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35 Cards in this Set
- Front
- Back
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BP=
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CO X SVR
Cardiac output X Systemic vascular resistance |
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LNC-7 Stages on BP measurement...
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-Normal (<120/<80)
-Prehypertension 120-139/80-89) -Stage 1 HTN (140-159/90-99) -Stage 2 HTN (>160/>100) |
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Classifing BP
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Unknown cause (primary/idiopathic) 90% of cases
-Known cause (2nd htn) 10% |
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Htn indicators
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-Post MI
-High Cardiovascular risk -HF -DM -Chronic Renal Failure -Cerebrovascular disease |
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Is high Diastolic pressure more dangerous than high systolic?
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NO, SBP associated w/ HF, stroke, and renal failure
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What is the initial drud therapy for most pts with HTN?
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Thiazide-type drugs
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What population are B-blockers and ACE inhibs. more effective on?
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Caucasians
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CCB and diuretics are more effective on whom?
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African-americans and geriatrics
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Adrenergic Agents
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-decrease BP
-Depletes NE stores -SNS not stimulated |
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Centally and peripherally acting Neuron Blocker
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Reserpine, only central and periferal neuron blocker in the US
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Adrenergic Agents,Central actors
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Clonidine (Catapres)
-guanfacine(Tenex) -methyldopa (aldomet |
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Adrenergic Agents periferal a-1 agonists
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decrease BP, SNS not stimulated
-doxazosin (Cardura) -Prazosin (Minipress) -terazosin (hytrin) |
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Adrenergic Agents
Indications: |
HTN
-seldom used due to side-effects -central a-2 ags. dysmenorrhea, glaucoma, menopausal flush -Clonidine used for withdrawal of opiod or nicotine |
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Adrenergic Agents indications for a-1 ags:
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-HTN
-severe HF w/cardiac glycosides and diuretics |
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Adrenergic Agents: Side-effects:
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-Dry Mouth, drowsiness, sedation, constipation
-Headache, nausea, sleep, palpitations, ortho Hypo tension |
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Where do Beta-blockers take theire effect?
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-peripherally
-decrease HR -propranolol -atenolol |
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Where do dual a-b recept work?
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-peripheral heart and blood vessels
-derease HR (beta) -Vasodil. (alpha) -combined w/ CCB or thiazide |
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ACE Inhibitors: mech of action.
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-RAAS (renin angiotensin-aldosterone system)is blocked therefore preventing angiotensin 2 from forming, prevents bradykinin
-RESULTS in decreased after load, vasodilation, decreased BP |
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ACE inhibitors: Indications
Rx of choice for pts w/ HTN and HF |
-HTN
-HF -Slows progression of L vent. HYP post MI. -Renal protection for DM |
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ACE Inhibitors: Drug names
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-captopril
-enalapril -lisinopril |
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ACE Inhibitors: Side-effects
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-Fatigue
-CSN typical (H,D,mood changes, retard taste) -Poss. hyperkalemia -dry non productive caugh |
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Does Angiotensin 2 blockers cause a dry caugh?
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NO
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How does Angiotensin 2's work?
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-block conversion od 1 o 2 therfore block vasoconstriction from occuring
(Iosatan, valsartan |
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When are Angiotensin 2's used
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-HTN
-w/others for HF -w/diuretics -for pts that can't handle ACE inhibitors |
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Angiotensin 2's side-effects
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-Up. Resp. Infect.
-Headache -dixxy, dyspnea, heartburn, nasal conjestion |
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CCB's mech of action
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-relax smooth muscle, prevent contraction
-decreases periferal resistance -decrease BP |
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Examples of CCB's
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-Benzothiazepines (Diliazem)
-Phenylalkamines (verapamil) -Dihydropyridines(amlodipine, nifedipine |
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CCB's indications
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Angina
-HTN -Dysrhythmias -Migraines -Raynaud's disease |
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CCB's side-effects
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CV: Hypotension, palp, Tach
GI: Constip. nausea -rash, flushing, peripheral edema, dermatitis |
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Diuretics what do they do?
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Decrease plasma and ECF
-Decrease pre-load, C/O Peripheral resistance, decrease workload of heart, decrease BP |
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What do Vasodilators do?
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-relax arteriolar smooth muscle, decreases systemic vascular response, afterload and periferal vascular dilation
-Examples: diazomide(hyperstat) --Hydralazine ' -minioxidil -sodium nitroprusside |
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When are vasodilators used?
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-HTN
-Na nitroprusside and diazomide are for HTN emergencies |
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Hydralazine side effects
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Dizzy, headache, anx, tach, naus, vomit, diarrhea, anemia, dyspnea, edema, nasal congestion
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Sodium nitroprusside side-effects
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Brady, hypptension, possible cyanide toxicity
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Nursing indications...
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take as directed, don't miss, double up, monitor BP (journal)
-stopping abruptly can cause rebound hypertension -take w/meals -caution w/ IV admin. -improve life style -change position slowely due BP -report SOB, swelling at feet, ankles, face, eys, weight Delta, CP, palps, excess fatigue. -impotence -Avoid activities or environments that effect low BP -BP shopuld be <140/90, w/ DM or renal disease (<130/800 |
