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hypertension Flashcards

(50 cards)

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1
Q

diuretics effect _______

A

preload (of Stroke Volume, of Cardiac Output)

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2
Q

diuretics cause volume depletion and work with pulmonary edema as it relates to ________

A

HF

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3
Q

thiazides have some ________ of peripheral arterioles

A

vasodilation

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4
Q

diuretics are the most commonly prescribed _____

A

antihypertensive (probably not used in HF)

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5
Q

BB MOA & therapeutic effect

A

inhibit cardiac response to sympathetic nerve stimulation

HR, CO, BP reduced

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6
Q

for BB, watch for _____ symptoms if decontractility is excessive

A

HF

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7
Q

common adverse effects of BB

A

bradycardia
masks hypoglycemic shock
not effective for African Americans

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8
Q

hold BB for BP <____ or HR<____

A

BP < 100
HR < 60

and contact prescriber

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9
Q

sudden discontinuation of BB can result in

A

worsening angina or MI

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10
Q

selective BB effect the

A

heart

blocks receptors in cardiac tissue

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11
Q

BB pts with wheezing or history of lung disease will be on _____ instead of ______

A

will be on selective instead of nonselective

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12
Q

3 selective BB

A

Metoprolol
Atenolol
Esmomol

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13
Q

Metoprolol

A

selective BB

treats HTN, angina

slows HR, decreases CO, reduces BP, decreases MI severity

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14
Q

Atenolol

A

selective BB

slows sinus node HR decreasing CO and BP, decreases myocardial oxygen demand

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15
Q

Esmolol

A

selective BB

rapid, short term control of ventricular rate in SVT, a fib, tachycardia, HTN

slows sinus HR, decreases CO, reduces BP

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16
Q

nonselective BBs effect the

A

heart and lungs (decrease HR, constrict bronchials)

may induce bronchospasm

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17
Q

3 nonselective BB

A

Labetalol
Propranolol
Sotalol

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18
Q

Labetalol

A

nonselective BB

treat HTN, may decrease effectiveness of selective BBs

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19
Q

Propranolol

A

nonselective BB

treats angina, HTN, migraines

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20
Q

Sotalol

A

nonselective BB

treats ventricular arrhythmias and a fib

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21
Q

BB are the

Study These Flashcards
A

LOLs

Beta blockers

22
Q

ACEIs are the

Study These Flashcards
A

PRILs

Angiotensin-converting enzyme inhibitors

23
Q

ACEI MOA & therapeutic effect

Study These Flashcards
A

disrupts the RAAS system (renin-angiotensin-aldosterone system hormones controls BP, fluid and electrolytes), reducing BP, preserves CO and increases renal blood flow

reduces preload (effects sodium and water retention, and venous tone) and afterload (reduces SVR through circulating regulators and local regulators)

can help reduce the work of the heart in HF

24
Q

which HTN meds do not work well for African Americans?

Study These Flashcards
A

BB
ACEI (unless combined with diuretic)
ARB alone

25
About 1/3 of patients develop a cough from
ACEIs
26
SVR
systemic vascular resistance
27
ACEI side effects
angioedema (swelling of face, eyes, lips, tongue, diffilty breathing) may cause fetal harm hyperkalemia hypotension monitor for nephrotoxicity/too much perfusion = elevated creatinine and s/s of renal failure
28
Lisinopril
ACEI (ACE Inhibitor) treats HTN in adults and kids 6yo and older, acute MI within 24 hrs to improve survival adjunctive therapy to reduce s/s of systolic HF
29
ARBs ar the
SARTANs Angiotensin II Receptor Blockers
30
ARB MOA & therapeutic effect
directly antagonizes angiotensin II receptors, blocks vasoconstrictor, aldosterone-secreting effects of angiotensin II, inhibiting binding of antiotensin II to ATj receptors produces vasodilation, decreases peripheral resistance, decreases BP, helps work of heart in HF, effects afterload and preload
31
Valsartan
ARB treats HTN alone or combo, treats HF, reduce mortality in high risk pts (left ventricular failure/dysfunction) following MI
32
ARB side effects
tachycardia GI watch kidneys hyperkalemia
33
NEVER TAKE AN ARB WITH
ACEI hypotension, hyperkalemia, renal impairment
34
CCB stands for
calcium channel blockers
35
CCB MOA and therapeutic effect
inhibit movement of calcium ions across cell membranes helps with HR & rhythm, reduces contractillity, effects systemic vascular resistance (afterload), reduces vascular tone, dilates coronary arteries & peripheral arteries/arterioles, decreases total peripheral vascular resistance and BP by vasodilation
36
CCB are ideal for
first or second line drug therapy for HTN effective in African American pts
37
CCB adverse effects
hypotension syncope edema bradycardia
38
do not injest ____ with CCBs
grapefruit juice
39
Amlodipine
CCP, dihydropyridine, vasodilator helps reduce afterload (HTN, angina, HF)
40
a1-b are
alpha 1 adrenergic blocking agents the ZOSINs
41
a1-b MOA and therapeudic effects
selectively blocks alpha 1 adrenergic receptors, decreasing peripheral vascular resistance used for HTN and urinary obstruction secondary to BPH produces vasodilation, decreases vascular resistance and BP, effect CO and SVR, affect venous and arterial tones
42
a1-b side effects
bradycardia peripheral edema headach
43
Doxazosin
a1-b treats HTN alone or combo, also treats urinary outflow obstruction relaxes smooth muscle of bladder and prostate, reducing BPH (benign prostatic hyperplasia) s/s
44
Centrally acting alpha 2 agonists MOA and therapeutic effects
reduces sympathetic outflow from CNS, reduces HR and SVR, causes drop in both systolic and diastolic BP adjunctive, used only in combo with other antihypertensives reduces peripheral resistance, decreases BP, HR, produces analgesia
45
Clonidine
centrally acting alpha 2 agonist adjunctive, used only in combos for HTN also used for ADHD and refractory cancer pain off label used for opiate and nicotine withdrawl, hot flashes, Tourettes
46
Direct vasodilators effect
Systemic Vascular Resistance
47
Direct vasodilators MOA and therapeutic effects
relaxes arterial smooth muscle, reducing SVR decreases BP and systemic vascular resistance
48
Direct vasodilator side effects
dizziness orthostatic hypotension tachycardia fever chills joint and muscle pain skin eruptions
49
Hydralazine
direct vasodilator used for stage 2 HTN (moderate to severe), renal disease HTN, toxemia of pregnancy
50
Nitroprusside sodium
direct vasodilator very strong, potent IV titratable drug, short action, for HTN crises, HG hemodynamics (reduce left ventricular end-diastolic pressure, pulmonary capillary pressure, peripheral vscular resistance, and mean arterial BP) used when immediate reduction of preload or afterload is needed preferred antihypertensive for pts with acute pulmonary edema

Pharm 2 (5 decks)

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