front 1 What is the prototype drug for ARBs? | back 1 Iosartan |
front 2 What do all ARBS end in? | back 2 "-sartan" |
front 3 What do ARBs do? | back 3 blocks angiotensin ll at various receptor sites and prevents effects of vasoconstriction and aldosterone secretion |
front 4 What would you use ARBs for? | back 4 hypertension, DM, HF, post MI |
front 5 What are some positives in ARBs compared to ACE inhibitors? | back 5 they don't produce a cough and angioedema is rare. |
front 6 What should you absolutely NOT do with ARBs? | back 6 administer with ACE inhibitors. PRILS SHOULD STAY AWAY FROM SARTANS |
front 7 ARBs have a BBw. What is it? | back 7 do not give to pregnant people |
front 8 What are some side effects of ARBs? | back 8 A ↓ angiotensin ll effects, aldosterone, ADH R ↓ resistance B ↓ blood volume |
front 9 What is the prototype drug for beta (andrenergic) blockers? | back 9 propranolol |
front 10 What do beta blockers do? | back 10 blocks nor/epinephrine at beta-andrenergic receptors, thus decreasing heart rate and contraction |
front 11 What would you use beta blockers for? | back 11 hypertension, stable angina, tachyarrhythmias, stable HF |
front 12 Beta blockers have a BBW. What is it? | back 12 abrupt discontinuation = exacerbation of angina, dysrhythmias, MIs with pts that have CAD |
front 13 What are some side effects of beta blockers? | back 13 BETABLOCKS
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front 14 Calcium channel blockers have 2 categories. What are they? | back 14 1. dihydropyridines ("-ine") 2. non-hydropyridines |
front 15 What are some calcium channel blocker drugs? | back 15 verapamil, nifedipine, diltiazem |
front 16 What is the prototype drug for dihydropyridines? | back 16 amlodipine |
front 17 What does amlodipine do? | back 17 it decreases the influx of calcium ions in smooth muscle of blood vessels (relaxes/dilates arteries) |
front 18 What are some uses for dihydropyridines? | back 18 treats hypertension, angina, conditions with vasoconstriction/vasospasms |
front 19 What are some non-dihydropyridine drugs? | back 19 verapamil and diltiazem |
front 20 What do non-dihydropyridine drugs do? | back 20 decrease the influx of calcium ions in cardiac cells and pacemaker cells leading to decreased conduction and heart rate. It also decreases contractility. |
front 21 What would you use non-dihydropyridine drugs for? | back 21 hypertension, angina, and tachyarrythmias |
front 22 What are some side effects for dihydropyridine drugs? | back 22 edema (peripheral and pulmonary = flushing/reflex tachycardia). increases vasodilation while decreasing heart function. |
front 23 What are some side effects for non-dihydropyridine drugs? | back 23 bradycardia. rare = arrythmias, heart block, HF. |
front 24 What patients should use caution with non-dihydropyridine drugs? | back 24 those with bradycardia, HF, and using BBs. DO NOT USE NDPs WITH BBs. |
front 25 What is a possible food interaction for CYP3A4 inducers? | back 25 St. John's worts (decreases effectiveness) |
front 26 What is a possible food interaction for CYP3A4 inhibitors? | back 26 grapefruit juice (will increase plasma concentration) |
front 27 What is some patient education on how to relieve edemas with dihydropyridines? | back 27 compression socks, ambulate, elevate extremity |
front 28 What are some adjunct medications for hypertension? | back 28 SNS - alpha adrenergic receptos blockers - prazosin RAAS - direct renin inhibitors - aliskiren -aldosterone antagonists Direct vasodilators - nitroprusside - hydralazine |
front 29 What is an urgent hypertensive crisis? | back 29 >180/>120 mmHg with no organ damage Outpatient management: urgent care Treatment: BP lowered over the course of hours/days |
front 30 What is an EMERGENCY hypertensive crisis? | back 30 >180/>120 mmHg with organ damage s/s- headache, difficulty speaking, vision changes, weakness, chest pain, SOB, hematuria Treatment: controlled lowering of BP (not to normal levels tho bc it can lead to ischemia) in min/hours with oral meds like beta blockers (laretalol) and/or Iv meds like sodium nitroprusside |
front 31 What is the prototype drug for direct acting vasodilators? | back 31 sodium nitroprusside |
front 32 How does sodium nitroprusside work? | back 32 it directly relaxes the smooth muscle in blood vessels to dilate and decreases peripheral vascular resistance |
front 33 What would we use sodium nitroprusside for? | back 33 to manage a hypertensive emergency |
front 34 What are some side effects of sodium nitroprusside? | back 34 nausea, agitation, twitching |
front 35 What are some nursing considerations for sodium nitroprusside? | back 35 It's given via IV and requires continuous BP monitoring. It has a rapid onset and a short duration. It converts to thiocyanate in liver (can lead to cyanide toxicity (s/s - coma, dilated pupils, pink color) so monitor the thiocyanate levels. |
front 36 What are some general nursing considerations for antihypertensive meds? | back 36 get complete health hx, monitor labs (electrolytes, CBC, BUN/Cr/urinalysis, LFTs, lipid panel), monitor BP before/after administration, start on lowest effective dose, if BP unmanaged with monotherapy, use combo therapy at lower dose, taper slowly, DO NOT DISCONTINUE ABRUPTLY |
front 37 What is some pt education given for antihypertensives? | back 37 Lower your sodium, caffeine, alcohol intake and try not to use any vasodilating hot baths/showers, hot tubs, sauna, DO NOT STOP ABRUPTLY. Assess compliance. Stop smoking and manage your weight. |