Chapter 22: Antihypertensive Drugs

Question 1

Goal of antihypertensive therapy

Answer 1

Reduce renal morbidity and mortality

Question 2

Which antihypertensive drug has a black box warning?

Answer 2

Aliskiren

Question 3

Which antihypertensive drug has asthma as a contraindication?

Answer 3

Carvedilol

Question 4

Which alpha 1 blocker is commonly prescribed?

Answer 4

Doxazosin ( cardura).

Treats: HTN and BPH.

Question 5

Which antihypertensive drug causes lesser degree is sexual dysfunction?

Answer 5

Nebivolol

Question 6

Which black box warning is given on Nitroprusside?

Answer 6

Hypotension

Question 7

What is true about calcium channel blockers (CCB)?

Answer 7

CCBs relax vascular smooth muscle.
It vasodilates the blood vessels to lower BP

Question 8

What is the appropriate site for clonidine patch application?

Answer 8

Upper arm

Question 9

What interaction can happen between an angiotensin II blocker and NSAID?

Answer 9

Decreased effect of angiotensin II receptor blocker

Question 10

Which medication will decrease vasoconstriction by blocking angiotensin II receptors?

Answer 10

Valsartan

Question 11

Which intervention is needed for a patient who is taking hydrochlothiazide?

Answer 11

Encourage intake of foods rich in potassium.

Question 12

What would the nurse teach the patient who is receiving transdermal clonidine?

Answer 12

Remove the old patch before applying new patch.

Question 13

Which is a priority for nursing intervention for patient who is prescribed nonselective beta blocker?

Answer 13

Respiratory assessment

Question 14

Treprostinil

Answer 14

An antihypertensive used to treat pulmonary artery hypertension related to severe heart failure

Question 15

Adverse effects of Hydralazine

Answer 15

Dizziness
Headache
Vomiting and diarrhea

Question 16

An adverse effect of ACE inhibitor that need immediate attention

Answer 16

Angioedema

Question 17

Which drug should be administered at bedtime for the first dose?

Answer 17

Doxazosin

Question 18

Which antihypertensive medication to avoid giving to a patient with DM?

Answer 18

Propranolol.

Because it can mask the indicators of hypoglycemia by blocking the sympathetic stimulation caused by low blood sugar.

Question 19

Side effect of Enalapril

Answer 19

Dry, hacking cough

Question 20

Which antihypertensive drug can be given to a patient with liver dysfunction?

Answer 20

Captopril and Lisinopril

Question 21

What adverse effect would happen if ACE inhibitor and Lithium are combined?

Answer 21

Toxic level of Lithium

Question 22

Common side effect of Clonidine

Answer 22

Constipation

Question 23

What is most important to assess in a patient receiving sodium nitroprusside infusion for 4 days?

Answer 23

Serum cyanide level.

Because cyanide toxicity can happen for prolonged treatment

Question 24

What is a nursing intervention for minoxidil toxicity?

Answer 24

Administer IV fluids.

Because minoxidil toxicity can cause excessive hypotension. IVF can counteract this.

Question 25

Which parameter would the nurse evaluate to determine effectiveness of lisinopril in a hypertensive patient with heart failure?

Answer 25

Breathing sounds. Because ACE inhibitors like lisinopril cause vasodilation which decreases after load and increase excretion of sodium and water. Breathing sounds should improve.

Question 26

Which medication would be given to treat hypertension after having an MI?

Answer 26

Eplerenone. This medication treats HTN and improves survival after MI.

Question 27

What action should the nurse perform for a patient who developed lisinopril toxicity?

Answer 27

Patient needs to be sent for hemodialysis as this toxicity will only respond to dialysis.

Question 28

What do Ace Inhibitors do?

Answer 28

- reduce after load - systemic vascular resistance (SVR) is decreased

Question 29

Which antihypertensives can cause tachycardia?

Answer 29

Diazoxide Hydralazine

Question 30

Which medications could cause interaction with ACE inhibitors?

Answer 30

Spironolactone Ibuprofen Potassium chloride

Question 31

What is contraindicated with captopril?

Answer 31

Spironolactone

Question 32

What is the antidote for Beta Blockers/ Calcium Channel Blockers?

Answer 32

Glucagon (makes you puke).

Question 33

Alpha 1 causes

Answer 33

Vasoconstriction

Question 34

Alpha 1 antagonist ( Doxazosin)

Answer 34

Vasodilation, lowers BP

Question 35

Alpha 2 causes

Answer 35

Calming effect, decrease BP. Example: Clonidine

Question 36

Clonidine

Answer 36

Lowers BP and HR by relaxing arteries.

Question 37

Selective Beta Blocker

Answer 37

Selectively blocks Beta 1 in the heart

Question 38

Non- Selective Beta Blocker

Answer 38

Blocks both Beta 1 & 2, Alpha 1.

Question 39

Contraindications of Nonselective Beta Blockers

Answer 39

Patients w/ COPD, asthma

Question 40

Natriuretic Peptides

Answer 40

Consists of ANP & BNP levels. They naturally decrease BP.

Question 41

BNP levels

Answer 41

Anything over 100 means heart failure .

Question 42

RAAS System (Renin Angiontensin Aldosterone System).

Answer 42

RAAS kicks in when it detects low blood volume and then increases BP.

Question 43

What happens when angiotensin 1 converts to angiontensin 2?

Answer 43

Angiotensin 2 causes vasoconstriction in the body. Therefore, BP is increased. Angiontensin 2 also stimulates Thirst.

Question 44

Aldosterone

Answer 44

Causes kidneys to retain Na & water, causing fluid retention. Therefore increase blood volume and BP. Outcome: patient decrease in urination

Question 45

ADH (Anti diuretic hormone)

Answer 45

Released by the pituitary gland. ADH causes kidneys to hold water.

Question 46

Aldosterone excretes ____

Answer 46

Potassium out of the body

Question 47

Vasodilators

Answer 47

A form of antihypertensives. 1. Hydralazine : treats HTN 2. Bosentan: helps lower BP in the lungs

Question 48

Which 2 classes of antihypertensives are Nephro & Cardio protective?

Answer 48

ACE inhibitors and ARBS. They slow progression of kidney failure, reduce cardiac work load and diabetes.

Question 49

Angiontensin 2 causes _________ in blood vessels

Answer 49

Constriction

Question 50

Rebound Hypertension

Answer 50

When you stop these medications abruptly, then BP comes back stronger. (Rubberband effect)

Question 51

Classes of AntiHypertensives

Answer 51

1. ACE inhibitors + ARBs 2. Beta Blockers 3. Calcium Channel Blockers (CCB) 4. Vasodilators

Question 52

ACE inhibitors -pril

Answer 52

Examples: enalapril, captopril, lisinopril Moa: prevents angiotensin 1 turning into 2 Cause: vasodilation (decrease BP and SVR). Also decreases Aldoesterone - causing excretion of Na + water, retains K. S/E: (ACE) Angioedema, Cough, Elevated K

Question 53

ARBs - sartan

Answer 53

Examples: losartan, candesartan, valsartan. Moa: blocks angiotensin 2 receptors. Cause: vasodilation (decrease BP, SVR). S/E: less likely to get angioedema or cough

Question 54

Beta Blocks - olol

Answer 54

Examples: metropolol, propanolol, carvedilol. Moa: blocks Beta 1 receptors (sympathetic). Cause: decrease HR & Bp, lower cardiac output and causes relaxation S/E: (B’s) Bradycardia, Breathing problems, Blood sugar masking, hypotension

Question 55

Calcium Channel Blockers - VND ( Very Nice Drugs)

Answer 55

Example: Verapamil, Nifedipine, Diltiazem Moa: blocks movement of calcium & decreasing contraction of the heart. Cause: calms vessels by blocking calcium. Decreases cardiac workload, increase oxygen to heart. S/E: bradycardia, AV blocks, peripheral edema.