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Antihypertensives

PHARM TEST 2

QuestionAnswer
HTN Stage 2 140/90
Hypertensive Crisis 180/120 IMMEDIATE INTERVENTION
"LOL" Beta-blockers
First line therapy (start here) Thiazide Diuretic (HCTZ) Beta-blockers
ACE Inhibitors Prototype "Pril" Lisinopril
What does Lisinopril do? Block activity of ACE (powerful vasoconstrictor) Suppress the RAAS system - H20 and sodium not retained so blood pressure drops
Lisinopril Contraindications Pt. has impaired real function -Look for BUN/Creatnine
ADRS Angioedema is EMERGENT bc of AIRWAY
Calcium Channel Blockers Prototype Amlodipine
What do calcium channel blockers do? Inhibit the movement of calcium ions across the cell membranes of cardiac and arterial muscle cells. Less calcium avaliable for transmission of nerve impulses Blood vessels relax and open/contract more Reduce cardiac workload
Amlodipine Contraindications Pt. with sick sinus AVOID GRAPEFRUIT JUICE Heart blocks (unless pacemaker in) Cautious: Pts with HF or renal/hepatic failure
Antihypertensive ADRs : CNS and OTHER Fatigue dizziness depression HA, Syncope Orthostatic hypotension - >10 SBP shift
Antihypertensive ADRs: Respiratory URI Cough (with ACE: dry, hacking cough that might not get better until med is discontinued)
Antihypertensive ADRs: GI Abdominal pain, nausea, diarrhea, constipation, gastric irritation
Antihypertensive Patient Education Check BP before and after administration (30 min) - be consistent Monitor weight for H20 retention Taper drug to prevent rebound hypotension Can cause drowsiness Change positions slowly Off label - panic attacks
ACE inhibitors with other Meds ACEI with NSAIDS = Decreased hypotensive effects ACEI with hypoglycemic and insulin = increased hypoglycemia - need less insulin/meds ACEI with potassium sparing diuretics = Increased potassium levels and hyperkalemia risk (TAKE BMP)
Clonidine (catapres): patch Oral/transdermal Change every 7 days Rotate sites Used for breakthrough hypotension -in hospital - PRN at home - long term
Created by: Mplaster
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