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UNRS 113 > Antihypertensive > Flashcards

Antihypertensive Flashcards

1
Q

What is blood pressure?

A

The measure of how hard blood is pressing against artery walls

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2
Q

What is systolic pressure?

A

The maximum pressure felt on the artery during left ventricular contraction

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3
Q

What is diastolic pressure?

A

The resting pressure that blood exerts constantly between each contraction

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4
Q

What is the formula for finding blood pressure?

A

BP = Cardiac Output (CO) x Peripheral Vascular Resistance (PVR)

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5
Q

What are the classifications of blood pressure?

A

Normal
Prehypertension
Stage 1 Hypertension
Stage 2 Hypertension

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6
Q

What is the numeric value of normal blood pressure?

A

SBP < 120

DBP < 80

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7
Q

What is the numeric value of prehypertension?

A

SBP 120 - 139

DBP 80 - 89

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8
Q

What is the numeric value of stage 1 hypertension?

A

SBP 140 - 159

DBP 90 - 99

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9
Q

What is the numeric value of stage 2 hypertension?

A

SBP > 160

DBP > 100

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10
Q

What is primary hypertension also known as?

A

Essential/idiopathic hypertension

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11
Q

What is the cause of primary hypertension?

A

Unknown

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12
Q

What is the percentage of hypertension cases that is primary hypertension?

A

90% of cases

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13
Q

What is the percentage of hypertension cases that is secondary hypertension?

A

10% of cases

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14
Q

What are the consequences of untreated hypertension?

A

End organ damage:

  • Stroke
  • Heart failure
  • End stage renal failure
  • Coronary artery disease
  • Peripheral vascular disease
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15
Q

What are the classes of drugs used to treat hypertension?

A 
Diuretics
Drugs inhibiting RAAS (reninangiotensin aldosterone system)
Drugs inhibiting the SNS
Calcium channel blockers (CCB)
Direct-acting vasodilators
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16
Q

What are some lifestyle modifications to treat hypertension?

A 
Weight reduction
DASH eating plan
Dietary sodium restriction (decrease sodium intake)
Aerobic activity
Moderation of alcohol consumption
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17
Q

What is the mechanism of action of ACE inhibitors?

A

Blocks the conversion of angiotensin I to angiotensin II through inhibition of ACE, leading to vasodilation

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18
Q

What are the drug effects of ACE inhibitors?

A

Vasodilation (decreases afterload)
Excretion of sodium and water (decreases preload)
Renal protective

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19
Q

What are some ACE inhibitors?

A 
Captopril (Capoten)
Enalapril (Vasotec)
Lisinopril (Prinivil)
Ramipril (Altace)
Benazepril (Lotensin)
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20
Q

What is the suffix of ACE inhibitors?

A

-pril

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21
Q

What is the suffix of beta blockers?

A

-olol

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22
Q

What is the suffix of ARBS?

A

-sartan

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23
Q

What are the indications of ACE inhibitors?

A

Hypertension (especially those with renal disease)

24
Q

What are the contraindications of ACE inhibitors?

A

Previous reaction of angioedema

25
Q

What is angioedema?

A

Type of swelling that affects deeper layers of skin (swelling of lips, mouth, tongue)

26
Q

What are the adverse effects of ACE inhibitors?

A

Angioedema
Cough (dry)
Extra potassium (hyperkalemia)

27
Q

What is the mechanism of action of ARBs?

A

Block binding of angiotensin II to angiotensin II receptors which prevents vasoconstriction and aldosterone formation

28
Q

What are the drug effects of ARBs?

A

Vasodilation of arterioles (decreases afterload)

Excretion of sodium and water (decreases preload)

29
Q

What are some ARBs?

A

Iosartan (Cozaar)
Valsartan (Diovan)
Olmesartan (Benicar)

30
Q

What are indications of ARBs?

A

Antihypertensive for those who can not tolerate ACEI due to cough

31
Q

What are adverse reactions of ARBs?

A

Similar to ACE I except for cough
Hypotension
Angioedema
Hyperkalemia

32
Q

What is the mechanism of action of CCBs?

A

Prevents influx of calcium ion across cell membrane of vascular smooth muscle

33
Q

What are the drug effects of CCBs?

A

Dilation of peripheral and coronary arteries and arterioles (decreases afterload)

34
Q

What are some CCBs?

A 
Amlopdipine (Norvasc)
Diltiazem (Cardizem)
Nicardipine (Cardene)
Nifedipine (Procardia)
Verapamil (Calan)
35
Q

What are indications of CCBs?

A

Hypertension

Angina

36
Q

What is angina?

A

Chest pain caused when the heart doesn’t get enough oxygen-rich blood

37
Q

What are the adverse effects of CCBs?

A 
Constipation
Dizziness
Hypotension
Peripheral edema
Suppression of cardiac function
38
Q

What are the nursing implications of CCBs?

A

Monitor blood pressure

Monitor heart rate

39
Q

What should you teach patients concerning CCBs?

A

Change positions slowly
Avoid hazardous activities while dizzy
Increase fluid and fiber intake to prevent constipation

40
Q

What is the mechanism of action of beta blockers?

A

Prevent sympathetic stimulation of beta receptors in the heart which decreases heart rate (negative chronotropic), myocardial contractility (negative inotropic), and rate of conduction thorugh AV node (negative dromotropic)

41
Q

What are the drug effects of beta blockers?

A

Decreased cardiac output

42
Q

What are some cardioselective beta 1 blockers?

A

Metoprolol (Lopressor)
Atenolol (Tenormin)
Esmolol (Brevibloc)

43
Q

What are some nonselective beta 1 and beta 2 blockers?

A

Propranolol (Inderal)

Nadolol (Corgard)

44
Q

What are indications for beta blockers?

A

Hypertension

45
Q

What are contraindications of beta blockers?

A

Bradycardia
AV block
Asthma

46
Q

What are adverse effects of beta blockers?

A 
Dizziness
Bradycardia, AV block
Bronchoconstriction
Mask s/s of hypoglycemia in diabetics
Black Box Warning: rebound myocardium excitation
47
Q

What are the nursing implications for beta blockers?

A

Assess for contraindications
Assess vital signs (notify if HR <60)
Monitor s/s of decreased cardiac output

48
Q

What should you teach the patient concerning beta blockers?

A

Change positions slowly
Avoid hot tubs/showers due to vasodilation
Monitor glucose closely if diabetic
Do not stop abruptly (BBW: cause severe rebound hypertension)

49
Q

What is the mechanism of action and drug effect of alpha 1 and beta blockers?

A

Alpha 1 blockade promotes dilation of arterioles and veins

Beta 1 blockade reduces heart rate and contractility

Blockade of beta 1 receptors on justaglomerular cells suppresses release of renin

50
Q

What are some alpha 1 and beta 1 blockers?

A

Carvedilol (Coreg)

Labetalol (Trandate)

51
Q

What is the mechanism of action and drug effect of vasodilators?

A

Direct vasodilation of arteries and veins resulting in rapid reduction of blood pressure

52
Q

What are indications for vasodilators?

A

Hypertensive crisis

53
Q

What are adverse effects of vasodilators?

A

Excessive hypotension
Monitor EKG
Avoid prolonged use due to cyanide poisoning (BBW)

54
Q

What are examples of vasodilators?

A

Nitroprusside (Nitropress)

IV only

55
Q

What is end organ damage?

A

The damage to a target organ due to uncontrolled hypertension

56
Q

Why is hypertension called the “silent killer”?

A

There are no early signs and symptoms of hypertension

UNRS 113 (4 decks)

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