ATI Pharmacology Antihypertensives Exam

What is the normal blood pressure? - 120/80 What are elevated blood pressure levels? - 120-129/80 What is the range for stage 1 hypertension? - 130/80-139/89 What are stage 2 hypertension levels? - 140/90 or greater How do the kidneys regulate blood pressure? - control of fluid volume via the renin-angiotensin-aldosterone system What other hormones regulate blood pressure? - antidiuretic hormone, atrial natriuretic peptide hormone, and brain natriuretic peptide hormone What type of diet increases blood pressure? - high in saturated fats and simple carbohydrates What increases renin secretions, causing the production of angiotensin II? - alcohol How does obesity affect the body? - increasing cardiac output, stroke volume, and left ventricular filling What race develops hypertension at an earlier age AND have a higher mortality rate from hypertension? - African Americans African Americans do not respond well to which medications? - beta blockers and ACE inhibitors What race is TWICE as sensitive as caucasians to beta blockers and other antihypertensives? - Asian Americans What are some non-drug methods to decrease blood pressure? - stress-reduction techniques, exercise, salt restriction, decreased alcohol ingestion, and smoking cessation Which drug is the most frequently prescribed diuretic for controlling mild hypertension by decreasing excess fluid volume? - hydrochlorothiazide Why are the loop diuretics, like furosemide, usually recommended? - they do not depress renal blood flow Instead of a single thiazide drug, a combination of what two diuretics may be useful? - potassium-sparing and potassium-wasting Propanolol and carvedilol are nonselective beta blockers that inhibit which receptors? - beta 1 and beta 2 receptors What type of beta blockers are preferred for hypertensive patients? - cardioselective (beta 1 only) List examples of drugs that are cardioselective beta blockers? - acebutolol, atenolol, betaxolol, bisoprolol, and metoprolol What are side effects of alpha 2 agonists? - drowsiness, dry mouth, dizziness, and slow heart rate What drug can not be used in patients with impaired liver function? - methyldopa As a nurse, what is one of the most important things you should teach your patient who is on centrally acting alpha2 agonists? - do NOT stop this drug abruptly What are some important nursing interventions for beta blockers? - - monitor BUN/serum creatinine/AST/LDH - advise abrupt discontinuation of antihypertensive drugs - avoid OTC drugs Which drug is an alpha 1 and beta 1 adrenergic blocker that causes vasodilation, which decreases resistance to blood flow? - Labetalol What are some nursing interventions for alpha-adrenergic blockers? - - check daily for fluid retention in extremities and weight gain - advise patients to NOT discontinue drug What are the names of three drugs that are selective alpha-adrenergic blockers? - doxazosin mesylate, prazosin hydrochloride, terazosin hydrochloride What are the names of two direct acting vasodilators that are used for moderate to severe hypertension? - hydralazine hydrochloride (severe), minoxidil (moderate) Which direct acting vasodilator is used for hypertensive emergencies, preeclampsia, and eclampsia? - hydralazine hydrochloride Which direct acting vasodilator is used for hypertension and alopecia? - minoxidil Prazosin hydrochloride is contraindicated in which patients? - -pregnant women - ocular surgery pts - hypersensitivity Excessive hair growth is a side effect of which medication? - minoxidil How do direct-acting vasodilators work? - act by relaxing the smooth muscles of the blood vessels, mainly the arteries, promoting vasodilation What happens when ACE is inhibited? - it inhibits the formation of angiotensin II (vasoconstrictor) and blocks the release of aldosterone What ending do all ACE inhibitor drugs end in? - -pril Name a few ACE inhibitor drugs? - benazepril, captopril, enalapril maleate, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, and trandolapril What race of people do NOT respond well to ACE inhibitors? - African Americans An African American man presents with hypertension. As the nurse, what drug(s) would you expect the doctor to prescribe? - ACE inhibitor WITH a diuretic What is the PRIMARY side effect of ACE inhibitors? - a constant, irritated cough What drug can be substituted for an ACE inhibitor that will NOT have a side effect of coughing? - ARB ACE inhibitors are contraindicated in which patients? - pregnant women What class of drug can you NOT TAKE WITH an ACE inhibitor? - potassiumsparing diuretics (spironolactone) OR salt substitutes that contain potassium