normal BP

A

<120 and <80 mmHg

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2
Q

elevated BP

A

120-129/ <80 mmHg

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3
Q

HTN stage 1

A

130-139 or 80-89 mmHg

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4
Q

HTN stage 2

A

> 140 or > 90 mmHg

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5
Q

What must be done prior to labeling someone w/ HTN?

A

use an average based on 2 or more readings obtain on 2 or more occasions

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6
Q

cultural considerations for HTN medications

A
  • ACE inhibitors and beta blockers may be less effective in African Americans
  • Asian Americans are more sensitive to beta blockers and may need a lower dose
  • Native Americans have a reduced response to beta blockers
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7
Q

nonpharmacologic control of HTN

A
  • exercise independent of weight loss lowers BP about 8 mmHg
  • salt and caffeine restrictions
  • decrease alcohol
  • smoking cessation
  • weight loss 10 lbs lower BP about 8 mmHg
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8
Q

MOA of metoprolol

A

promotes blood pressure reduction via cardio selective beta-blocking effect: reduce HR, contractility, and renin release

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9
Q

Use of metoprolol

A
  • control HTN
  • acute MI
  • angina
  • heart failure
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10
Q

side effects and adverse effects of metoprolol

A
  • fatigue/weakness
  • blurred vision
  • insomnia
  • ED (reason for not adhering to med)
  • peripheral edema
  • tinnitus
  • depression/bradycardia
  • hypotension
  • stroke
  • thrombocytopenia
  • DM
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11
Q

life threatening adverse effects of metoprolol

A
  • AV heart block
  • bronchospam
  • agranulocytosis
  • HF
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12
Q

What medications should patients taking metoprolol avoid?

A

NSAIDs

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13
Q

patient teaching and safety for metoprolol

A
  • do NOT abruptly withdrawal

- monitor pulse and BP (don’t give if pulse < 60)

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14
Q

What type of medication is prazosin hydrochloride?

A

alpha-adrenergic blocker

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15
Q

MOA of prazosin

A

dilates peripheral blood vessels by blocking alpha-adrenergic receptors

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16
Q

side effects and adverse effects of prazosin

A
  • orthostatic hypotension
  • tachycardia
  • pancreatitis
  • elevated LFTs
  • dry mouth
  • ED
  • urinary incontinence
  • tinnitus
17
Q

What is first dose phenomenon w/ prazosin?

A
  • results in orthostatic hypotension, palpitations, dizziness, and syncope 1-3 hours after first dose
  • take at bedtime to reduce effect
18
Q

What can intensify hypotension when taking prazosin

A

alcohol

19
Q

patient teaching for prazosin

A

risk for rebound HTN with abrupt withdrawal

20
Q

What type of medicine is Lisinopril

A

angiotensin-converting enzyme inhibitor (ACE-i)

21
Q

MOA of Lisinopril

A
  • inhibits conversion of Ang I to Ang II -> blocks release of aldosterone
  • lowers peripheral resistance
  • little change in cardiac output or HR
22
Q

Uses of Lisinopril

A
  • HTN
  • MI
  • HF
23
Q

side effects and adverse effects of lisinopril

A
  • hypotension
  • headache
  • dizziness
  • syncope
  • hyperkalemia
  • dry hacking cough (due to bradykinin)
  • angioedema
24
Q

Why should lisinopril not be given during pregnancy

A
  • 1st trimester: cardiac malformation can occur

- 2nd and 3rd trimesters: impaired renal function

25
Q

What type of medicine is Losartan

A

angiotensin II receptor blockers (ARBs)

26
Q

MOA of losartan

A

inhibits binding of angiotensin II -> prevents release of aldosterone

27
Q

uses of losartan

A
  • HTN

- diabetic neuropathy w/ elevated CRE and proteinuria

28
Q

side effects/adverse effects of losartan

A
  • weakness
  • dizziness
  • cough
  • hypotension
  • anemia
  • angioedema
  • hyperkalemia
29
Q

Why should Losartan not be used in pregnancy

A

causes injury and death to fetus

30
Q

What type of medicine is Diltiazem

A

calcium channel blocker

31
Q

MOA of diltiazem

A

block calcium channel in vascular smooth muscle to promote vasodilation (free Ca increases muscle contractility, peripheral resistance, and BP)

32
Q

uses of diltiazem

A
  • HTN
  • angina
  • dysrhythymia
33
Q

contraindications for diltiazem

A
  • pt on beta blockers
  • heart failure w/ reduced ejection fraction
  • sinus node dysfunction
  • 2nd or 3rd degree AV block WITHOUT a pacemaker
34
Q

side effects/adverse effects of diltiazem

A
  • peripheral edema
  • dizziness
  • dyspepsia
  • bradycardia
  • hypotension

Pharmacology (22 decks)

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