pharm hypertension

Question 1

primary hypertension

Answer 1

Essential (Primary) (90%): unknown cause

Question 2

secondary hypertension

Answer 2

Secondary (10%): related to identifiable cause
(e.g., obesity, sleep apnea, excess sodium
intake, drug induced) in which treatment is
directed toward correcting the underlying cause

Question 3

Gestational HTN

Answer 3

> 140/ > 90
 After 20 weeks gestation
 No proteinuria

Question 4

medications that can cause HTN (Lock NESS causes HTN)

Answer 4

 Estrogens
 NSAIDs
 Stimulants
 Steroids

Question 5

Primary Mechanisms to Control Blood Pressure - short and long term

Answer 5

 Adrenergic nervous system or baroreceptor
reflex (brain): a rapid-acting system
 Renin-angiotensin-aldosterone
mechanism: a long-acting system

Question 6

Activation of a receptors leads to

Answer 6

smooth muscle
contraction

Question 7

Activation of b2
receptors leads to (2nd is lungs)

Answer 7

smooth
muscle relaxation - lungs

Question 8

Activation of b1
receptors leads to (what happens to the muscles?)

Answer 8

smooth
muscle contraction - (especially in heart)

Question 9

b2 agonist used for

Answer 9

asthma

Question 10

b1 antagonists (BETA BLOCKERS) used for what? And does it slow down or speed up heart? And what about contraction?

Answer 10

treatment of hypertension and angina (slow heart and
reduce force of contraction)

Question 11

alpha 1 antogonist used for (only the big alpha will cure HTN)

Answer 11

lowering of the blood pressure (relaxation of smooth
muscle and dilation of the blood vessels)

Question 12

Clonidine (Catapres®) - agonist to…(Clonidine agonizes over little alpha) AND what is it used for?

Answer 12

Agonist to the CNS alpha – 2 adrenergic receptors (relaxes
vascular smooth muscle) - severe pain for cancer used with opiates

Question 13

Withdrawal HTN when taking with (when adriene is blocked she withdraws)

Answer 13

beta – adrenergic
blocking agents and abruptly discontinued

Question 14

Prazosin (Minipress®) (the minipress blocks big Alpha)

Answer 14

Selectively blocks alpha1-adrenergic receptors, decreases
vascular sympathetic tone (dilates arterioles and veins)

Question 15

minipress nursing implications - and limit dose to what? (minipress makes me dizzy)

Answer 15

First time usage has reported risk of syncope
w/sudden loss of consciousness. Limit dose to 1mg PO
at bedtime to start

Question 16

Propranolol (Inderal®) - Competitively blocks what? And what does that do? (MJ just blocks beta, now he’s the alpha)

Answer 16

Competitively blocks beta adrenergic receptors in the heart
and juxtaglomerular apparatus decreasing the influence of
the sympathetic nervous system

Question 17

Propranolol (Inderal®) getting off it…(MJ for 2 weeks)

Answer 17

Taper over 2 weeks if pt is to discontinue after long
term therapy

Question 18

Calcium Channel Blockers - approved and non FDA approved for (Calcium helps with my hemmorage, but not with Raynaud)

Answer 18

approved - ▪ Subarachnoid hemorrhage
non approved - Raynaud’s phenomenon

Question 19

Nifedipine (Adalat®) (Procardia®) side effects (nifty gingevitis)

Answer 19

Gingival hyperplasia

Question 20

Nifedipine (Adalat®) (Procardia®) overdose antidote (glue is nifty during an overdose)

Answer 20

 Antidote: Calcium gluconate (IV). ER tabs may not be chewed

Question 21

Captopril (Capoten®) adverse effects (The captin is puffy and coughing)

Answer 21

• NON PRODUCTIVE cough
• Angioedema

Question 22

Angiotensin II Receptor Blockers
(ARB’s) - examples (get a tan at Arby’s)

Answer 22

 Includes losartan and valsartan

Question 23

Losartan (Cozaar®)

Answer 23

Angiotensin II receptor blocker (ARB)

Question 24

losartan adverse effects (loose the tan, loose the puffy cough with this one)

Answer 24

• Same as ACE inhibitors but does not cause
• Dry cough, angioedema

Question 25

Vasodilators - Arteriolar dilators ex. (Art expands with hydra and hair)

Answer 25

hydralazine, minoxidil

Question 26

Hydralazine (Apresoline®) precautions (hydros cause stroke, headache and I can't pee)

Answer 26

Caution with CVAs (stroke), increased ICP (risk of ischemia) difficulty with micturation

Question 27

Diuretics - what is recommended as firstline drug therapy? (Thia is always first)

Answer 27

*Thiazide diuretics

Question 28

Hydrochlorothiazide (HCTZ / HydroDIURIL®) peak (hydros only work for 4-6 hours)

Answer 28

Peaks 4-6 hours

Question 29

Hydrochlorothiazide (HCTZ / HydroDIURIL®) - dosing? (You don't need hydro every day)

Answer 29

 Not always a daily dose, help patients mark calendar for 3 or 5 dose/week administration

Question 30

Furosemide (Lasix®) - can still work when what occurs?

Answer 30

Renal Failure: Lasix works even when GFR is low

Question 31

Blood Pressure Control precautions -dosing?

Answer 31

NEVER double up on doses if 1 is missed

Question 32

vasodilators - Arteriolar and venous dilators (sodium on nitro works everywhere, veins and arteries)

Answer 32

sodium nitroprusside

Question 33

propranolol - what does it do to 02 consumption by the heart? (MJ takes my O2)

Answer 33

Decreases cardiac O2 consumption

Question 34

Activation of alpha and beta 1 receptors leads to

Answer 34

smooth muscle contraction

Question 35

Activation of b2 receptors leads to (think asthma for beta 2)

Answer 35

smooth muscle relaxation - lungs

Question 36

Activation of b1 receptors leads to

Answer 36

smooth muscle contraction - (especially in heart)

Question 37

Agonists of the b2 receptors are used in the treatment of

Answer 37

asthma (relaxation of the smooth muscles of the bronchi)

Question 38

Antagonists of the b1 receptors are used in the treatment of

Answer 38

hypertension and angina (slow heart and reduce force of contraction)

Question 39

Antagonists of the a1 receptors are known to cause

Answer 39

lowering of the blood pressure (relaxation of smooth muscle and dilation of the blood vessels)

Question 40

1

Answer 40

contracts

Question 41

2

Answer 41

relaxes

Question 42

clonidine and withdrawal?

Answer 42

Withdrawal HTN when taking with beta – adrenergic blocking agents and abruptly discontinued

Question 43

clonidine side effects (the usual)

Answer 43

dry mouth, constipation, skin rash

Question 44

minipress dosing (minipress, mini dose)

Answer 44

Limit dose to 1mg PO at bedtime to start

Question 45

nifedipine is a (calcium is nifty)

Answer 45

CCB

Question 46

if pt has diabetes, use which HTN med? (diabetics get Arby's)

Answer 46

ARB first, then ACE inhibitor

Question 47

Captopril (Capin' is an ACE)

Answer 47

Ace inhibitor

Question 48

Arby's v. ACE (soda to sooth cough at Arbys)

Answer 48

no cough or edema with Arbs

Question 49

hydralizine - rebound? (Hydros ALWAYS cause a rebound)

Answer 49

Do not discontinue abruptly – may cause a severe increase in BP

Question 50

Antidysrhythmics classes

Answer 50

1 - 4

Question 51

class 1 examples (Na is first)

Answer 51

(QUINIDINE, LIDOCAINE,FLECANIDE)

Question 52

class 2 example (don't be second class at the met)

Answer 52

METOPROLOL

Question 53

class 3 example (Amor is my fav class, 3)

Answer 53

AMIODARONE

Question 54

class 4 (try diazapam last, 4)

Answer 54

DILTIAZEM

Question 55

Quinidine precautions (Quin and Gab don't mix)

Answer 55

Tends to promote atrial emboli in afib

Question 56

Amor treats what?

Answer 56

Recurrent V-Fib (or tach) - emergency A-Fib (oral)

Question 57

Amor side effects (blinded by love)

Answer 57

Corneal Microdeposits & Blindness

Question 58

don't mix digoxin with what drugs? (can't pee, can you dig?)

Answer 58

Diuretics: Combine to lower K+

Question 59

normal potassium levels

Answer 59

3.5 - 5