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pharm final

antihypertensive drugs

BP readings that are hypertensive systolic > 140 and/or diastolic >90
Why is hypertension a major health problem increases demands on heart/kidney; "silent killer"
what percentage of causes of hypertension are unknown 90%
3 causes of hypertension vessels constrict, cardiac contractility high, blood volume high
What happens with BP is elevated (what is activated in the body) baroreceptor (fast response) stretch stimulates vagus nerve
What is the result of stimulation of the vagus nerve by baroreceptors in hypertension decrease heart rate and force of contraction; decreased resistance by peripheral vasodilatation
what NS causes BP to decrease sympathetic nervous system
What hormone causes BP to decrease norepinephrine
What is the result of SNS stimulation and norepinephrine that results from decreased BP vasoconstriction
effect of beta-1 receptors increases heart rate and force
What happens in the kidney if BP or sodium is low nephron releases rennin-Angiotension: aldosterone (slow process)
mathematical equation to produce BP BP = resistance of artery x cardiac output
define stitch in relation to BP regulation simplified treatment intervention to control hypertension
lifestyle changes to lower BP diet, exercise, stop smoking
first line therapy for HTN diuretics (thiazide alone)
2nd line of drug therapy for HTN Thiazides with ACE inhibitor/ARB/BB
3rd line of drug therapy for HTN increase dosage of thiazide with ACE inhibitors/ARB/BB
4th line of drug therapy for HTN add calcium channel blocker
2 possible antioxidants to help decrease blood pressure dark chocolate and grape seed extract
What antihypertensives work on CNS beta blockers or alpha 2 agonists
What antihypertensives work on heart beta blockers
What antihypertensives work on the kidney diuretics; beta blockers; ACE inhibitors
what antihypertensives work on the blood vessels alpha 1 receptor blockers; calcium channel blockers; vasodilators, AT1 receptor antagonists; ACE inhibitors
where do beta blockers work CNS; heart; kidney
where do alpha 2 agonists work CNS
where do diuretics work kidneys
Where do ACE inhibitors work kidney and blood vessels
where do alpha 1 receptor blockers work blood vessels
Where do calcium channel blockers work blood vessels
Where do vasodilators work blood vessels
Where do AT1 receptor antagonists work blood vessles
5 primary antihypertensive drug categories diuretics; calcium channel blockers, ACE inhibitors; ARBS; beta blockers
ACE angiotension-converting enzyme
ARB angiotensin II receptor blockers
dynamics of diuretics increase urine output and decrease fluid volume/ dilates vessels
diuretic prototype hydrochlorothiazide (HydroDiuril)
hydrochlorothiazide diruteic
Diuretic kinetics po (onset 2 hours; peak 4 hours)
Advantage of using diuretics inexpensive, reduce morbidity and mortality, few side effects
disadvantage of using diuretics potassium loss = biggest side effect
general side effects of diuretics orthostatic hypotension; dizziness; hypokalemia
common ending in calcium channel blockers "dipine"
Dynamics of calcium channel blockers blocks calcium ion channels in arterial smooth muscles = vasodilation and reduced afterload
physiologic effect of the dynamics of calcium channel blockers vasodilatation; reduced afterload
prototypes for calcium channel blockers nifedipine (Procardia); amlodipine (Norvasc);
Are calcium channel blockers used for monotherapy or polytherapy not for monotherapy
nifedipine (procardia) calcium channel blocker
amlodipine (Norvasc) calcium channel blocker
kinetics of calcium channel blockers po (onset 10-30 minutes)
advantages of calcium channel blockers usefull for elderly and African Americancs
Calcium channel blockers are another kind of medication along with antihypertensive class IV antidysrhythmic
Are calcium channels slow or fast slow; takes along time to work
disadvantages of amlodipine (Norvasc) calcium channel blocker reflex tachycardia (causes a spike in heart rate from vasodilation)
Side effects associated with hypotension of amlodipine (Norvasc) calcium channel blocker dizziness; headache; flushing
What is the use of amlodipine (Norvasc) calcium channel blockers linked to? more heart attacks, depression, suicide
What should you avoid when taking amlodipine (Norvasc) calcium channel blockers grapefruit juice
2 antihypertensive drugs affecting renin-angiotensin system ARBS and ACE inhibitors
What group of antihypertensives are known as the coughing prils angiotension-converting enzyme (ACE) inhibitors
dynamics of ACE inhibitors decrease in vascular tone; inhibit aldosterone release = secrete fluids
prototype of ACE inhibitors enalapril (Vasotec); Lisinopril (Zestril)
enalapril (vasotec) ACE inhibitor
lisinopril (Zestril) ACE inhibitor
kinetics of ACE inhibitors po; IV
what should you monitor when giving first dose of IV profound hypotension
Side effects of ACE inhibitors cough; skin rash
what type of cough is caused by ACE inhibitors dry hacking cough; non-productive
What kind of skin rash is caused by ACE inhibitors angioedema
What blood irregularity are caused by ACE inhibitors neutropenia (decreased WBC); agranulocytosis
What is a risk with agranulocytosis in ACE inhibitors increased risk of infection
When should you give ACE inhibitors at bedtime due to profound hypotension
What should you monitor when giving ACE inhibitors signs of infection
What group of antihypertensives are known as the sartan sisters angiotension II receptor blockers (ARBs)
ARB dynamics blocks angiotension II after formed
ARB prototype losartan (Cozaar)
What is angiotension II potent vasoconstrictor
losartan (Cozaar) ARB
kinetics of ARBs po (slow) often given with other drugs
advantage of ARBs dose not cause cough or angioedema
What other antihypertensives are more likely tried before ARBs diuretics; ACE inhibitors
What NS are peripheral blood vessels innervated by sympathetic nervous system ONLY
Adrenergic antagonists work with what nervous systems autonomic nervous system; sympathetic division
what does autonomic nervous system control involuntary body function
What is the sympathetic division of the autonomic nervous system in charge of fight-or-flight response (adrenalin)
Effect of adrenergic antagonists on BP slows pulse and BP down
what antihypertensives are known as "olol twins" beta-adrenergic blockers
Beta blocker dynamics block binding of norepinephrine to heart
physiologic effect of beta blockers decrease heart rate and contractility
beta blocker prototype propranolol (inderal); atenolol (Tenormin)
propranolol (inderal) beta blocker
atenolol (tenormin) beta blocker
kientics of propranolol (inderal) po, IV
kinetics of atenolol (tenormin) po
side effects of beta blocker fatigue, impotence, bradycardia, Steven-Johnson syndrome, agranylocytosis
define Steven-Johnson syndrome toxic epeidermal necrolysis; skin breaks out in patches of "raw" area
alpha 1 adreneric blocker prototype prozasin (HCl) minipress
prozasin hcl (minipress) alpha 1 adrenergic blocker
alpha 1 adrenergic blocker dynamics prevent norepinephrine from acting on alpha receptors in arteries in smooth muscles (VESSELS)
side effects of alpha 1 adrenergic blockers orthostatic hyptension, dizziness, fainting, first dose phenomenon
define first dose phenomenon BP will decrease the first time you take it
What antihypertensives have the first dose phenomenon alpha 1 adrenergic blockers
When should alpha 1 adrenergic blockers be taken at bedtime due to first dose phenomenon
alpha 2 adrenergic antagonist prototype clonidine hydrochloride (Catapres); methylodopa (Aldomet)
clonidine hydrochloride (Catapres) alpha 2 adrenergic antagonist
methyldopa (aldomet) alpha 2 adrenergic antagonist
dynamics of alpha 2 adrenergic antagonist blocks the binding of norepinephrine to the HEART
How do alpha 2 adrenergic antagonists decrease BP decrease cardiac output
How do alpha 2 adrenergic antagonists suppress renin production cause decreased flow to kidney which reduces renal resistance
When are alpha 2 adrenergic antagonists best when given with diuretic due to sodium retention
alpha 2 adrenergic antagonists kinetics po (30 minutes to 1 hour); transdermal (Catapress TTS)
What is needed before alpha 2 adrenergic antagonists are given eye exam due to retinal degeneration
what happens if alpha 2 adrenergic antagonists are discontinued after long-term therapy rebound hypertension (BP will spike back up after discontinued)
What antihypertensives are known as "strong DAV" direct acting arteriolar
dynamics of direct acting arteriolar direct relaxation of peripheral arteries (BP drops immediately)
use of direct acting arteriolar hyptertensive emergency
direct acting arteriolar prototype hydrazaline (Apresoline); diazoxide (hyperstat)
hydrazaline (apresoline) direct acting arteriolar prototype
diazoxide (hyperstat) direct acting arteriolar prototype
kinetics of direct acting arteriolar rapid IV push; half life 2 minutes (gets in and gets out)
nursing implications for direct acting arteriolar give to patient in recumbent position; monitor BP every 5 minutes
What is an adverse effect of direct acting arterolar reflex tachycardia (compensatory)
what medications should be given along with direct acting arteriolar beta blocker (slow down relfex tachycardia) and diuretic (sodium and water retention)
prototype of direct acting arteries and veins sodium nitropresside (Nipride)
dynamics of direct acting arteries and veins relaxes both arteries/veins
kinetics of direct acting arteries and veins IV emergency
Side effects of direct acting arteries and veins nausea, agitation, muscle twitching
nursing implications for direct acting arteries and veins monitor, caution with renal problem
What is direct acting arteries and veins drugs sensitive to light (wrapped with foil)
What happens when sodium nitropresside (Nipride) reacts with light converts to thiocynatie in liver, can have toxicity
Signs of cyanide poisoning with sodium nitropresside coma, dilated pupils, pink color (looks like sunburn)
Antidote for sodium nitropresside (Nipride) amylnitrate inhalation
life style changes to decrease BPO reduce salt in diet; reduce intake of caffeine/alcohol; quit smoking; loose weight
Teaching for when on antihypertenisve medicaiton weight twice a week; monitor BP; limit vasodilating bath
why is there a problem with compliance in antihypertensive medications side effects make patients feel worse (don't stop medications abruptly)
Created by: 1818554924
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