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NUR 325 PATHO > Hypertension Medications (Exam 1) > Flashcards

Hypertension Medications (Exam 1) Flashcards

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1
Q

Diuretics

A

Potassium-Sparing: Mild

Thiazide (thiazide-like): Mild

Loop: Moderate to profound

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2
Q

General Diuretics

A

MOA: Increasing urinary output, Decreasing circulating volume, Decreasing arterial resistance

-Lower BP by decreasing CARDIAC OUTPUT. (Block Sodium and Chloride reabsorption)

-Can enhance effects of other anti-hypertensives

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3
Q

Cardiac Output

A

Amount of blood the heart is pumping out. Calculated by HR x SV

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4
Q

Thiaziaide (Thiaziade like) Diuretics

A

Hydrocholorothiazide [HCTZ] (HydroDiuril)

-1st line management of mild hypertension

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5
Q

Thiazaide Diuretics: MOA

A

-Works on the distal convoluted tubule to inhibit resorption of sodium/potassium/ and chloride = decreases Cardiac Output

-Results in water loss

-Also relaxes arterioles = decreased in (PVR)

-Can be used alone or in combination with other anti-hypertensives

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6
Q

Thiazide Diuretics: Side Effects

A

-Electrolyte and Metabolic disturbances. HYPOKALEMIA (low potassium)

-Orthostatic Hypotension

-May worsen renal insufficiency

-Hyperuricemia — watch out with gout patients

-Can elevate levels of glucose, cholesterol, and triglycerides

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7
Q

Thiazide Diuretics: Nursing Actions

A

Monitory Potassium Levels

HYPOKALEMIA (low potassium) can lead to issue with our cardiac rhythms

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8
Q

Loop Diuretic Medication

A

Furosemide

(very strong)

(PO or IV)

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9
Q

Loop Diuretics: MOA

A

-Inhibit the kidneys ability to reabsorb sodium in the LOOP OF HENLE

-Makes kidneys put more sodium in the urine. (Water follows sodium so you pee more)

-Decreases fluid in the blood vessels—-decreases cardiac output—-decrease blood pressure

-PROFOUND DIURESIS POSSIBLE

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10
Q

Loop Diuretic: Side effects

A

-HYPOKALEMIA

-Other electrolyte abnormalities

-Dehydration (Strong Medication)

-Hypotension

-Otooxicity — Causing hearing problems

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11
Q

Loop Diuretics: Nursing Considerations

A

-Monitor potassium levels. Patients typically receive KCL supplements with their Lasix doses

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12
Q

Hypokalemia

A

-Low Potassium (Normal 3.5-5)

-Loop and Thiazide diuretics can cause potassium loss in the blood

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13
Q

Potassium-Sparing Diuretics (Aldosterone Antagonist)

A

-Spironolactone

-Spare potassium

-ONLY given PO

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14
Q

Potassium-Sparing Diuretics: MOA

A

-Block the action of aldosterone (Sodium and water retention) = potassium retention and excretion of sodium and water

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15
Q

P-S Diuretics: Side Effect

A

-HYPERkalemia

-Endocrine effects: Deepened voice, impotence, irregular menstrual cycles, gynecomastia, hirsutism

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16
Q

5 classes of types of medications that treat hypertension

A

Diuretics

Sympathetic Nervous system blockers

Beta Blockers

Calcium Channel Blockers

Vasodilators

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17
Q

Sympatholytics

A

Alpha-adrengic blockers

Centrally acting alpha 2 agonists

Beta adrenergic blockers

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18
Q

Sympatholytics

A

-Sympathetic nervous system blockers

-SNS usually VASOCONSTRICTS, when it is BLOCKED = decreased vasoconstriction

-Decrease blood pressure by decreasing PERIPHERAL VASCULAR RESISTANCE

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19
Q

Beta adrenergic blockers (Beta-Blockers) (Sympatholytic)

A

-Metoprolol

-Propranolol

-Carvedilol

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20
Q

Beta Adrenergic Blockers

A

-Block 2 types of receptors

-Beta 1 receptors found in the heart (Cardioselective beta receptors) (One Heart)

-Beta 2 receptors: Found in lungs (focus on beta 1) (Two Lungs)

-OLOL = Beta Blocker

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21
Q

Which Beta Blocker is non-selective?

A

Propanolol

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22
Q

Which beta blocker blocks both alpha receptors and beta blockers?

23
Q

Which beta blockers only works on Beta 1 receptors in the heart?

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A

Metoprolol (Selective)

24
Q

Beta-Blockers: MOA

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A

Works by decreasing force, rate, and rennin secretion.

-Increases nitric oxide = vasodilation response

-Blocks stimulation of beta-1 receptors = decreases HR and contractility

25
Beta-Blockers: Side Effects
-Fatigue/Lethargy -Bradycardia -Hypotension -Mask hyopglycemia ----- prevents tachycardia which is a common sign of DM
26
Beta Blockers: Nursing Considerations
-Wean patients off -Possible rebound HTN if discontinued abruptly----critical rise in BP, high risk for CVA -If non selective beta blocker------do not use with patients who have asthma or other breathing conditions -RECONGIZE THE RISK FOR HYPOTENSION AND BRADYCARDIA. MEASURE HR AND BP EVERYTIME BEFORE GIVING MED
27
Alpha-2 Adrenergic Agonist
clonidine Typically not first-line treatment because of high side effects.
28
A2AA's: MOA
Decrease sympathetic outflow resulting in decreased stimulation of adrenergic receptors (both alpha AND beta receptors) Can be given PO or Transdermal (patch)
29
A2AA: Side effects
-Drowsiness----most common. (given at night) -Rebound HTN -Pre-existing liver disease
30
Selective Alpha-1 Blockers
doxazosin
31
Selective Alpha 1 Blocker: MOA
-Directly blocking sympathic NS. Blocking A1 receptors
32
SA1 Blocker: Side effect
-Hypotension -Dizziness
33
RAAS Blockers
-ACE inhibitors -ARB's -Renin inhibitor
34
Where do ACE inhibitors work?
Between Angiotensin I and Angiotensin II
35
What does ARBS block?
ATII receptor
36
When is the RASS system activated?
Loss of blood volume Drop of BP
37
ACE Inhibitors
-captopril -lisinopril Safe medication and first line therapy for HTN and HF -Ends with -pril ACE-pril
38
ACE inhibitors: MOA
-Block angiotensin-converting enzyme -Inhibits production of Angiotensin-2 (powerful vasoconstrictor) -Inhibits aldosterone secretion---less water retention -Slows progression of left ventricular hypertrophy associated with HTN -Drug choice for DM--- has some renal protective effects
39
ACE inhibitor: side effects
-First dose hypotension---common, 15-20% drop in 6-8 hours -Dry non productive and persistent cough---largest complaint from patients -ANGIODEMA---rare but more common in blacks (Swelling of face) -DO NOT USE IF PREGNANT -Do not take if you are driving or during something active. Take at night
40
ACE Inhibitors: Nursing Considerations
-Renal insufficincy----use cautiously in patients with history of renal disease -Captopril can cause neutropenia---monitor WBC
41
Angiotensin Receptor Blockers
-ARBS -Iosartan -SARTAN suffix
42
ARBS: MOA
-Block the action of angiotensin 2 after it is formed -Causes vasodilation -Increased sodium and water excretion -Does not affect the HR or Cardiac issues
43
ARBS: Side Effects
-Well tolerated -Some risk of angioedema. No racial disparity like ACEi -Do not use in someone who is pregnant and should be prescribe a contraceptive if in childbearing age
44
Renin Inhibitor
aliskiren
45
Renin Inhibitor: MOA
-Direct inhibition of Renin -Induces vasodilation, decrease blood volume, decrease SNS, and inhibitors cardiac and vascular hypertrophy
46
Renin Inhibitor: Side effects
-GI discomfort -When given with ACEi watch for hyperkalemia, especially in patients with diabetes
47
Renin inhibitor: Nursing considerations
-Takes several weeks to see fell effect (half-life) -Do NOT take pregnant
48
Calcium Channel Blockers
nifedipine nicardipine verapamil diltiazem (More common for heart rythym disorders) -Block Ca channels which cause Vasodilation of Smooth muscle. Arterial vasodilation
49
What is given when trying to treat for crisis refractive HTN IV
Calcium channel blocker (Nicardipine)
50
Calcium Channel Blockers: Side Effects
-Orthostatic Hypotension -Peripheral edema
51
Calcium Channel Blocker: Nursing Considerations
-CCB are best for elderly and AA's -Diurectics with to adress edma that comes along with
52
Vasodilators
Hydralazine
53
Vasodilators: MOA
Work directly on arterial and venous smooth muscles and cause relaxation -Direct vasodilation cause decreased systemic and pheripheral vascular resistance PO and IV (Emergnecy)
54
Vasodilators: Side Effect
Hypotension dizziness, headache, tachy, edema, dyspnea.

NUR 325 PATHO (44 decks)

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