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Pharm Unit 2
Pharm - Antihypertensive Drugs
| Question | Answer |
|---|---|
| Hypertension defined | 60 years or older: systolic blood pressure of greater than 150/90 Younger than 60 years and those who have chronic kidney disease or diabetes: greater than 140/90 |
| Types of drugs to treat hypertension | - Diuretics Adrenergic drugs Vasodilators Angiotensin-converting enzyme (ACE) inhibitors Angiotensin II receptor blockers (ARBs) Calcium channel blockers (CCBs) Direct renin inhibitors |
| The number of people with hypertension in the United States is estimated to be | 75 million |
| Beta Blockers | Propranolol, metoprolol, and atenolol |
| Peripherally Acting Alpha1 Blockers | Doxazosin, prazosin, and terazosin |
| Centrally Acting Adrenergic Drugs | Clonidine and methyldopa |
| Dual-Action Alpha1 and Beta Receptor Blockers | Labetalol and carvedilol |
| Adrenergic Drugs: Adverse Effects | High incidence of orthostatic hypotension First-dose syncope Most common Bradycardia with reflex tachycardia Dry mouth Drowsiness, sedation Constipation Depression Edema Sexual dysfunction |
| Adrenergic Drugs: Interactions | Can cause additive CNS depression with alcohol, benzodiazepines, opioids |
| When administering an alpha-adrenergic drug for hypertension, it is most important for the nurse to assess the patient for the development of what response? | Hypotension |
| SNS stimulation responses | increased bp increased blood to heart and brain decreased blood to viscera (organs) and skin increased cellular metabolism sweating incr resp rate pupil dilation incr blood sugar decr insulin production |
| PNS stimulation responses | dilation of blood vessels in skin decr HR incr digestive enzymes incr GI movement bronchial constriction contraction of skeletal muscles no effect on blood sugar |
| adrenergic receptors | norepinephrine epinephrine |
| "fight or flight" | sympathetic nervous system |
| "rest and digest" | parasympathetic nervous system |
| alpha 1 receptor location, agonist, antagonist | blood vessels, vasoconstriction, vasodilation |
| alpha 2 receptor location, agonist, antagonist | blood vessels/pre-synaptic membranes, vasoconstriction/inhibit NE release, vasodilation |
| beta 1 receptor location, agonist, antagonist | heart, increased HR and force, slows heart rate/angina |
| beta 2 receptor location, agonist, antagonist | bronchiole smooth muscle, skeletal muscle, arterioles bronchiole dilation ??? |
| alt term for SNS stimulation | adrenergic sympathomimetic |
| alt term for PNS stimulation | cholinergic |
| SNS inhibition (block) | antiadrenergic |
| PNS inhibition (block) | anticholergic |
| Alpha 1 blocker function | Drugs that primarily cause arterial and venous dilation through their action on peripheral sympathetic neurons |
| Orthostatic hypertension | A common adverse effect of adrenergic-blocking drugs involving a sudden drop in blood pressure when a person changes position, especially when rising from a seated or horizontal position. |
| The nurse is administering antihypertensive drugs to older adult patients. The nurse knows that which adverse effect is of most concern for these patients? | Hypotension |
| The nurse is administering antihypertensive drugs to older adult patients. The nurse knows that which adverse effect is of most concern for these patients? | Alpha blockers such as doxazosin |
| A 46 yo man started antihypertensive drug therapy 3 months earlier and is in the office for a follow-up visit. He informs the nurse that he has had problems with sex. Which is the most appropriate response by the nurse? | “The physician can work with you on changing the dose and/or drugs.” |
| When a patient is being taught about the potential adverse effects of an ACE inhibitor, which of these effects should the nurse mention as possibly occurring when this drug is taken to treat hypertension? (Select all that apply.) | dizziness, fatigue, dry cough |
| The nurse is assessing a patient who will be starting antihypertensive therapy with an ACE inhibitor. Which condition, if present in the patient, would be a reason for cautious use? | renal insufficiency |
| A patient states that he does not like the side effects of his blood pressure medication, clonidine, and wants to stop it immediately. The nurse knows that which of these conditions may occur if this medication is stopped abruptly? | severe rebound hypertension |
| ACE Inhibitors: Indications | hypertension, heart failure, renal protective effects in pts with diabetes |
| A woman who is allergic to bees has just been stung while out in her garden. She reaches for her bee-sting kit, which would most likely contain which drug? | Epinephrine |
| Drug type that mimics the parasympathetic NS | Cholinergic |
| Drug type that mimics the sympathetic NS | Adrenergic |
| The nurse is aware that adrenergic drugs may be used to treat which conditions? | Asthma, Open-angle glaucoma, nasal congestion |
| The nurse is administering dopamine to the patient in cardiogenic shock after a motor vehicle accident. Which assessment finding indicates the dopamine is achieving its desired effect? | Blood pressure of 110/64 mm Hg Decrease in heart rate to 100 beats/min Increase in urine output to 30 mL/hr |
| Which instruction should the nurse provide to the patient taking salmeterol by inhaler? | Rinse mouth after use. |
| Antagonist | drug that blocks a response |
| Agonist | drug that mimics a response |
| Blocker = | Antagonist |
| Mimetic = | Agonist |
| Effect of PNS on heart | reduces heartbeat |
| Effect of SNS on heart | increases heartbeat |
Created by:
kalanijade
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