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Blood Pressure Meds

QuestionAnswer
What is the prototype for ACE inhibitors? captopril (capoten)
What is the mechanism of action of ACE inhibitors? blocks conversion of angiotension I to angiotension II which causes vasodilation and excretion of sodium and water, but retention of potassium.
What is the suffix associated with ACE inhibitors? "ril" or "pril"
What are the therapeutic uses for ACE inhibitors? Heart failure, HTN, MI, diabetic and nondiabetic nephropathy.
What are the adverse effects/nursing considerations for ACE inhibitors? Orthostatic HTN Dry Cough Hyperkalemia Rash Angioedema- life threatening allergic reaction! Neutropenia- emergency, but rare monitor WBC
What are the pt. teaching points of ACE inhibitors? take one hour before meals on an empty stomach don't take in pregnancy Category D medication monitor for cough, ortho HTN, infections and rash
What is the prototype for ANgiotensin II Receptor Blockers (ARBS)? losartan (cozar)
What is the mechanism of action of ARBS? blocks action of angiotensin II and causes vasodilation and excretion of sodium and water.
What is the suffix associated with ARBS? "tan"
What are the therapeutic uses for ARBS? HF, HTN, MI, diabetic and nondiabetic nephropathy
What are the adverse effects of ARBS? Angioedema- life threatening emergency ortostatic HTN
What are the pt. teaching points of ARBS? lifestyle modifications give with food don't take in pregnancy cat. D monitor for adverse effects- orth HTN
What is the prototype of Aldosterone Antagonists? eplerenone (Inspira) spironolactone (aldosterone)
What is the mechanism of action of Aldosterone Antagonists? blocks aldosterone promoting the excretion of sodium and water.
What are the adverse effects of Aldosterone Antagonists? hyperkalemia/hyponatremia lithium toxicity-monitor levels avoid potassium supplements and other medications that increase potassium
What is the prototype for Calcium Channel Blockers? Selective- adalat(Procardia) nonselective- diltazem(Cardizem)
What is the mechanism of action of Calcium Channel Blockers? blocking calcium channels causing relaxation of arteries (selective) and slowing of conduction through the AV nodes and decreases force of contraction (nonselective)
What suffix do some Calcium Channel Blockers have? "pine"
What is the therapeutic use of Calcium Channel Blockers? angina, hypertension, cardiac arrhythmias(nonselective only)
What are the adverse effects of Calcium Channel Blockers? Reflect tachycardia(s) peripheral edema (b) hypotension(b) Bradycardia/dysrhythmias (ns) avoid beta-blockers and other meds that slow HR with nonselectives Give IV verapamil (2-3 min); cardizem given continuous infusion avoid in MI, shock or HF
What are the pt teaching points of Calcium Channel Blockers? Don't take in pregnancy monitor BP follow up/don't stop until consult with physician avoid grapefruit juice in both!
What is the prototype of Alpha Adrenergic Blockers (selective to alpha 1)? prazosin(minipress) doxazosin mesylate (cardura)
What is the mechanism of action of Alpha Adrenergic Blockers? selectively blocks alpha 1 receptors causing venous and arterial vasodilation; smooth muscle relaxation in prostate and bladder neck (used for BPH)
What are the therapeutic uses for Alpha Adrenergic Blockers? HTN, Benign prostatic hyperplasia (BPH)
What are the adverse effects of Alpha Adrenergic Blockers? on first dose- ortho HTN- start low and monitor BP for 2 hrs after admin dizziness- careful driving and with anything causing mental alertness
What are the pt teaching points of Alpha Adrenergic Blockers? avoid in pregnancy manage ortho HTN take first dose before bed
What is the prototype for Centrally Acting Alpha 2 Agonists? clonidine (catapress)
What is the mechanism of action of Centrally Acting Alpha 2 Agonists? act within CNS to decrease sympathetic simulation of adrenergic receptors (both alpha 2 and beta) of heart and peripheral vascular system leading to lowered BP and HR.
What are the therapeutic uses for Centrally Acting Alpha 2 Agonists? HTN and other investigational purposes
What are the adverse effects/pt teaching points of Centrally Acting Alpha 2 Agonists? drowsiness/sedation dry mouth constipation rebound HTN- don't stop suddenly administer patch on hairless, clean, dry skin and be sure to remove old patch avoid taking with alcohol and other meds that cause drowsiness
What is the prototype for Beta Adrenergic Blockers? metoprolol (lopressor)- cardioselective for Beta 1 propanolol (Inderal)- nonselective also block beta 2
What is the mechanism of action of Beta Adrenergic Blockers? blocking beta 1 causes decreased heart rate(negative chronitropic action), decreased myocardial contractility (negative intropic action), decreases rate of conduction through AV node (negative dromotropic action
What is the suffix for Beta Adrenergic Blockers? "lol"
What are the therapeutic uses for Beta Adrenergic Blockers? HTN, tachyarrhytmias, HF, and MI
What is an adverse effect specific to nonselective beta blockers? will cause bronchioconstriction and decreased blood glucose levels. Use VERY CAUTIOUSLY in pts with pulmonary disorders.
What are adverse effects of Beta Blockers? bradycardia(both)- hold if HR is under 60 decreased cardiac output ortho HTN masked symptoms of hypoglycemia (beta 1)- monitor diabetics closely do not give to pts experiencing AV blocks & bradycardia or if receiving other meds that decrease HR or BP
How should you give Beta Blockers? intravenously and slowly (over 5 minutes)
What are the pt. teaching points of Beta Blockers? do not stop taking abruptly- wean off over 2 weeks ortho htn monitor HR and BP at home may cause sexual dysfunction
What is the prototype for Hypertensive Crisis? nitroprusside (nipride) also use calcium channel blockers and ACE inhibitors
What is the mechanism of action for Hypertensive Crisis Meds? direct acting vasodilation of arteries and veins causes rapid decrease in blood pressure only used in critical care units
What pts are at an increased risk for toxicity when given Hypertensive Crisis meds? Pts who are in kidney and liver failure.
What are the adverse effects of direct-acting vasodilators? extreme hypotension- do NOT give rapidly, between 0.3-4mcg/kg/min on infusion pump constant monitor of BP and ECG maintain bedrest thicyanate toxicity (byproduct) cyanide poisoning (byproduct of metabolism) protect meds from light & discard in 24hrs
What medication should you avoid prolonged use of and not give after three days? Direct-Acting vasodilators
What are some good things to remember about antihypertensive agents in genera? teach lifestyle changes manage ortho HTN monitor BP/HR don't stop suddenly keep appoinments don't take in pregnancy
Created by: ksrq5d