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Antihypertensive drug classifications
Which anti-hypertensive medication classification group has the suffix of -pril? (ex. capopril, ramipril, prinivil)
Which antihypertensive medication classification group has the suffix of -sartan? (ex. valsartan, losartan)
ANGIOTENSION II RECEPTOR ANTAGONISTS
What is a common Side effect of the Peripheral vasodilator Minoxidil?
Increased hair growth !
Name the two Alpha 2 agonist drugs.
Clonidine (CATAPRES)- dry mouth S/E
Which two Beta Blockers can be used for both Heart Failure and Hypertension?
Carvedilol (COREG)-Primary HF Tx drug
Which Anti-hypertensive medication classification group has the suffix of -sin? (ex. prazonin, terazosin, doxazosin)
What is the most common side effect from an ACE Inhibitor?
Persistent Dry Cough!
If a patient's blood pressure remains high after starting Lisinopril (ACE), then what drug class should be added in as a combination treatment?
Add a diuretic- like THIAZIDE.
What are the two CLASSES of Potassium wasting diuretics?
What is one use for a Carbonic Anhydrase Inhibitor besides treating Hypertension?
Treats acute mountain sickness or high altitude sickness.
Out of the three Peripheral vasodilators, which one is most effective at controlling a black person's hypertension?
Which drug classes used to treat hypertension cause impotence in men? Which class DOES NOT?
a. Beta Blockers and Alpha Blockers- impotence
b. ACE Inhibitors- NO impotence :)
Which heart & lung conditions are contraindicated with Beta Blocker drugs?
Bradycardia- because it already lowers HR
2nd and 3rd Degree Heart Block
Asthma and COPD- bronchoconstriction is a S/E
HTN- name the classification used as First Line Drugs for all of the following pt's:
A. Moderate HTN, uncomplicated
C. Recent MI patient
a. Diuretic- always try first with uncomplicated, mod. HTN
b. ACE Inhibitor- BB's raise blood glucose!
c. Beta Blocker- a Post MI pt will ALWAYS be started on a BB.
A person being treated for HTN with an Alpha Blocker should be educated by the nurse about which common side effect?
Orthostatic Hypotension!! Always advise pt to sit before standing.
Blocking Alpha 1 receptors will result in what hemodynamic change?
clonidine (Catapres) belongs to which drug classification?
If your patient on an ACE inhibitor becomes hyperkalemic, what drug could be combined with the ACE to counteract the high levels of potassium?
Hydrochlorathiazide (K+ wasting diuretic)
Which common, TEMPORARY side effect should the nurse inform her patient about when starting an ACE Inhibitor?
Light-headedness for the first week.
If your patient cannot tolerate the ACE Inhibitor medication he is on for HTN, which drug classification should he be switched to?
Angiotensin II Receptor Antagonist (ARB)- both have similar actions.
If your patient tells you that he is allergic to sulfa, which drug classification for HTN treatment is immediately "off the table" as choices for treatment?
Direct Rennin Inhibitors
Nitroprusside (NITROPRESS) should always be used where? and why?
In the ER or ICU- because it is a POWERFUL VASODILATOR.
Which drug is preferred to treat pregnant women with HTN?
hydralazine (Apresoline) -Peripheral Vasodilator.
Which common side effect should be monitored for in the pt taking Verapamil (CALAN) ?
Constipation- tell pt to Increase fluids and fiber in their diet.
Which common side effect should be monitored for in the pt taking nifedipine (PROCARDIA)?
Name six main "ACTIONS" of the Calcium Channel Blockers
1. Vasodilation; 2. Decreases SA firing (decrease HR); 3. Decreases AV conduciton; 4. Decreases myocardial contractility; 5. INCREASES cardiac output; 6. Decreases blood pressure.
Knowing that the THIAZIDE diuretics are the first line treatment for HTN, which specific drug is used first from this classification?
furosemide (LASIX) belongs to which type of Diuretic class?
spironolactone (ALDACTONE) belongs to which type of diuretic class?
Loop Diuretics act on which part of the kidneys? (the name gives you a BIG HINT)
The ascending LOOP of Henle
Thiazide Diuretics act on which part of the kidneys?
Distal convoluted renal tubule
Which drug class enhances the action of Lithium and Digoxin- thus increasing the risk for Digoxin toxicity?
Name three 'conditions' that Calcium Channel Blockers are used to treat? (HINT- three of them are ones covered on this test!)
In the Calcium Channel Blockers, what is the PRIMARY action of the subdivision 'non-dihydropyridines'?
Primary effect is to slow the HR. - NON-dihydropyridines
Primary effect is vasodilation- Dihydropyridines- also slow the HR a little.
Name the three components of the Cardiovascular system:
1. Heart- pump
2. Vessels- pipes
3. Blood- fluid
What is the criteria for an emergency hypertensive episode?
B/P of 200/120 or more.
Explain Selective vs. Nonselective
Selective: Only affects the Heart- Slows heart rate
Non-selective: affects the heart and the lungs- Add bronchoconstriction
What is the goal in Hypertensive therapy?
Reduce blood pressure in order to avoid long-term consequences of hypertension.
A. What is a normal B/P?
B. What is a preferred B/P for a Diabetic?
C. What is a preferred 'goal' B/P for a HTN pt?
C. < 140/90
What medications can increase a person's B/P and should be avoided by the pt with HTN?
NSAIDS, Diet Pills, Decongestants.
What is the recommended alcohol intake limit for a pt with HTN in both males and females?
Males: 2 drinks/ day- MAX
Women: 1 drink/day -MAX
What risk factors CAN be controlled by the pt with HTN?
smoking, weight, exercise, and alcohol intake.
What risk factors CANNOT be controlled by the pt with HTN?
Age, gender, race, family Hx.
How much exercise should you advise your pt to complete?
30-60 mins /day (6 days a week)
60 mins/day if weight loss is desired.
"Essential Hypertension" accounts for what percentage of all HTN?
Secondary HTN accounts for the other 10%.
Loop Diuretics are better than Thiazide diuretics for which condition? give a drug example.
Loop diuretics produce an almost immediate diuresis whereas Thiazides will not. Ex. Furosemide (Lasix).
How do ACE Inhibitors protect the kidneys?
They protect the Diabetic pt with Proteinuria from sustaining damage to their Glomerulus.
What are the two main actions of the ACE Inhibitors?
Decreased Water retention
Why is the Beta Blocker, Coreg highly effective in treating HTN and HF?
Coreg is NON SELECTIVE. It also has Alpha 1 properties.
What is the best indicator of fluid status changes?