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25 Cards in this Set
- Front
- Back
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Factors determining/influencing BP |
Blood volume and vascular tone
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Antihypertensive therapy effects on 5 areas:
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CO, HR, cholesterol/triglycerides, GFR (renal blood flow), circulating blood volume
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Angiotensin Converting Enzyme (ACE) inhibitors
"-pril" |
prevent conversion of angiotensin I to II, affect of aldosterone, increase effect of bradykinin
No change in postural reflexes or pulse Decreases afterload, improve CO Slow onset, for chronic management of essential HTN and CHF Cardioprotectve and nephroprotective can cause dry cough |
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Lisinopril (Prinivil, Zestril)
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ACE inhibitor (conversion of angiotensin I to II)
Monitor BP especially when beginning Tx, caution with K+ sparing diuretics (K+ retention) teach about cough |
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Angiotensin II receptor blockers (ARBs)
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selectively block angiotensin II at receptor, blocks aldosterone secretion, less bradykinin (less cough)
No effect on GFR, HDL/LDL, BG, or HR (nice) Essential HTN and CHF (newer and more expensive than ACE inhibitors) Ex) Losartan (Cozaar) |
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Losartan (Cozaar)
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Agiotensin receptor blocker (ARB)
only one that's currently generic |
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Renin inhibitors
(no drug example) |
newer, decrease plasma renin activity, inhibits formation of angiotensin I
Risk of angioedema (swelling of skin and mucous membranes) |
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Alpha-2 stimulants
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Alpha-2 stimulation actually decreases norepi
Inhibits sympathetic vasomotor stimulation in brain Adverse effects: usually fade over couple weeks, must d/c slowly/gradually, teach! Ex) Clonidine (Catapres) |
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Clonidine (Catapres)
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Alpha-2 stimulant (central acting agent)
OP for hypertensive crisis, or patch Also used for addiction treatment craving reduction, some uses w/ ADD/ADHD |
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Beta Blockers
"-olols" |
Reduce BP, CO, renin/angiotensin, -iso and chronotropic
treat HTN and angina But: bradycardia, CHF aggravation, bronchospasm (unwanted beta-2 affects in non selective), lowers HDL, increase cholesterol/triclycerides |
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Propranolol (Inderal)
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non-selective beta-blocker
used for vascular headaches, "stage-fright" and "test anxiety" |
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Metoprolol (Lopressor, Toprol)
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cardioselective beta-1 blocker (yay)
less problems with lungs (beta-2 effects) fewer unwanted effects |
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Alpha-1 blockers
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Relax vascular smooth muscle, reduces afterload
use for HTN and benign prostatic hypertension (BPH) No effect on CO, HR, cholesterol Downside: edema --> diuretics needed Ex) Prazosin (Minipress) |
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Prazosin (Minipress)
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selective alpha-1 blocker
for HTN and BPH |
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Calcium channel blockers
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vasodilation, decrease afterload
Two types: cardioselective (effect on heart, -chrono and isotropic) and dihydropyridine (relax vascular smooth muscle, reduce systemic BP, little effect on heart) Uses: HTN, angina, supravent. dysrhythmias, A-fib Adverse: aggravate CHF Nursing: minute to minute monitoring! Ex) Diltiazem (Cardizem, Tiazac) |
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Hydralazine (Apresoline)
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relaxes arterioloar and venous smooth muscle, vasodilator
Used for pregnancy induced HTN But: reflex tachy, Na+ and H2O retention, autoimmune syndromes w/ chronic use |
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Goal for antihyperlipidemic drugs
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lower total cholesterol to under 200mg/dL
LDL under 130mg/dL (or at least matching HDL) Triglyceride under 150 lipid differential gives best picture |
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Bile-acid binding resins
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oldest and safest
LDL and cholesterol decrease as resins bind to bile and increase excretion in stool Adverse: GI disturbances, dose related Ex) Cholestyramine (Questran) |
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Cholestyramine (Questran)
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bile-acid binding resin
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Hmg-CoA reductase inhibitors, Statins
"-statin" |
Effects rate-limiting step in cholesterol synthesis, stabilizes plaques in vessels, lowers total, LDL, and TGs.
Reduce CHD risk, ACS, stroke, mortality, heavily researched Low incidence of adverse effects Nursing: teach adherence to therapy |
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Atorvastatin (Lipitor)
Rosuvastatin (Crestor) |
Hmg-CoA reductase inhibitors, Statins
heavily researched |
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Niacin, Nicotinic Acid, Vit B3 (higher than vit dose)
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Lowers TGs, serum LDL and VLDL, increases HDL
mechanism not clear, not a first line drug, used in combos Adverse: GI upset, flushing, OTC not effective, more adverse effects Teach: take w/ food, take ASA 30min before |
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Fibric Acids, Fibrates
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Lowers TGs, VLDL, some decrease in LDL, some increase in HDL
unknown mechanism Averse: GI upset, gallstones, myopathy, hepatotoxicity, increased risk in combo w/ statins Ex) Fenofibrate (Tricor) |
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Fenofibrate (Tricor)
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Fibric acid
unknown mechanism of action Lowers TGs, VLDL, some decrease in LDL, increase in HDL |
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Antihyperlipidemia methods
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Vigorous diet change trial for 6 months, diet low in cholesterol, omega-3s, control BGs, whole grains, weight loss, therapy adherence, combination therapy
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