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23 Cards in this Set
- Front
- Back
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What is the difference between secondary and essential HTN?
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secondary HTN is caused by a specific underlying pathology and essential HTN there is no clear cause of the elevated blood pressure
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What are the 5 ways of treatment of HTN?
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diuretics, sympatholytic drugs, vasodilators, renin-angiotensin system inhibitors, calcium channel blockers
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What do diuretics do?
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increase formation and excretion of urine thus decreasing the plasma fluid volume
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Identify the 3 major types of diuretics
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loop, thiazide, potassium sparing
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What is the mechanism of action of Thiazide (HCTZ)
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inhibit sodium reabsorption causing water to be retained in nephron ultimately resulting in increased water and sodium excretion
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What is the mechanism of action of loop diuretics?
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act on the loop of Henle along the distal convoluted tubule to inhibit sodium reabsorption caused increased water excretion
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What are two types of Loop diuretics?
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Lasix, furosemide
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Name two K sparing diuretics
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spironolactone and aldactone
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What is the mechanism of action for K sparing diuretics?
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later portion of distal convoluted tubule, allows sodium to remain in the nephron but prevents potassium from being secreted from the body into the nephron
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What type of condition do K sparing diuretics prevent?
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hypokalemia
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Adverse effects of diuretics
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volume depletion, electrolyte imbalance, and impaired glucose metabolism
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What are the effects of volume depletion?
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may cause reflex increase in CO or TPR or activate the renin-angiotensin system puting increased demand on cardiac muscle
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What types of electrolyte imbalance can occur?
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hypokalemia can result from thiazide and loop diuretic use; hyperkalemia can result from K-sparing
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What do vasodilators do?
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vasodilate the peripheral vasculature which will decrease peripheral resistance thus decreasing BP
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Name 2 drugs of vasodilators
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Minoxidil (Linoten); Nitroprusside (Nipride, Nitropress)
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What is the mechanism of action for Minoxidil and Nitroprusside?
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directly inhibit vascular smooth muscle which allows decrease in BP
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What are the adverse effects of vasodilators?
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reflex tachycardia, dizziness, hypotension, weakness, mausea, fluid retention, HA
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When is it a good idea to use vasodilators for HTN?
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in emergent cases, not usually a first choice
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What is the purpose of renin-angiotensin system inhibitors?
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to decrease the vasoconstriction that occurs due to release of angiotensin 2
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Name 2 types of renin-angiotensin system inhibitors
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ACE ( angiotensin-converting enzyme) inhibitors (Iisinopril) and angiotensin 2 inhibitors such as Iosartan (Cozaar)
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What is the advantage of administering renin-angiotensin inhibitors?
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lower incidence of adverse effects
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How do calcium channel blockers aid in treating HTN?
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block entry into smooth muscle cells which causes VD and decreases vascular resistance, inhibits cardiac contraction
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What should a PT keep in mind when treating a patient who is on anti-HTN meds?
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Beta blockers may blunt HR
watch for hypotension and OH encourage pt with meds and non pharm tx such as change in diet, no smoking, stress management, and exercise |
