Term
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Definition
| hypertension with no know cause 90% of people |
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Term
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Definition
| High blood pressure resutling from a known cause. ( a tumor in the adrenal medulla) |
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Term
| The step care approach to manage hypertension |
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Definition
1)Lifestyle modifications
2) Inadequate response
-Diuretic, beta blockers, angiotensis, calcium channel blocker, angiotensis II
Step 3: Inadequate response
-Consider change in dose, class, addition of another drug
Step 4: Inadequate response
-a second or third agent or diuretic is added if not already prescribed |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
> or equal to 160
or > equal to 100 |
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Term
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Definition
Pro-Captopril (ending with pril)
Treatment of
hypertension
Treatment of heart
failure & left ventricular dysfunction |
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Term
Ace inhibitors
Adverse effects |
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Definition
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Term
Angiotensin II Receptor
Blockers (ARB’s) |
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Definition
Prototype-Losartan (Cozaar)
Treatment of
hypertension
Treatment of heart failure in patients intolerant to ACE inhibitors
Slow progression of renal disease in those with type 2 diabetes |
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Term
Angiotensin II Receptor
Blockers (ARB’s)
Adverse Affects |
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Definition
Hypotension
GI complaints
Upper resp infections
Cough
Alopecia |
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Term
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Definition
prot-Diltiazem (Cardizem,
Dilacor CR)
Treatment of
hypertension
Treatmen
t of angina
Treatment of
arrhythmias (atrial
fibrillation) |
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Term
Calcium Channel Blockers
Adverse affects |
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Definition
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Term
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Definition
Prot-Nitroprusside (Nitropress)
Severe hypertensive
emergencies or
hypertensive crisis that
has not responded to
other treatment |
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Term
Vasodialators
Adverse affects |
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Definition
Reflex tachycardia
Nausea/vomiting
Cyanide toxicity |
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Term
Ace inhibitors
Implementation |
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Definition
Do not confuse captopril with carvedilol.
Correct volume depletion, if possible, before initiation of therapy due to possible precipitous drop in BP during first 1–3 hr following first dose. Risk of hypotension may be decreased by discontinuing diuretics or cautiously increasing salt intake 2–3 days prior to beginning captopril. Monitor BP closely. Resume diuretics if BP is not controlled.
PO: Administer 1 hr before meals or 2 hr after meals. May be crushed if patient has difficulty swallowing. Tablets may have a sulfurous odor..
An oral solution may be prepared by crushing the tablets. |
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Term
Ace Inhibitor
patient Teaching |
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Definition
Instruct patient to take captopril as directed at the same time each day, even if feeling well. Take missed doses as soon as remembered but not if almost time for next dose. Do not double doses. Warn patient not to discontinue ACE inhibitor therapy unless directed by health care professional..
Caution patient to avoid salt substitutes containing potassium or foods containing high levels of potassium or sodium unless directed by health care professional. See Appendix M.
Caution patient to change positions slowly to minimize orthostatic hypotension. Use of alcohol, standing for long periods, exercising, and hot weather may increase orthostatic hypotension.
Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications, especially cough, cold, or allergy remedies.
May cause dizziness. Caution patient to avoid driving and other activities requiring alertness until response to medication is known.
Advise patient to inform health care professional of medication regimen prior to treatment or surgery.
Advise patient that medication may cause impairment of taste that generally resolves within 8–12 wk, even with continued therapy.
Instruct patient to notify health care professional if rash; mouth sores; sore throat; fever; swelling of hands or feet; irregular heart beat; chest pain; dry cough; hoarseness; swelling of face, eyes, lips, or tongue; difficulty swallowing or breathing occurs; or if taste impairment or skin rash persists. Persistent dry cough may occur and may not subside until medication is discontinued. Consult health care professional if cough becomes bothersome. Also notify health care professional if nausea, vomiting, or diarrhea occurs and continues.
Advise women of childbearing age to use contraception and notify health care professional of pregnancy is planned or suspected.
Emphasize the importance of follow-up examinations to evaluate effectiveness of medication.
Hypertension: Encourage patient to comply with additional interventions for hypertension (weight reduction, low sodium diet, discontinuation of smoking, moderation of alcohol consumption, regular exercise, and stress management). Medication controls but does not cure hypertension..
Instruct patient and family on correct technique for monitoring BP.
Advise them to check BP at least weekly |
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Term
Angiotensin II Receptor
Blockers (ARB’s)
Implimentations |
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Definition
Correct volume depletion, if possible, prior to initiation of therapy.
PO: May be administered without regard to meals.
Losartan
PO: For patients with difficulty swallowing tablets, pharmacist can compound oral suspension; stable for 4 wk if refrigerated. Shake suspension before each use. |
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Term
Angiotensin II Receptor
Blockers (ARB’s)
Teaching |
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Definition
Emphasize the importance of continuing to take as directed, even if feeling well. Take missed doses as soon as remembered if not almost time for next dose; do not double doses. Instruct patient to take medication at the same time each day. Warn patient not to discontinue therapy unless directed by health care professional.
Caution patient to avoid salt substitutes containing potassium or food containing high levels of potassium or sodium unless directed by health care professional. See Appendix M.
Caution patient to avoid sudden changes in position to decrease orthostatic hypotension. Use of alcohol, standing for long periods, exercising, and hot weather may increase orthostatic hypotension.
May cause dizziness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications, especially cough, cold, or allergy remedies.
Instruct patient to notify health care professional of medication regimen prior to treatment or surgery.
Instruct patient to notify health care professional if swelling of face, eyes, lips, or tongue occurs, or if difficulty swallowing or breathing occurs.
Advise women of childbearing age to use contraception and notify health care professional if pregnancy is suspected or planned, or if breastfeeding. If pregnancy is detected, discontinue medication as soon as possible.
Emphasize the importance of follow-up exams to evaluate effectiveness of medication.
Hypertension: Encourage patient to comply with additional interventions for hypertension (weight reduction, low-sodium diet, discontinuation of smoking, moderation of alcohol consumption, regular exercise, stress management). Medication controls but dose not cure hypertension..
Instruct patient and family on proper technique for monitoring BP. Advise them to check BP at least weekly and to report significant changes. |
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Term
Calcium Channel Blockers
Implementation |
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Definition
PO: May be administered without regard to meals. Administer with meals if GI irritation becomes a problem. Administer verapamil with meals or milk to minimize gastric irritation. Felodipine should be taken on empty stomach or with a light meal..
Do not open, crush, break, or chew sustained-release capsules or tablets. Empty tablets that appear in stool are not significant..
Crush and mix diltiazem with food or fluids for patients having difficulty swallowing. |
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Term
Calcium Channel Blockers
Teaching |
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Definition
Instruct patient to take medication as directed, even if feeling well. Take missed doses as soon as possible unless almost time for next dose; do not double doses. May need to be discontinued gradually..
Advise patients taking felodipine, nifedipine, nimodipine, nisoldipine, nicardipine, and verapamil to avoid drinking grapefruit juice during therapy.
Instruct patient on technique for monitoring pulse. Instruct patient to contact health care professional if heart rate is <50 bpm.
Caution patient to change positions slowly to minimize orthostatic hypotension.
May cause drowsiness or dizziness. Advise patient to avoid driving or other activities requiring alertness until response to the medication is known.
Instruct patient on importance of maintaining good dental hygiene and seeing dentist frequently for teeth cleaning to prevent tenderness, bleeding, and gingival hyperplasia (gum enlargement).
Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to avoid concurrent use of alcohol or OTC medications and herbal products, especially cold preparations, without consulting health care professional.
Advise patient to notify health care professional if rash, irregular heartbeat, dyspnea, swelling of hands and feet, pronounced dizziness, nausea, constipation, or hypotension occurs or if headache is severe or persistent.
Caution patient to wear protective clothing and use sunscreen to prevent photosensitivity reactions.
Angina: Instruct patient on concurrent nitrate or beta-blocker therapy to continue taking both medications as directed and use SL nitroglycerin as needed for anginal attacks..
Inform patient taking isradipine or nifedipine that anginal attacks may occur 30 min after administration as a result of reflex tachycardia. This is usually temporary and is not an indication for discontinuation.
Advise patient to contact health care professional if chest pain does not improve, worsens after therapy, or occurs with diaphoresis; or if shortness of breath or persistent headache occurs.
Caution patient to discuss exercise restrictions with health care professional before exertion.
Hypertension: Encourage patient to comply with other interventions for hypertension (weight reduction, low-sodium diet, smoking cessation, moderation of alcohol consumption, regular exercise, and stress management). Medication controls but does not cure hypertension..
Instruct patient and family in proper technique for monitoring BP. Advise patient to take BP weekly and to report significant changes to health care professional. |
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Term
Vasodilators
Implementations |
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Definition
If infusion of 10 mcg/kg/min for 10 min does not produce adequate reduction in BP, manufacturer recommends nitroprusside be discontinued.
» May be administered in left ventricular HF concurrently with an inotropic agent (dopamine, dobutamine) when effective doses of nitroprusside restore pump function and cause excessive hypotension. |
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Term
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Definition
| Advise patient to report the onset of tinnitus, dyspnea, dizziness, headache, or blurred vision immediately. |
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