Ch. 44 - Antihypertensives Flashcards Preview

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Flashcards in Ch. 44 - Antihypertensives Deck (22):
1

Sympatholytics (Sympathetic Depressants):

Beta-Adrenergic Blockers:
1.) Beta1 = preferred for HTN
2.) Use with a diuretic
3.) African American clients DO NOT respond well to beta-blockers

4.) Depress/supresss Sympathetic Nervous System

2

Example (CardioSELECTIVE beta 1):

Metoprolol:
1.) Blocks beta 1 receptors
2.) Diminish sympathetic n.s. response = vascular resistance is diminished = decrease BP

3

Metoprolol:

- PO (HTN)

- IV (MI)

SE:
1.) Fatigue, weakness, dizziness
2.) Drowsiness, HA, blurred vision
3.) Should not be D/C abruptly = rebound HTN

4

Examples: (Nonselective):

propranolol (Inderal):
-Reduce heart rate & force of contraction
-Bronchoconstriction

DO NOT USE FOR RESPIRATORY PT

5

Nonselective --- Side Effects:

1.) Decreased pulse rate

2.) Markedly decreased BP

3.) Nonselective:
-Bronchospasm
-Inhibits ability to convert glycogen to glucose (problem for diabetic pt)

6

Direct Acting Vasodilators (1):

Potent antihypertensive agents

ACTION:
-Directly dilates peripheral arterioles =  decrease BP

7

Direct Acting Vasodilators (2): ---- Give with....

Heart compensates:
-Palpitations, tachycardia

beta-adrenergic blocking agent to counteract effects of REFLEX TACHYCARDIA

8

Direct Acting Vasodilators (3): ---- Decreased BP.....

= sodium & water retention = peripheral edema

Diuretics

9

Direct Acting Vasodilators -Side Effects (many):

1.) Tachycardia, palpitations

2.) Edema, nasal congestion

3.) HA, dizziness

10

Angiotensin-Converting Enzyme (ACE) Inhibitors (1):

Interferes with conversion of angiotensin I to angiotensin II = Peripheral vasodilation

11

Angiotensin-Converting Enzyme (ACE) Inhibitors (2): --- Blocks....

release of aldosterone =
-Sodium excreted
-K+ retained

12

Angiotensin-Converting Enzyme (ACE) Inhibitors --- EX:

lisinopril (Prinivil, Zestril)

13

Angiotensin-Converting Enzyme (ACE) Inhibitors --- Side Effects:

1.) Irritating, dry cough

2.) n/v, diarrhea

3.) HA, dizziness, fatigue

4.) Hyperkalemia, tachycardia

14

Angiotensin-Converting Enzyme (ACE) Inhibitors --- Contraindications:

-Pregnancy = (decrease placental blood flow)

-Not to be taken with K+ sparing diuretics =  hyperkalemia

15

(ACE) Inhibitors --- Nursing interventions:

Monitor:
-Renal function
-Hypoglycemic reaction with DM clients

16

(ACE) Inhibitors --- Teach (1):

Do not:
-d/c abruptly
-Take if pregnant or contemplating pregnancy

How to take own BP & record

17

(ACE) Inhibitors --- Teach (2):

Dizzy/lightheaded 1st week of therapy

Take captopril (Capoten) 20 min – 1 hr before a meal

18

Calcium Channel Blockers:

Calcium:
-Increase myocardial heart contraction, peripheral restistance & blood pressure

Calcium blockers:
-Promote vasodilation = decrease BP

19

Calcium Channel Blockers -- Examples:

verapamil (Calan)
nifedipine (Procardia)

20

Calcium Channel Blockers -- Side Effects:

-HA
-Hypotension
-Dizziness, flushing

21

Nursing Process – Long Term Management (HTN) (1):

1.) Wt loss, exercise (aerobic)

2.) Stop smoking

3.) Avoid alcohol

4.) Coping with stress

5.) OTC = labels can be contraindcated

22

Nursing Process – Long Term Management (HTN) (2) ---- Teach:

Do not stop taking meds just because BP is down

Active in self care