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40 Cards in this Set

  • Front
  • Back
Normal BP
119/79 mmHg or less
Prehypertension-
120-­‐139/80-­89
Stage 1 hypertension
140-­‐159/90-­99
Stage 2 hypertension
160 or higher/100 or higher
-accounts for 10% of all cases of HTN
is the result of another disease &/or
medicati ons
Secondary HTN
Studies have shown that elevated ___ BP is strongly associated with heart failure, stroke, and renal failure
SYSTOLIC
the amount of blood ejected in a single contraction from the left ventricle (LV) measured in L/ min
Cardiac output (CO)
the opposing force (resistance) the LV has to overcome to eject its volume of blood
Systemic Vascular Resistance (SVR)
Major determinant of DBP
Systemic Vascular Resistance (SVR)
Major determinant of SBP
Cardiac output (CO)
β-­‐blockers and ACE inhibitors have been found to be more effective in ____ than _____
white patients than
African-­‐American patients
CCBs and diuretics have been shown to be more effective in _______ patients than in _____ patients
African-­‐ American
white
BP=
CO X SVR
CO=
HR X STROKE VOLUME
Mechanisms that regulate BP can affect either ___ OR ____ OR ___
CO or SVR or both
Sympathetic nervous system
alpha & beta adrenergic receptors
Cardiovascular system
HR and force of contractility
Renal system
control Na and H2O
renin-­‐angiotensin-­‐aldosterone system
Endocrine system
adrenal gland (aldosterone, catecholemines, cortisol
Incidence of HTN is higher for which race?
African Americans
what is the initial drug of choice for HTN?
thiazide diuretics either alone or in combo with another med
hydrochlorothiazide (Hydrodiuril), metolazone (Zaroxolyn)
Thiazides
furosemide (Lasix)
Loop diuretics
triamterene (Dyrenium); spironolactone (Aldactone)
Potassium-­‐sparing diuretics
how do diuretics work?
• Decreases circulating volume
• Increase Na excretion
• Decreases cardiac output
• Decreases systemic vascular resistance
• Decrease workload of the heart • Decrease BP
Inhibit tubular resorption of sodium, chloride, and potassium ions
Thiazide Diuretics
Action primarily in the distal convoluted tubule
Thiazide Diuretics
Result: water, sodium, and chloride are excreted and potassium to a lesser extent
Thiazide Diuretics
Dilate the arterioles by direct relaxation – *Lowered peripheral vascular resistance
Thiazide Diuretics
• F&E imbalances: volume depletion; ✓orthosta\c hypotension
decreased Na+, K+, Chloride, Mg
increased glucose, calcium, uric acid, metabolic alkalosis
• GI: gastric irritation, N/V, change in bowel
paoerns
• CNS: dizziness, blurred vision, HA, weakness
• Sexual dysfunction: erectile dysfunction, decreased libido
• Integumentary: photosensi\vity, rash
Thiazide Diuretics: Adverse Effects
Act directly on the ascending limb of the loop of Henle to inhibit chloride and sodium reabsorption and thus...increase Na, K+ & Chloride excretion/depletion
Loop Diuretics
Increase renal prostaglandins, resulting in the dilation of blood vessels and reduced peripheral vascular resistance
Loop Diuretics
More potent than the thiazide diuretics but shorter duration
Loop Diuretics
F&E imbalances: same as thiazide diuretics except no hypercalcemia
• CNS: dizziness, orthostatic hypotension
• Ototoxicity: tinnitus, hearing impairment,
vertigo (usually reversible)
• Metabolic:increases glucose, uric acid, LDL, cholesterol, triglycerides, decrease HDL’s
• Heme: neutropenia, thrombocytopenia
Loop Diuretics: Adverse Effects
Weakling of the diuretics but great to counteract K+ loss from other diure4cs
Potassium Sparing Diuretics
Work in collecting ducts and distal convoluted tubules
Potassium Sparing Diuretics
Interfere with sodium-­‐potassium exchange
Potassium Sparing Diuretics
Competitively bind to aldosterone receptors
Potassium Sparing Diuretics
Block the resorption of sodium and water
usually induced by aldosterone thus K+ is conserved
Potassium Sparing Diuretics
• Hyperkalemia-­‐check K+ levels and S&S of hyperkalemia
• Dizziness, HA, weakness, N/V, diarrhea spironolactone
• Gynecomastia
• Amenorrhea
• Irregular menses
• Postmenopausal bleeding
Potassium Sparing Diuretics Adverse Effects