HTN Drugs Flashcards by Kaelyn Willms

Diuretics

Indications

hypertension, HF

How well did you know this?

Not at all

Perfectly

Diuretics

Mechanism of action

reduce blood volume

lower BP

How well did you know this?

Not at all

Perfectly

Diuretics

Adverse affects

Hyponatremia (low sodium in blood)

Hypokalemia (low potassium)

Hyperkalemia (high potassium)

Nocturia (urination at night)

How well did you know this?

Not at all

Perfectly

Diuretics

Assessment

○ Obtain complete health hx
○ Obtain baseline VS and weight
○ Assess for pulmonary and peripheral edema (Auscultate lungs)
○ Obtain blood and urine samples

How well did you know this?

Not at all

Perfectly

Diuretics

Planning

○ Pt to exhibit reduction in systolic and diastolic BP while maintaining normal electrolyte levels
○ Provide drug education regarding drug action, precautions, and possible adverse effects
○ Pt to report dizziness, headaches, hypotension

How well did you know this?

Not at all

Perfectly

Diuretics

Interventions

monitor for…

signs of hyperglycemia
liver and kidney function
signs of hypersensitivity to drug
alcohol and caffeine use (hypotensive effect of thiazides)
hearing and vision (loop diuretics are ototoxic)

How well did you know this?

Not at all

Perfectly

Calcium Channel Blockers

Indications

Used for HTN, variant/vasospastic angina, Raynaud’s phenomenon and hypertrophic cardiomyopathy

heart and BV

How well did you know this?

Not at all

Perfectly

Calcium Channel Blockers

3 categories

Arteriole selective drugs (nifedipine)

Cardioselective drugs (diltiazen)

Non-selective drugs (Verapamil)

How well did you know this?

Not at all

Perfectly

Arteriole selective drugs

CCB

relax arterial smooth muscle

indicated for hypertension, angina, Raynaud’s

How well did you know this?

Not at all

Perfectly

Cardioselective drugs

CCB

decreases HR and force of contraction

indicated for hypertension, angina dysrhythmias

How well did you know this?

Not at all

Perfectly

Non-selective drugs

CCB

affect arterial smooth muscle and heart

indicated for hypertension, angina, certain dysrhythmias

How well did you know this?

Not at all

Perfectly

Calcium Channel Blockers

Adverse effects

●	Dizziness, flushing, hypotension
●	Reflex tachycardia (w/ nifedipine)
●	Peripheral edema
●	Dysrhythmias
●	Exacerbation of heart failure

How well did you know this?

Not at all

Perfectly

Nifedipine (Adalat)

Therapeutic effects/uses:

CCB
○ Hypertension
○ Chronic stable or variant angina

How well did you know this?

Not at all

Perfectly

Nifedipine (Adalat)

Mechanisms of action

○ Selectively blocks calcium channels in vascular smooth muscle, causing vasodilation which reduces resistance and BP

How well did you know this?

Not at all

Perfectly

Nifedipine (Adalat)

Adverse effects

○ Hypotension
○ Dizziness
○ Headache
○ Peripheral edema

How well did you know this?

Not at all

Perfectly

Nifedipine (Adalat)

Serious adverse effects

○	Hepatotoxicity
○	Paradoxical angina (inadequate delivery of O2 to myocardium)
○	Severe hypotension
○	Exacerbation of heart failure
○	Confusion

How well did you know this?

Not at all

Perfectly

Nifedipine (Adalat)

Assessment

○ Obtain baseline ECG
○ Assess for pulmonary and peripheral edema
○ Assess neurological status and LOC

How well did you know this?

Not at all

Perfectly

Nifedipine (Adalat)

Planning

○ Pt to exhibit reduced systolic and diastolic BP

○ Provide education

How well did you know this?

Not at all

Perfectly

Nifedipine (Adalat)

Interventions

Study These Flashcards

Vs, ECG, S/S orthostatic hypotension

ACE inhibitors

Indications

Study These Flashcards

HTN, HF

ACE inhibitors

Mechanism of action

Study These Flashcards

Reduce production of angiotensin II

Promotes vasodilation, reducing peripheral resistance and BP
Reduces secretion of ADH and aldosterone, increasing urine output, decreasing blood volume and decreasing blood pressure
Enhances effects of diuretics

ACE inhibitors

Adverse effects

Study These Flashcards

○ Persistent cough (bradykinin builds up to cause irritation due to vasodilation)
○ Postural hypotension
○ Hyperkalemia
○ Angioedema

ACE inhibitors

Assessment

Study These Flashcards

obtain blood and urine samples for lab testing

ACE inhibitors

Planning

Study These Flashcards

Pt to maintain normal electrolyte levels throughout duration of therapy (K+ is at risk)

ACE inhibitors

○ When giving first dose, monitor pt for "first-dose phenomenon" syncope ○ Observe for angioedema at start of therapy ○ Monitor for blood dyscrasias ○ Monitor: - S/S infection or bruising - Liver and kidney function - K+ levels

Angiotensin II receptor blockers indications

HTN and HF

ARBs Mechanism of action

- block receptors for angiotensin II in arteriolar smooth muscle and in the adrenal gland - causes BP to fall - arteriolar dilation and increases sodium excretion by the kidneys (different from ACE inhibitors because it blocks the action of angiotensin II after it is formed)

ARBs Adverse effects

○ Orthostatic hypotension, hypotension ○ First-dose phenomenon ○ Dizziness, headaches ○ Hyperkalemia

Beta 1 adrenergic antagonists (beta blockers): Indications

Hypertension, dysrhythmias, angina

Beta Blockers Mechanism of action

- Block beta1 receptors decreased CO - Can be non-specific as well and block beta2 and/or alpha1 receptors - Block sympathetic response to low blood glucose

Cardio selective beta blockers

- decreases HR and affect myocardial conduction and contractility (decreases oxygen demand)

Nonspecific beta blockers

- decreases HR and affect myocardial conduction and contractility (decreases oxygen demand) AND - act on respiratory system and BV, producing vasoconstriction and bronchoconstriction

Beta blockers Adverse affects

○ Bradycardia, dysthymias ○ Hypotension ○ Bronchospasm ○ Hypoglycemia b/c it blocks body's normal response to adjust to blood sugar, inhibits release of glucose, blocks release of insulin

Beta Blockers Assessment/Planning

○ Obtain baseline CO and urinary output | ○ Assess for presence of respiratory disease (as beta blockers can affect beta 2 receptors)

Beta Blockers Interventions

monitor - VS, pulse, dysrhythmias - Signs of pulmonary edema - Adverse effects including orthostatic hypotension, fatigue, weakness, drowsiness - Signs of hypoglycemia - Fluid intake and output, body weight

Alpha 1 adrenergic antagonists Indications

HTN

Alpha 1 adrenergic antagonists Mechanism of action

Block alpha1 receptors -> vasodilation

Alpha 1 adrenergic antagonists Adverse effects

- orthostatic hypotension - Tachycardia, palpitations - Dizziness, headaches, flushing - Nausea, vomiting

Direct-acting Vasodilators Indications

HTN

Direct-acting vasodilators Mechanism of action

Relax arterial smooth muscle directly causing vasodilation

Direct-acting vasodilators Adverse effects

- Hypotension - Reflex tachycardia - Dizziness, headache, flushing

Prototype drug Hydralazine (Apresoline) Therapeutic effects/uses

- Moderate to severe hypertension - Hypertensive emergencies - Acute heart failure

Prototype drug Hydralazine (Apresoline) Mechanism of action

Causes peripheral vasodilation of arterioles, reducing peripheral resistance and pressure

Prototype drug Hydralazine (Apresoline) Serious adverse effects

- Lupus-like syndrome | - Blood dyscrasias

Prototype drug Hydralazine (Apresoline) Assessment/Planning

- Obtain baseline ECG - Auscultate heart and chest sounds - Assess LOC and neuro status - Obtain blood and urine sample

Prototype drug Hydralazine (Apresoline) Interventions

- Monitoring BP - Monitoring dizziness, LOC - Monitor any signs of angina - Evaluate for lifestyle changes that may occur

HTN emergency

- Life-threatening conditions present when diastolic pressure over 120 mmHg - Fast-acting direct vasodilators such as Nitroprusside sodium are used - Mechanism of action: donates nitric oxide, a direct vasodilator - Adverse effects: hypotension, flushing, dizziness, headache

HTN Drugs Flashcards

(47 cards)