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Nurs 2800 > Perfusion Pharm > Flashcards

Perfusion Pharm Flashcards

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1
Q

Thiazide and Thiazide -like Diuretics

A

Anthihypertension and are a thiazide type drug

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2
Q

MOA of thiazide drugs

A

Chloride pump blocker
= keeps the chloride and sodium in distal tubule

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3
Q

Thiazide drugs act in which part of the renal system

A

distal TUBULE
Thiazide = tubes

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4
Q

Potassium sparing diuretics prototype

A

Spironolactone

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5
Q

Benefit of spironolactone

A

spare the potassium so they can give to those in hypokalemia

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6
Q

where and what does potassium sparing dietetics work on

A

Works on aldosterone in the distal tubule and collecting ducts

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7
Q

Spironolactone adverse effects

A

Hyperkalemia, dysrhythmias, gynecomastia, impotence, and deminished

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8
Q

Why isn’t potassium-sparing diuretics used as a primary diuretic

A

It’s a weak diuretic and usually is added as a second

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9
Q

mild fluid retention would most likely get which diuretic

A

Thiazide

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10
Q

Severe edema would most likely get what diuretic

A

LOOP

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11
Q

Potassium rich foods to avoid for a spironalactone

A

Avacado, bananas, broccoli

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12
Q

hypertension is the ____ common cardiovascular disease

A

most

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13
Q

HTN can cause

A

heart failure, MI are most common deaths related to hypertension
damage to
1. kidney
2. brain
3. your eyes (oh my!)
4. blood vessels

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14
Q

Dx of HTN

A

2 BP readings on 2 separate occasions

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15
Q

Categorizing BP (normal- stage 2 HTN

A

Normal: <120/80
Elevated: 120-129/<80
Stage 1: 130-139/80-89
Stage 2 >140/>90

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16
Q

Hypotension is considered

A

< 100/60 (unless provider specifies)

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17
Q

Is stage 1 HTN treated with drugs

A

only if there is cardiovascular risk

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18
Q

Is stage 2 HTN treated with drugs

A

oh yes.

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19
Q

First line drugs for non black people with HTN

A

Thiazides, Calcium channel blocker, Ace inhibitor, or Angiotension receptor blockers

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20
Q

Black people with HTN recommended to get treated with

A

Thiazides, Calcium CB before ACE or Angiotension receptor blockers

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21
Q

Medications for Kidney diseased people with HTN

A

ACE or ARB

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22
Q

Therapeutic lifestyle changes to people with HTN with no drugs

A

TLC
1. good weight
2. - alcohol
3. restrict sodium
4. exercise

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23
Q

4 first line medications for htn

A

thiazide
ACE inhibitors
angiotensin receptor blockers
calcium channel blockers

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24
Q

what can we do keep patients adherence to meds on HTN

A

Educations on why its important
consider generic forms (cost)
report adverse effects to dose can be adjusted or changed

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25
Thiazide diuretics used in
mild to moderate HTN used to reduce fluid reduction
26
Adverse effects Thiazide
Dehydration Increase uric acid levels
27
Renin-Angiotensin-Aldosterone System (RASS) is important because
Is one of the primary homeostatic mechanisms to control BP and fluid balance
28
Renin is secreated by and does what
kidneys and changes angio-tensin 1 that floating around in the blood to angiotensinogen
29
Types of angiotensin
Angiotensinogen: no change Angiotensin 1: See cards***
30
Steps to the RAAS system
BP is low so the kidney produces renin which makes agiotensin 1 from angiotensinogen 2. ace coverts 1 to 2 3. A2 causes vasoconstriction and the release of aldosterone
31
ACE inhibitors do what
Blocks the enzyme that creates Angiotensin 2 from being created from A1
32
ARB blockers do what
A2 is still being made, but A2 receptor is blocked so A2 cannot be utilized
33
can you be on both ACE and ARB meds
nah
34
ACE inhibitors meds all end in
-pril
35
What are ACE inhibitors often used with?
Thiazide
36
ACE inhibitors adverse effects
Hyper K dry cough angioedema (females and black) orthostatic hypotension
37
Contraindications to ACE inhibitors
Pregancy cat. D due to defects Hyperkalemia
38
MOA of ACE inhibitors
Block conversion of A1 to A2
39
ACE inhibitors Food/Drug interactions
NSAIDS - decrease antihypertensive activity and worsen preexisting renal disease.
40
ARB Pharmacologic class Angiotensin 2 receptor blocker
Angiotensin 2 receptor blocker -> antihypertension
41
therapeutic effect/uses of ARB
HTN, stroke prophylaxis in LVH, prevention of DMII nephropathy and off label for HF
42
MOA of ARB
43
Routes of
44
Adverse Effect of ARBs
HZ, Dizzy, nasal congestion (vasodilation), fatigue insomnia Angioedema
45
Contraindications of ARB
Allergic and pregnancy
46
Food/Drug interactions to ARB
NSAID same as ACE
47
Calcium channel Blocker class
calcium channel blocker, dihydropyridines type
48
Therapeutic use of calcium channel blocker
HTN, CAD, Angina, and dysrhythmia
49
MOA for Calcium channel blockers
Selectively blocks calcium channels in vascular smooth muscle
50
Routes for Calcium channel blockers
PO
51
Adverse effects of Calcium channel blockers
CNS effects GI: liver damage and nausea CV: hypotension, flushing of the skin (big vessels) peripheral edema Heart block and heart failure Non dihydro - brady, constipation Dihydro - reflecx tachy , gingival hyperlasia
52
Medications that are Calcium channel blockers
end in -pine (mostly for BP due to long acting) Verapamil and diltiazem (short acting for vascular and cardiac muscle shitt)
53
Contraindications for Calcium channel blockers
allergic renal or hepatic dysfunction brady and heartblock
54
Drug/food interacitons
Booze (vasodillation) Other hypertensives Digoxin grape fruit juice (enhances absoption
55
adrenergic receptors
Alpha and beta
56
Alpha 1
mydriasis (pupil dilation) Vasoconstriction Ejaculation Relax the bladder neck and prostate
57
Alpha 2 (don't worry for test)
Location in presynaptic junction Inhibits Norepi release
58
Beta 1
Heart rate increases, increases inotropic contractility, renin release from kidney
59
Beta 2
Bronchial dilation relaxation of uterine muscle vasodilation glycogenolysis (breakdown glycogen into glucagen) Skeletal muscle contraction
60
Alpha1 Adrenergic Antagonists uses
HTN and enlarged prostate
61
Alpha 1 antagonists end in
-sin (ahhaha sex joke)
62
Alpha 1 onset
4-6 weeks for optimal therapeutic effects
63
Alpha 1therapeutic effect/use
BPH, Raynauds disease
64
Adverse effects with Alpha 1
what ever is increased with parasympathetic activity - hypotension -orthostatic hypotension (first dose phenomenon hypotension is especially bad at the beginning or at an increase of dose - reflex tachy (use a beta blocker to prevent) - ED, decreased libido, inability to ejaculate - CNS depression (crosses blood brain barrier)
65
Beta Blockers (antagonist) are both selective and non selective and are used in
HTN, Angina, glaucoma, HF, MI, Migraine prophylaxis, Off label: PTSD and situational anxiety
66
pregnancy category for beta antagonist
C
67
selective and non selective prototypes
Selective (B1): metoprolol Non selective (B1&2) propanolol
68
Adverse effects beta blocker agonist
prevents the signs of hypoglycemia, impotence (no feelings about it at all) and libido, abrupt withdrawal can cause rebound cardiac excitation (MI)
69
beta blockers are Contraindicated in
COPD and asthma (non selective like propranolol) bradycardia and severe heart failure
70
During an Overdose of Beta blockers (antaganist) give
Atropine (agonist)
71
Nonselective A1 and Beta blocker antagonists
Carvedilol and labetalol
72
Direct acting vasodilators are
directly cause vasodilation by relaxing smooth muscle
73
Direct acting vasodilator medications
Nitroprusside (IV) Hydralazine (PO, IV, IM) Minoxidil aka rogaine lol (PO)
74
Adverse effects of DA vasodilators
sodium and water retention, reflex tachycardia, lupis symptoms, chest pain HF
75
Hypertensive emergency vs urgency
diastolic of pressure of >120 with organ system damage is an emergency and without organ system damage is urgent
76
Meds during a hypertensive emergency
77
Most common symptoms of medications
Chest pain, Dyspnea, headache
78
Treatment of HTN urgency
conservative, current med is increased or 2nd drug is added they need to follow up in 1-3 days on the new regimen
79
Treatment of HTN E
BP lowered by 20-25% over 30-60 minutes. Additional reduction over 12-48 hours period until bp is within normal range parenteral over oral because fucking duh
80
Nitroprusside is a
direct vasodillator
81
Therapeutic effect/uses of nitroprusside
1st line for aggressive, life threatening, HTN - continuous monitoring to prevent hypotension - limited to 72 hours because the drug is metabolized to thiocyanate and cyanide - Switched to antihypertensive as soon as BP stabilizes
82
Nitroprusside contraindications
HARD FUCKING NO - inadequate cerebral circulation kidney impairment *increased risk of thiocyanate toxicity*
83
second line drug for hypertention
prozosin - beta adrenergic

Nurs 2800 (16 decks)

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