Week 9 - Antihypertensives

Question 1

Blood pressure

Answer 1

BP = CO X SVR

(SVR = systemic vascular resistance)

Question 2

Hypertension types (3)

Answer 2

Essential hypertension

Secondary hypertension

Malignant hypertension

Question 3

Essential hypertension

Answer 3

90-95% of cases
Idiopathic

Aka primary

Question 4

Secondary

Answer 4

5-10% of cases

Most commonly due to RAD, sleep apnea, thyroid disease

Question 5

Malignant hypertension

Answer 5

BP above 180/120

Medical emergency

Question 6

Categories of antihypertensive drugs (7)

Answer 6

Adrenergic drugs
ACE inhibitors
Angiotensin 2 receptor blockers
Calcium channel blockers
Diuretics
Vasodilators
Direct renin inhibitors

Question 7

Adrenergic drug (5 subclasses)
(My notes say dont worry about this much so yeah)

Answer 7

Adrenergic neuron blockers

A2 receptors agonists
A1 receptor blockers
Beta receptor blockers
Combo a1 and beta recoetros blockers

Question 8

Adrenergic drugs suffix

Answer 8

Sin

Drug names end in SIN

Question 9

Adrenergic drugs indications

Answer 9

All for hypertension
Glaucoma as well

Management of HF when used with cardiac glycosides and diuretics

Ex. Doxazosin, proposing

Question 10

Adrenergic drugs adverse effects

Answer 10

Orthostatic hypotension

Also
- bradycardia
- dry mouth
- drowsiness
- constipation
Edema

Question 11

ACE inhibitors facts

Answer 11

Large group of safe and effective drugs

Often first line use for hypertension

May be combined with thiazide diuretic or Ca channel blockers

Question 12

ACE inhibitors suffix

Answer 12

PRIL

Ramipril, enalapril, perindopril

Question 13

Ace inhibitors indications

Answer 13

Hypertension
HF
Used to slow left ventricular hyper trophy after MI

Question 14

ACE inhibitors mechanism of action

Answer 14

Inhibit ACE haha

ACE converts a1 into a2
A2 is a vasoconstrictor that induces aldosterone

Aldosterone = water/salt absorption which raises BP

We dont want any of that shit
#InhibitACE

Question 15

Primary effects of ACE inhibitors

Answer 15

Reduce BP by decreasing SVR

HF
- prevent sodium and water resorption
- decreases heart work because of less BP

Question 16

Ace inhibitors renal effects

Answer 16

Reduce GFR

Reduce proteinuria

Question 17

ACE inhibitors adverse effects

Answer 17

Fatigue yata yata

Mood changes

Hyperkalemia

Dry cough

Angioedema

Question 18

Angiotensin 2 receptor blockers

Answer 18

Also called angiotensin 2 blockers

Question 19

Difference between ACE inhibitors and angiotenisve 2 blockers

Answer 19

Blockers dont cause a dry cough

Appear to be equally effective for hypertension

ACE inhibitors may treat HF better

Question 20

Angiotensin 2 blockers suffic

Answer 20

TAN / sartan

Losartan, valsartan,

Question 21

Ag2 receptor blocker mechanism of action

Answer 21

Block binding off ag2 to receptors, preventing aldosterone release

This blocks vasoconstriction

Question 22

Ag 2 blocker indications

Answer 22

Hypertension
Adjunctive treatment for HF

Question 23

Ag 2 blocker adverse effects

Answer 23

URT infections

Dizziness etc

Back pain

Hyperkalemia (less likely than ACE inhibitors)

Question 24

Ca channel blockers use

Answer 24

Treatment for hypertension and angina

Causes smooth muscle relaxation by block that binding of calcium to receptors (prevent contraction0

Question 25

Ca channel blockers mechanism of action

Answer 25

Bind to Ca receptors to prevent contraction of muscle Leads to decreased muscle tone, SVR and BP

Question 26

Ca channel blockers indications

Answer 26

Angina Hypertension Dysrhythmias Migraines

Question 27

Diuretics facts

Answer 27

First line antihypertensives - decrease plasma and ECF volumes This decreases workload of the heart and BP

Question 28

Most common diuretic used in hypertension

Answer 28

Thiazide diuretics

Question 29

Vasodilators examples

Answer 29

Minoxidil Diazoxide

Question 30

Vasodilators mechanism of action

Answer 30

Directly relax smooth muscle Used for their ability to cause peripheral vasodilation Results in decreased SVR

Question 31

Vasodilators indications

Answer 31

Hypertension

Question 32

Vasodilators adverse effects (different for different meds) I can’t imagine this is that important

Answer 32

Hydralazine - dizziness etc, tachycardia, edema, dyspnea, lupus Minoxidil - T wave ECG changes - breast tenderness, rash, pericardial effusion Sodium nitroprusside - bradycardia, decrease platelet aggregation, rash, hypotension

Question 33

Nursing implications

Answer 33

- obtain history - assess for contraindications - educate on important of not missing dose - monitor BP - dont stop abruptly - give with meals - IV with extreme caution - dont go in saunas n shit - educate about not being fat as hell - monitor for adverse effects

Question 34

Ace inhibits and lab values

Answer 34

Ace inhibitors can cause renal impairment - identified by serum creatinine Can cause hyperkalemia