Final: Hypertension

Question 1

Lisinopril

Answer 1

ACE-inhibitor

HTN, heart failure, diabetic nephropathy, post-MI

Contraindications: Impaired renal function

Adverse effects:
-Angioedema (emergent)
-Cough (dry, non-productive)
-Electrolyte imbalance (hyperkalemia)
First dose orthostasis, neutropenia (rare)

Drug-drug: things that worsen kidney function or increase potassium

Assess: Hypovolemia (dehydration), hyperkalemia (paresthesias), labs (K+, renal function), BP

Question 2

Propanolol

Answer 2

Slows, beta blocker

Contraindications: Asthma, COPD, DM, bradycardia, dysrhythmias

Adverse effects: Bradycardia, low BP, breathing problems, blood sugar masking (below 70), fatigue, sexual dysfunction, bad for worsening heart failure

Assess: Obtain baseline EKG, monitor pulse apically for one minute, monitor for CHF signs (weight gain, SOB, edema), slow position changes to prevent orthostasis, monitor blood sugar and follow DM regimen

Question 3

Furosemide

Answer 3

Potassium wasting diuretic

Assess: BP, BUN/Creat, K+ levels, signs of hypokalemia (paresthesia, muscle cramps, weakness)

Watch IV push rates, too fast = ototoxic

Question 4

Spironolactone

Answer 4

Potassium sparing diuretic

Adverse effects: Hyperkalemia (palpitations, chest pain, SOB, nausea), hyponatremia, EKG changes