Term
| What are the possible consequences of uncontrolled hypertension (5)? |
|
Definition
-Heart disease
-Heart failure
-Stroke
-Renal disease
-Blindness |
|
|
Term
| What lifestyle changes should be made to control hypertension (6)? |
|
Definition
-Exercise
-Weight reduction
-Sodium restriction
-Stop smoking
-No alcohol
-No stress |
|
|
Term
| Treatment of Hypertension |
|
Definition
-Aim is to keep BP below 140/90
-Individualize treatment
-Counseling and life-style changes
-Life-long therapy
-Therapy will help to control, but it won’t cure
-Special attention to elderly on antihypertension medication
-Do not stop taking abruptly |
|
|
Term
| What are the first-line drugs used to treat hypertension (4)? |
|
Definition
-Thiazide diuretics
-Beta blockers
-Angiotensin-converting enzyme (ACE) inhibitors
-Angiotensin II-receptor blockers (ARBs) |
|
|
Term
| What are 2 alternatives to the first-line drugs used to treat hypertension? |
|
Definition
-Calcium channel blockers (CCBs)
-Alpha blockers |
|
|
Term
| What third-line drugs are used to treat hypertension? |
|
Definition
-Centrally-acting drugs
-Adrenergic neuron blockers
-Direct-acting vasodilators |
|
|
Term
| Name 3 Thiazide diuretics used to treat hypertension. |
|
Definition
Hydrochlorothiazide
-Chlorothiazide
-Bendroflumethiazide |
|
|
Term
| What is the mechanism of action of Thiazide Diuretics? |
|
Definition
| They inhibit tubular reabsorption of Na+. Na+ is then excreted, followed by water, which causes diuresis. Blood volume is decreased which leads to a drop in blood pressure. |
|
|
Term
| ADRs of Thiazide Diuretics (6) |
|
Definition
-Hypotension
-hypokalemia
-may increase serum uric acid
-may increase glucose
-may increase cholesterol
-may increase triglycerides |
|
|
Term
| When should Thiazide Diuretics be taken? |
|
Definition
|
|
Term
| What are contraindications for Thiazide Diuretics (1)? |
|
Definition
|
|
Term
| What two groups of Beta-blockers are there? |
|
Definition
-Non-selective B blockers
-Cardioselective B1 blockers |
|
|
Term
| Name 2 Non-selective B Blockers. |
|
Definition
|
|
Term
| Name 2 Cardioselective B1 Blockers. |
|
Definition
|
|
Term
| What is the mechanism of action of Beta Blockers? |
|
Definition
| They decrease heart rate and the force of contraction. They inhibit renin production (RAA; Renin-Angiotensin-Aldosterone System). |
|
|
Term
| What are Beta Blockers used for (5)? |
|
Definition
-Antihypertensive agents
-Can be used in combination with diuretic
-Best used in patients w/ high renin levels
-Angina
-Dysrhythmias |
|
|
Term
| ADRs of Beta Blockers (10) |
|
Definition
-Hypotension
-Bradycardia
-Nausea
-Vomiting
-Diarrhea
-Fatigue
-Depression
-Nightmares
-Bronchospasm
-Allergic reactions |
|
|
Term
| Nursing Considerations When Administering Beta Blockers (7) |
|
Definition
-Renal, hepatic function
-Check weight daily
-Check blood pressure
-Check apical/radial pulse
-Check for edema in feet, legs daily
-Change position slowly
-Report bradycardia, depression, etc. |
|
|
Term
| Name 3 Angiotensin-Converting Enzyme (ACE) Inhibitors used to treat hypertension. |
|
Definition
-Captopril
-Enalapril
-Lisinopril |
|
|
Term
| What are ACE inhibitors used for? |
|
Definition
| Mild to severe hypertension. Can be used by patients with diabetes or renal disorders. Combined with diuretic. Also used for congestive heart failure. |
|
|
Term
|
Definition
-Hypotension
-Angiodema
-Persistent dry cough
-Renal impairment/failure
-Hyperkalemia
-Skin rash |
|
|
Term
| Name 3 Angiotensin II Receptor Blockers (ARBs). |
|
Definition
-Losartan
-Candesartan
-Eprosartan |
|
|
Term
| ARBs are the drugs of choice in treating hypertension when patients also suffer from what other conditions? |
|
Definition
|
|
Term
| What is the mechanism of action of ARBs? |
|
Definition
| They block vasoconstriction and facilitate the release of aldosterone and ADH. |
|
|
Term
| What are the contraindications of ARBs? |
|
Definition
|
|
Term
|
Definition
-Dizziness
-Hypotension
-Hyperkalemia |
|
|
Term
| Name 4 Calcium Channel Blockers (CCBs). |
|
Definition
-Diltiazem
-Nicardipine
-Nifedipine
-Verapamil |
|
|
Term
| What is the mechanism of action of CCBs? |
|
Definition
| They decrease the entry of calcium into smooth muscle. This reduces vascular tone and results in vasodilation (and depressed cardiac contractility). |
|
|
Term
| What are CCBs used for (3)? |
|
Definition
-Hypertension
-Angina
-Arrhythmias |
|
|
Term
|
Definition
-Hypotension
-Bradycardia (report after it drops below 60 bpm)
-Constipation
-Leg, muscle cramps
-Allergic reactions
-Edema
-Use w/ caution if patient has CHF (congestive heart failure)
-Headache
-Fatigue
-Flushing |
|
|
Term
|
Definition
|
|
Term
| What is the mechanism of action of Alpha blockers? |
|
Definition
| They block a1 receptors in blood vessels which results in vasodilation. |
|
|
Term
|
Definition
-Orthostatic hypotension
-Nasal congestion
-Nausea
-Vomiting
-Diarrhea |
|
|
Term
| Name 2 Centrally-Acting Antihypertensives |
|
Definition
|
|
Term
| What is the mechanism of action of centrally-acting antihypertensives? |
|
Definition
| They act on the a2 receptors in the medulla which decreases activity of the SNS |
|
|
Term
| ADRs of Centrally-Acting Antihypertensives (6) |
|
Definition
-Sedation
-Depression
-Dizziness
-Headache
-Dry mouth
-Bradycardia |
|
|
Term
| Name two Andrenergic Neuron Blockers |
|
Definition
|
|
Term
| What is the mechanism of action of Andrenergic Neuron Blockers? |
|
Definition
| They interfere with the storage and release of NE from sympathetic nerve endings |
|
|
Term
| Name 4 direct-acting vasodilators. |
|
Definition
-Hydralazine
-Nitroprusside
-Diazeoxide
-Minooxidil |
|
|
Term
| What is the mechanism of action of direct-acting vasodilators? |
|
Definition
| They decrease peripheral vascular resistance by direct relaxation of vascular smooth muscle. |
|
|
Term
| ADRs of Direct-Acting Vasodilators |
|
Definition
-GI disturbances
-Fluid retention
-Minooxidil may cause hirsutism |
|
|
Term
| Name the 3 mechanisms through which hypertension is treated. |
|
Definition
-Renal (salt and water)
-Neural (heart and blood vessels)
-Hormonal (RAA) |
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