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Pharm 201 > Chapter 23 > Flashcards

Chapter 23 Flashcards

(49 cards)

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1
Q

Primary HTN

A

idiopathic

no known cause

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2
Q

Secondary HTN

A

caused by another disease

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3
Q

Peripheral Resistance

A

Friction in arteries as blood flows through vascular system
Autonomic nervous system plays a roll
greater resistance means greater BP

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4
Q

Blood Volume medications

A

Medications that affect blood volume may lower or raise B/P

ex: aldosterone

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5
Q

Vasomotor center

A

Reacts to information from baroreceptors & chemoreceptors to raise or lower blood pressure

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6
Q

Primary Antihypertensive Agents

A 
Diuretics
ACE inhibitors
Angiotensin II receptor blockers
Beta blockers
Ca channel blockers
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7
Q

Diuretics action

A

Decrease BP by inhibiting sodium & water retention by kidneys this decreases fluid volume

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8
Q

Negative effects of diuretics

A

Cause loss of electrolytes
Increase urine flow
Reduce blood volume and cardiac workload
Reduce edema and pulmonary congestion

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9
Q

Types of diuretics

A

Thiazide & thiazide-like (HCTZ)
Potassium-sparing (Spironolactone)
Loop (Lasix)

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10
Q

Thiazide & thiazide-like diuretics

A

1st line Tx
Relatively safe & inexpensive
Primary adverse effect: potassium loss

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11
Q

Potassium-sparing diuretics

A

Modest diuresis

Primary adverse effect: potassium retention Concurrent use with ACE or ARB increases risk of hyperkalemia

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12
Q

Loop diuretics

A

Produce most diuresis

Adverse effects: dehydration, potassium loss

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13
Q

SNS Neurotransmitters

A

Alpha 1, 2

Beta 1, 2

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14
Q

Alpha 1

A

1—receptors in Arteriole smooth muscle (vasoconstrict to increase BP)

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15
Q

Alpha 2

A

receptors in Brain—inhibits (regulates) CNS output of epinephrine

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16
Q

Beta 1

A

receptors in Heart rate & strength of contraction, Kidneys

Release renin

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17
Q

Beta 2

A

receptors in skeletal muscle, bronchioles of Lungs (bronchodilation),

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18
Q

Ca channel blockers for HTN

A

Safe & well tolerated, hold for HR < 60, BP < 90/60
Treat constipation
Good for elderly and african americans
not use as monotherapy

pine

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19
Q

Verapamil

A

Ca2+ blocker
Non-selective- both blood vessels & cardiac arterioles
Block ca channels on myocardium & vascular smooth muscles, AV node

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20
Q

Verapamil side effects

Study These Flashcards
A

HA, low BP, constipation, dysrhythmias, CHF, bradycardia, tachycardia, edema in feet & hands
constipation

21
Q

Verapamil effects

Study These Flashcards
A

↑ blood flow to the heart
↓ impulses through the AV node—
↓ workload of heart & slow heart rate; HTN, angina, dysrhythmias, atrial fibrillation

22
Q

Diltiazem

Study These Flashcards
A

Ca2+ blocker

blocks Ca+ channels in myocardium, relaxes coronary vessels & periphery-not in bowel Non-selective

23
Q

Diltiazem uses

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A

Atrial fibrillation, HTN, Angina, Vasospasm

24
Q

Diltiazem side effects

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A

vasodilation-HA, dizziness, dysrhythmias, peripheral edema, brady or tachycardia
Stevens-Johnson syndrome
Less constipation

25
DIPINES
Peripheral vessel calcium channel blockers | Block the myocardial & coronary arteries & peripheral vascular calcium channels
26
DIPINES side effects
BP < 90/60, dizziness, SOB Vasodilation, crackles, HA, dysrhythmias, peripheral edema, wt. gain, brady or tachycardia *Serious, life threatening  BP
27
ACE Inhibitors action
reduces levels of Angiotension II (a vasoconstrictor) & aldosterone lowers peripheral resistance & ↓ blood volume Reduces afterload Used in DM PT's
28
ACE inhibitors side effects
``` postural hypotension, hyperkalemia, renal failure Angioedema Cough Electrolyte imbalance ```
29
ACE inhibitors and African Americans
↑ risk for angioedema, can be fatal
30
Angiotension II Receptor Blockers-ARBs
"sartan" Often combined with other drugs for management HTN Used when PT can not use ACE inhibitor
31
ARBs action
Block receptors for angiotension II | Cause arteriolar dilation & increased sodium excretion
32
ARBs side effects
hypotension, rare angioedema
33
Adrenergic Antagonists
Betas work best for HTN
34
Beta–Adrenergic Blockers action
decrease heart rate and contractility ↓ conduction velocity through AV node Blockade of Beta 1-receptors in kidney which inhibits secretion of renin & formation of angiotension II
35
Beta–Adrenergic Blockers Indications
First-line drug for hypertension | Angina, Dysrhythmias, Heart failure, Myocardial infarction
36
Beta–Adrenergic Blockers considerations
Non-compliance-impotence & ↓ libido
37
Beta–Adrenergic Blockers
Selective (effect beta 1 only) and Non-selective effect beta 1 & 2) poor response in African Americans
38
“Olols, alols, ilols"
Beta blockers
39
Alpha 1- Adrenergic Blockers
"zosin" | Block sympathetic receptors in arterioles causing vasodilatation
40
Alpha 1- Adrenergic Blockers adverse effects
bradycardia, bronchoconstriction, fatigue, activity intolerance, dizziness, nausea, decreased libido Taper off to prevent rebound HTN
41
Alpha 1- Adrenergic Blockers nursing considerations
do not give within 4 hours of viagra
42
Alpha 2- Adrenergic Agonists action
decreases heart rate, BP & dilates arterioles
43
Alpha 2- Adrenergic Agonists adverse effects
sedation, dizziness, other CNS effects, nasal stuffiness
44
Vasodilators action
relaxes smooth muscles of blood vessels | Vasodilatation drops BP & increases water & sodium retention (leading to peripheral edema)
45
Vasodilators side effects
reflex tachycardia, sodium & water retention, dizziness, palpitations, CVA, BP hypotension
46
Calcium Channel Blockers “pine” uses
Used to treat HTN, Angina pectoris, dysrhythmias
47
Calcium Channel Blockers “pine” action
inhibit Ca+ from entering cell, limiting muscular contraction Relax arterial smooth muscle, ↓ peripheral resistance, ↓ BP ↓ automaticity in the SA node & slows myocardial (AV) conduction velocity ↓ heart rate & prolongs refractory period
48
Calcium Channel Blockers “pine” indications
safe & well tolerated Not used as monotherapy Useful for elderly & African American
49
ACE Inhibitors considerations
if tx is not working, check kidney function

Pharm 201 (24 decks)

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