Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
NURS 572 Pharm Ch46
Pharm HTN drugs
| Question | Answer |
|---|---|
| what is essential HTN = EHT | 90% of all pts have EHT, which is HTN with no identifiable cause |
| what drug categories are PROVEN to decrease premature death from HT and its complications | diuretics---Beta Blockers---ACEIs |
| what are consequences of HTN | CAD/MI---HF/CHF---CVA---kidney dx/RF---blindness |
| normal bp values | <120----<80 |
| preHTN bp values | 120-139----------80-89 |
| Stage 1 HTN values | 140-159----------90-99 |
| Stage 2 HTN values | >160------------->100 |
| what is goal for HTN tx - normal pts | goal is < 140/90 |
| goal HTN tx - kidney disease, diabetic pts | goal is <130/80 |
| majority of patients require how many drugs to acheive goal | most require 2 drugs |
| What are the compelling indications in the tx of HTN (require specialized drug regimes) | HF-----post-MI-----high-risk CVD-----diabetes----chronic renal disease----recurrent stroke prevention |
| how do we tx normal or pre-HTN | no drug indications - encourage lifestyle modification |
| what lifestyle modification results in a 5-20 mm Hg/10kg bp decrease | weight reduction, the most important lifestyle modification |
| what lifestyle modification results in an 8-14 mmHg bp decrease | DASH eating plan, the second most impactful lifestyle modification |
| what is the third most impactful lifestyle modification to reduce HTN | aerobic exercise lowers bp 4-9 mmHg |
| what TWO lifestyle modifications reduce bp 2-4 mmHG | reduce dietary Na----moderate ETOH consumption |
| Stage 1 HTN - first line drug class | thiazides are first line ---stage 1 HTN |
| name 4 thiazide diuretics | chlorothiazide---hydrochlorothiazide---chlorothalidone----metolozone |
| Stage 1 HTN - other drug classes that may be considered after thiazides | may consider ACEIs----ARBs----BB---CCB---or combination thereof |
| Names of ACEIs that may be considered for Stage 1 tx | The 'prils, who have ADR of cough/angioedema---benzapril, catopril, lisonopril and anything else ending in pril |
| Name the ARBs that may be considered for stage 1 tx | the sartan family with less cough ADR---losartan, valsartan, olmesartant---any anything ending in sartan |
| can we use renin-blocker aliskiren as a consideration for Stage 1 HTN tx | yes, we may consider it as it works upstream of ACEIs and ARBs |
| Stage 1 HTN consider selective B-1 blockers (3) | atenolol---metoprolol---nebivolol----'amen' |
| Stage 1 HTN consider non-selective B-1 B-2 blocker (1) | propanolol |
| stage 1 HTN consider non-selective B-1 B-2 with smypathomimetic activity | pindolol |
| stage 1 HTN consider combined A-1, B-1,B-2 blockers | carvedilol----labetalol |
| What alpha-1 blockers can be used (3) | doxazosin---prazosin---tarazosin |
| What centrally-acting Alpha-2 blockers can be used (4) | clonidine---methyldopa---guanfacine---guanabenz |
| Stage 2 HTN class of drugs, usually given in combination (but not within class) | thiazide diuretic---ACEI---ARB---BB---CCB |
| name 4 K-sparing antidiuretics that can be used | Aldosterone blockers = spironolactone, eplerenone------Na/K pump blockers= triamterene, amiloride |
| what CCBs can be used | verapamil, diltiazem-----and the DHP dihydropyridine family----amlodipine, felodipine, nicardipine and anything else ending in 'dipine |
| combining rules---if first drug used WAS a diuretic that gave inadqueate response--- | keep it in regime, add a second drug (not in same class) |
| if first drug WAS NOT a diuretic and gave an inadequate response | second drug ALMOST ALWAYS a diuretic----take note of potentiating effect on other drugs |
| when adding drugs from a DIFFERENT class, you cannot combine these classes | do not combine ACEIs/ARBs - same MOA-----do not combine BBs/CCBs - coupled MOA yields same result |
| can we combine 2 diuretics? | yes, provided one is loop/thiazide and the other is K sparing |
| patient is already on lisinopril. what drug should be given next | a thiazide diuretic. go ahead, name them -----chlorothiazide, hydrochlorothiazide, chlorothalidone, metolazone |
| what centrally acting Alpha-2 blockers (4) could be used to tx HTN | clinidine, methyldopa, guanabenz, guanfacine |
| what renin inhibitor could be used to tx HTN | aliskiren |
| what drug would we add to hydrochlorothiazide and atenolol | check the answers to make sure you are not combining within class---nor are you combining BBs/CCBs or ACEIs/ARBS |
| just for the fun of it, what are two combinations that MUST be avoided | avoid BBs/CCBs-----avoid ACEIs/ARBs |
| what is 1 DHP that you must watch for to make sure he doesn't slip it in because it CANNOT be used for HTN | nimopidine CANNOT be used for HTN tx ---ONLY indicated for subarachnoid hemorr stroke |
Created by:
lorrelaws
Popular Nursing sets