Pharmville

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Author:
alyn217
ID:
159382
Filename:
Pharmville
Updated:
2012-06-25 16:03:38
Tags:
PT3 Antihypertensive
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Description:
Antihypertensive drugs
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  1. Verapamil
    Calan 
    • Blocks calcium
    • reducing AV conduction 
  2. Adverse effects of Calcium channel blockers
    Verapamil
    • Constipation
    • Dizziness
    • Facial flushing
    • Headache
    • Edema of ankles
    • Gingival hyperplasia
    • Heart block
  3. Calcium channel blockers
    Nifedipine
    • Vasodilation
    • Reflex cardiac stimulation
    • Major indications
    • Angina pectoris
    • Hypertension
    • Migraine headaches
    • Same Adverse Effects as Verapamil 
  4. Antihypertensive Drugs—
    Drugs Acting on the Renin-Angiotensin System
    • Regulation of blood pressure
    • Regulation of blood volume
    • Regulation of electrolyte balance
  5. Regulation of Blood Pressure by the Renin Angiotensin System
    Angiotensin II
    • Action
    • Vasoconstrictor
    • Release of aldosterone
    • Alters cardiac and vascular structures
    • Formation
    • Renin catalyzes angiotensin I from angiotensinogen-->Renin
    • Angiotensin converting enzyme (Kinase II)
    • Regulation of blood pressure
    • Tissue effects
  6. Angiotensin-Converting Enzyme Inhibitors (ACE)
    Captopril
    *"opril" in name indicates an ACE drug.
    • Uses
    • Hypertension
    • Heart failure
    • Adverse Effects
    • Cough: primary side effect. 
    • First–dose hypotension (take at bed time)
    • Hyperkalemia (K+ retension)
  7. Angiotensin II Receptor Blockers (ARBs)
    Losartan (Cozaar)
    • Hypertension
    • Heart failure
    • Adverse effects
    • Dizziness
    • Birth defects*
  8. What are the differences in the Rx's chosen to treat hypertension based on race?
    • Whites 
    • ACE inhibitors
    • Beta Blockers

    • Blacks
    • Diuretics
    • Ca Channel Blockers
  9. Nursing Implications for administering Antihypertensive drugs.
    • Monitor BP prior to and during therapy
    • Monitor and caution patient concerning postural hypotension (each time a new Rx is added, chance for orthostatic hypotension increases)
    • Assess for edema
    • Monitor lab values
    • K
    • Na
    • Ca
  10. Fundamentals of Antihypertensive drug therapy
    • Lifestyle changes first
    • Begin with single drug  (Diuretic or beta blocker)
    • Add another drug or substitute drug to produce adequate response
    • Then add another drug if needed
    • Each should come from a different class
    • Start with low dose and gradually increase
    • Clients with co-existing disease
    • Avoid drugs that would make pre-existing conditions worsen 
  11. What is step-down therapy as related to antihypertensive drug therapy?
    • After 1 year, attempt to reduce dosages and number of drugs.
    • Those who would be considered for step-down are:
    • Well controlled BP
    • Low pretreatment DBP
    • No end organ disease
    • Monotherapy
    • Lifestyle changes have been successful
  12. Individualizing therapy 
    • Children
    • --Secondary HTN more prevelent
    • --Do not sue ACE I's or ARB's in sexually active girls 
    • Elderly
    • --65% incidence in those over 60.
    • Diabetics
    • --Probably will be hypertensive just because of the metabolic effect of teh disease.  
  13. Hypertensive emergencies
    • DBP>120 mmHg
    • Treatment
    • --Sodium nitroprusside
    • --Nifedipine
    • --Labetolol
    • --Diazoxide
    • --Trimethapham

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