Cardiovascular medications

Question 1

Anti-Hypertensive drugs

Anti-hypertensive drugs

Answer 1

used to treat hypertension aka high blood pressure.

Question 2

Hypotension or high blood pressure is classified as?

Answer 2

Elevated BP >160/90

Question 3

Hypertension can be..

Answer 3

Age related, genetics, caused by diet - high sodium’s and fats

Question 4

Hypertensive management:

Answer 4

First approach: lifestyle changes, reduce salt, fats and alcohol intake, promote exercise, cease smoking.
Second approach: Anti-hypertensive therapy - depending on age and gender, medical history and side effects

Question 5

Drug therapy consists of:

Answer 5

A - Ace Inhibitors
- Angiotensin Receptor Antagonists
- Alpha Antagonist/Blockers
B - Beta Blocker
C - Calcium Channel Antagonists
D - Diuretics
E - Endothelin Receptor Antagonists

Question 6

ACE INHIBITORS - (PRILS)

Answer 6

Prevent conversion of Angiotensin 1 to Angiotensin 2,
This decreases blood pressure
reduction in blood volume reduces blood pressure

Question 7

Examples of Ace Inhibitors:

Answer 7

• Captopril
• Perindopril
• Ramipril
• Quinapril

Question 8

Side effects of Ace Inhibitors:

Answer 8

• dizziness
• headaches
• dry cough (common at night and in women)
• risk of hyperkalemia (increase blood potassium level)

Question 9

ACE Inhibitors:

Answer 9

• Should be commenced at night to reduce complications of hypertension
• diuretics should be suspended
• cease potassium supplements
• most are daily with 24 hour effect
• extracted by kidneys

Question 10

ANGIOTENSIN RECEPTOR ANTAGONISTS (SARTANS)

Answer 10

• block angiotensin 2 receptors at receptor sites
• have similar effects as Ace inhibitors
• reduce side effects than Ace inhibitors - less chance of hyperkalemia or cough
• takes 4-6 weeks for maximum effect

Question 11

Examples of Angiotensin receptor antagonists:

Answer 11

Irbesartan - used to treat hypertension and heart disease

Question 12

Side effects ^ include:

Answer 12

• dizziness
• headaches
• hypotension
• GI upset

Question 13

ALPHA ANTAGONISTS (AZOSINS)

Answer 13

• block alpha receptors in blood vessels that cause vasoconstriction
• work by binding to and blocking alpha 1 receptors, which are located in the smooth muscle lining blood vessels in the prostate and in the neck of the bladder

Question 14

Examples of Alpha Bockers:

Answer 14

Prazosin (minipress) - treats high blood pressure, mild enlargement of prostate

Question 15

Side effects of Alpha Blockers include:

Answer 15

• postural hypotension
• nasal congestion
• pupil constriction
• fatigue
• erectile dysfunction
• diarrhea

Question 16

Alpha Blockers:

Answer 16

• gradual increase of dose minimalises side effects
• is administrated once daily
• educating the client on minimising of postural hypotension is important

Question 17

BETA BLOCKERS (OLOLS):

Answer 17

• block beta receptors in the heart, blood vessels, bronchi (also the pancreas, uterus, kidney, brain and liver)
• reduce cardiac output by reducing heart rate and stroke volume

Question 18

Examples of Beta Blockers:

Answer 18

• Atenolol (excreted by kidneys)
• Metoprolol (excreted by liver)
• Carvedilol
  These medications are used to treat high blood pressure, angina (heart related chest pain), irregular heartbeats)

Question 19

Side effects of Beta Blockers”

Answer 19

• insomnia
• depression
• hypotension
• bradyarrhythmia

Question 20

Beta Blockers:

Answer 20

• are not recommended as first line of therapy - not as effective as other anti-hypertensive drugs
• abrupt withdrawal causes rebound hypertension
• non-selective beta blockers can alter lipids and glucose levels in diabetes

Question 21

CALCIUM CHANNEL ANTAGONISTS:

Answer 21

• dopiness, verapamil and diltiazem effect the availability of calcium to the muscles of the heart and blood vessels

Question 22

Examples of Calcium Channel Antagonists:

Answer 22

• Nifedipine
• Amlodipine
• Verapamil
• Cardizem
  These medications are used to treat high blood pressure and prevent angina

Question 23

Side effects ^ include:

Answer 23

• hypotension
• bradycardia
• headaches
• facial flushing
• skin rash
• peripheral edema (venous pooling)

Question 24

Calcium Channel Antagonists:

Answer 24

• Nifedipine and Felodipine have short half life - can cause reflex tachycardia - sustained release overcome these problems
• DO NOT CRUSH

Question 25

DIURETCIS:

Answer 25

- reduce blood volume by excretion of water via kidneys - increase excretion of sodium and chloride - leads to decrease of Blood pressure - Thiazide (first choice with beta blockers), loop and potassium sparing diuretic groups - loop diuretics (freusemide) are useful for people with renal impairment - must be given early during the day

Question 26

Side Effects of Diuretics:

Answer 26

- dehydration - electrolyte imbalance - hypotension

Question 27

What are the Nursing considerations of hypertensive therapy?

Answer 27

- Assess Vital signs - lying, sitting and standing blood pressure assessment to determine postural hypotension (take bp on both arms) - Assess for signs and symptoms of hypertension - such as headaches, pitting oedema of legs, nocturia, lethargy, vision changes - monitor electrolytes if on diuretics - if on Ace Inhibitors monitor renal function - monitor patient's weight - monitor urine output - supervise ambulation if patient becomes faint

Question 28

ANTIARHYTHMIC DRUGS:

Answer 28

- AKA cardiac dysrhythmia medications - used to suppress abnormal rhythms of heart - atrial fibrillation, atrial flutter, ventricular tachycardia, ventricular fibrillation

Question 29

Dysrhythmia Physiology:

Answer 29

- abnormality in heart rhythm - can affect atria, ventricles or both - Bradycardia: <60 beats per minute - Tachycardia: 100-150 beats per minute - Flutter: 150-350 beats per minute - Fibrillation: >350 beats per minute

Question 30

Causes of Dysrhythmia:

Answer 30

- myocardial hypoxia - scarring - ischaemia -electrolyte imbalance - inflammation

Question 31

ANTIARRHYTHMIC DRUGS:

Answer 31

- alter the movement of ions across cell membranes in myocardium - suppress and stabalise excitable myocardium - most suited for rapid heartbeat or ectopic beats - four classes of agents - classes 1-4