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60 Cards in this Set

  • Front
  • Back
Essential Hypertension
unknown direct cause
approx. 90% of cases
Secondary Hypertension
linked to another problem
approx. 10% of cases
Target Organ Disease of Hypertension
Heart, Brain, Kidneys, Eyes, Circulation
Major Risk Factors of Hypertension
Smoking, Obesity, DM, Dyslipidemia, Physical inactivity, Diet (increased salt/fat, decreased veggies/fiber), Age > 60, Genetic predisposition (male gender)
Primary Prevention of Hypertension
Lifestyle (dietary modifications - alcohol moderation, Excercise program - weight reduction, skoking cessation, stress managment)

Minimize modifiable risk factors (stop smoking and control dislipidemia and DM, treat any underlying cause)
Generic ARBs end with what?
- sartan
ARBs MoA ?
Block the binding of ATII to its receptors
ARBs Therapeutic effects
decrease BP, constriction, resistance, and afterload

Major use of this class is afterload reduction (CHF, MI)

Often second line treatment for patients intolerant of ACE-I
ARBs SE / AEs ?
Most common - headache
ARBs Interactions ?
Other antihypertensives and diuretics (increase hypotensive effects)
ARB examples of drugs in class.
Cozar (losartan)
Diovan (valsartan)
ARBs Nursing Actions ?
Monitor BP, I/O, daily weight, SEs

Assess and monitor serum K levels, renal function

Focus assessment - cardiac and pulmonary

Patient education - medication, hypotension symptoms
Generic Beta Blockers end with ?
- olol
Beta Blockers MoA ?
Cardioselective - bind to, and block, beta 1 receptors

Nonselective - bind to, and block, beta 1 and 2 (heart and lungs)

negative inotrope

negative chronotrope
Beta Blockers Therapeutic effects ?
decrease HR and myocardial O2 demand.

Decrease angina and cardiac rhythm disturbances

decrease renin release (dec. angioensin II formation)
Beta Blockers SE / AEs?
Dysrhythmias (ie. bradycardia), heart failure

Bronchospasm / Bronchoconstriction - dyspnea, wheezing

Fatigue, depression, impotence
Beta Blockers Interactions ?
Other antihypertensives and diuretics (increase hypotensive effects)
Beta Blockers Examples ?
Inderal (propranolol)
Lopressor (metoprolol)
Tenormin (atenolol)
Beta Blocker Nursing Actions ?
Monitor BP, I/O, dialy weight,SEs

Focus assessment - cardiac and pulmonary

Contraindicated with some dysrhythmias, heart failure, some lung diseases
CCBs MoA ?
Inhibits the transport of calcium into myocardial and smooth muscle cells

Dilates peripheral arterioles = dec. afterload

negative inotrope and chronotrope
CCBs Therapeutic effects ?
Lower HR and BP - depending on which drug in class

dec. myocardial O2 demand, coronary artery spasms, angina, and dysrhythmias
CCBs SE/AEs ?
Bradycardia, reflex tachycardia

Peripheral edema
CCBs Interactions
Other antihypertensives and diuretics (inc. hypotensive effects)
CCBs examples of drugs in class
Calan (Verapamil)
Cardizem (diltiazem)
Norvasc (amlodipine)
CCBs Nursing Actions
Monitor BP, HR, I/O, daily weight, SEs

Focus assessment - cardiac and pulmonary.
Diuretics Therapeutic effects (overall)?
Site of action is the kidney, specifically the nephron (exact site depends on the drug)

Goal: inc. rate of urine formation / output = net wate loss from teh body = dec BP
Five main types of diuretics
Loop
Potassium-sparing
Thiazide and thiazide-like
osmotic
carbonic anhydrase inhibitors
Loop Diuretic MoA
Inhibits Na and Cl resorption in the loop of Henle, and, therefore, water

Dilate blood vessels
Loop Diuretic Therapeutic Effects
Potent diuresis resulting in substantial fluid loss

Treats edema associated with CHF, hepatic, or renal disease

Treats hypercalcemia
Loop Diuretic SE / AEs ?
decrease K (potassium)

dizziness, tinnitus
Loop Diuretic examples ?
Lasix (furosemide)
Loop Diuretic Nursing Actions?
Monitor I/O, BP, K

Monitor effects of Lanoxin (digoxin)
K Sparing Diuretic MoA ?
Acts directly on distal renal tubule

inc Na and water excretion while retaining K and H.
K Sparing Diuretic Therapeutic effects
Diuresis

Less K excretion
K Sparing Diuretic SE and AEs?
inc K

weakness, dizziness
K Sparing Diuretic examples of drugs in class?
Aldactone (spironolactone)
K Sparing Diuretic Nursing Actions
Monitor I/O, BP, K
Monitor effects with Lanoxin (digoxin)
Thiazide and thiazide like diuretics MoA ?
Inhibits Na and Cl reabsorption in the distal tube = dec water reabsorption

Dilate arterioles = dec resistance
Thiazide and thiazide like diuretics Therapeutic effects ?
Excretion of H20, Na, K, Cl, w/o altering the pH

Treatment of edema

Idiopatic hypercalciuria (kidney stones)
Thiazide and thiazide like diuretics SE and AEs?
dec K

headache, dizziness
Thiazide and thiazide like diuretics examples of drugs in class?
HydroDiuril (hydrochlorothiazide, HCTZ)

Zaroxolyn (metolazone)
Thiazide and thiazide like diuretics Nursing Actons?
Monitor I/O, BP, K

Monitor effects with Lanoxin (digoxin)
Osmotic diuretics MoA ?
inc. osmotic pressure = fluid shift out of renal tubules for excretion = diuresis
Osmotic diuretics Therapeutic effects
dec. cerebral edema = dec. intracranial pressure

Rapid excretion of fluid, electrolytes, and toxic substances from kidneys
Osmotic diuretics examples of drug in class
Mannitol
Essential Hypertension
unknown direct cause
approx. 90% of cases
Secondary Hypertension
linked to another problem
approx. 10% of cases
Target Organ Disease of Hypertension
Heart, Brain, Kidneys, Eyes, Circulation
Major Risk Factors of Hypertension
Smoking, Obesity, DM, Dyslipidemia, Physical inactivity, Diet (increased salt/fat, decreased veggies/fiber), Age > 60, Genetic predisposition (male gender)
Primary Prevention of Hypertension
Lifestyle (dietary modifications - alcohol moderation, Excercise program - weight reduction, skoking cessation, stress managment)

Minimize modifiable risk factors (stop smoking and control dislipidemia and DM, treat any underlying cause)
Generic ARBs end with what?
- sartan
ARBs MoA ?
Block the binding of ATII to its receptors
ARBs Therapeutic effects
decrease BP, constriction, resistance, and afterload

Major use of this class is afterload reduction (CHF, MI)

Often second line treatment for patients intolerant of ACE-I
ARBs SE / AEs ?
Most common - headache
ARBs Interactions ?
Other antihypertensives and diuretics (increase hypotensive effects)
ARB examples of drugs in class.
Cozar (losartan)
Diovan (valsartan)
ARBs Nursing Actions ?
Monitor BP, I/O, daily weight, SEs

Assess and monitor serum K levels, renal function

Focus assessment - cardiac and pulmonary

Patient education - medication, hypotension symptoms
Generic Beta Blockers end with ?
- olol
Beta Blockers MoA ?
Cardioselective - bind to, and block, beta 1 receptors

Nonselective - bind to, and block, beta 1 and 2 (heart and lungs)

negative inotrope

negative chronotrope
Beta Blockers Therapeutic effects ?
decrease HR and myocardial O2 demand.

Decrease angina and cardiac rhythm disturbances

decrease renin release (dec. angioensin II formation)