Term
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Definition
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Term
What is BP also known as?
Why? |
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Definition
"Silent Killer"
Most people have no symptoms |
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Term
| Where are beta 1 receptors found and what does their function include? |
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Definition
Beta 1 receptors are located primarily in the heart and stimulation of these receptors increases
1. heart rate
2. the force of cardiac contraction
3. speed of cardiac conduction
4. blood pressure since cardiac output is increased
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Term
| Where are beta 2 receptors found and what is their function? |
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Definition
| Beta 2 receptors are located primarily in the bronchial and vascular musculature. Stimulation of these receptors induces bronchial and peripheral dilation which contributes to decreased blood pressure. |
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Term
| What happens when alpha 1 receptors are stimulated? |
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Definition
| Alpha 1 receptors cause peripheral constriction and blood pressure increases as a result. |
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Term
| What does sympathomimetic mean? |
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Definition
| When something mimics the effect of the sympathetic system. |
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Term
| Which adrenergic receptor has a sympathomimetic effect? |
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Definition
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Term
| What happens when alpha 1 receptors are blocked? |
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Definition
| It dilates resistance vessels (arteries) and capacitance vessels (veins), thereby decreaseing blood pressure. |
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Term
| Where are alpha 2 receptors located and what is their effect on blood pressure? |
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Definition
Alpha 2 recepors are located within the brain and stimulation of these receptors
1. decreases heart rate
2. decreases vasoconstriction
3. decreases blood pressure |
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Term
| What is the sympatholytic effect? |
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Definition
| one that stops the effect of the sympathetic system |
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Term
| Which receptor has a sympatholytic effect? |
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Definition
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Term
| Describe the action of the ventricles during systole? |
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Definition
| Ventricles contract, aortic and pulmonic valves open allowing blood to be ejected into the aorta and pulmonary artery |
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Term
| Describe the action of the ventricles during diastole? |
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Definition
| The ventricles relax, mitral and tricuspid valves are open allowing blood to flow into the atria. |
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Term
| The highest pressure measured is known as? |
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Definition
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Term
| The lowest pressure measured is known as? |
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Definition
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Term
| When cardiac output or peripheral resistance increases, blood pressure ________? When cardiac output pr peripheral resistance decreases, blood pressure _______? |
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Definition
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Term
| Renin is synthesized by the ______ and produces _______? |
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Definition
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Term
| Angiotensin 1 is converted into ____________ by what enzyme? |
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Definition
| Angiotensin 2/ ACE (angiotensin converting enzyme) |
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Term
| Angiotensin 2 stimulates the secretion of ______? |
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Definition
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Term
| Aldosterone secretes from __________ and what is it's function? |
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Definition
| adrenal medulla/ increases retention of sodium and water in the body |
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Term
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Definition
| persistent elevation of systolic pressure equal to or greater than 140 or diastolic pressue equal to or greater than 90 |
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Term
| What are some lifestyle changes included in the first line treatment for HTN? |
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Definition
| stop smoking, lose weight, diet modification, exercise, stress managemnt, alcohol in moderation |
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Term
| What is the inital drug choice used in first lone treatment for HTN? |
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Definition
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Term
|
Definition
generic names end in "lol"
ex. atenolol (Tenormin), metoprolol (Lopressor) |
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Term
| Selective beta 1 affect _______? |
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Definition
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Term
| Nonselective beta blockers (1 and 2) affect _______? |
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Definition
lungs, heart, kidneys, liver
ex. propranolol (Inderal) |
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Term
| What is the action of beta blockers? |
|
Definition
| stops the sympathetic nervous system to decrease heart rate, contractility, and inhibit renin secretion |
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Term
| What type of conditions does beta blockers treat? |
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Definition
| htn, MI, dysrhythmias, angina |
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Term
| Common adverse effects of beta blockers |
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Definition
| wheezing, bronchospasms, bradycardia, sexual dysfunction, peripheral vasoconstriction |
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Term
| precautions for beta blockers |
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Definition
| heart failure (decreases contractility), severe bradycardia or heart block, asthma/COPD (brochospasm), diabetes (hypoglycemia = hides symptoms), peripheral vascular disease, aviod in pregnacy or breast feeding women |
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Term
| drug interactions with beta blockers |
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Definition
| other hypertensive meds (increases risk for hypotension) |
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Term
| Nursing intervention/education for beta blockers |
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Definition
| teach how to take BP and check HR, report pulse <50 or irregular pulse, report sexual dysfunction, do not stop abruptly (symptoms of MI) taper dosage over 2 weeks |
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Term
calcium channel blockers
what are some drugs? |
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Definition
end in "pine" and the exceptions
amlodipine (Norvasc), nicardipine (Cardene), diltiazem (Cardizem), verpamil(Calan) |
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Term
what is the action of
calcium channel blockers |
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Definition
| inhibits movement of calcium ions across cell membranes, which decreases the mechanical contraction of the heart, reduces impulse formation, lessens conduction velocity ( decreases speed via AV node), and dilates coronary vessels and arteries thereby decreaseing peripheral resistance and blood pressure. |
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Term
| What conditions does calcium channel blockers treat? |
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Definition
| htn, angina pectoris, dysrhythmias, subarachnoid hemorrhage |
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Term
| common adverse effects of calium channel blockers |
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Definition
| constipation, syncope, peripheral edema |
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Term
| what does calcium channel blockers NOT decrease? |
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Definition
| cardiac output because of the reflex tachycardia that occurs secondary to vasodilation |
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Term
| precautions of calcium channel blockers |
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Definition
| severe heart failure, severe hypotension, heart block, or shock; renal/hepatic impairment (increased half-life), pregnancy category c |
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Term
| what are drug interactions with calcium channel blockers |
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Definition
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Term
| calcium channel blockers nutsing interventions/education |
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Definition
| avoid grapefruit juice (increases the amount of CCB); monitor BP & HR (hold if <90/60); monitor daily weight and I/O (Symptoms of left sisded heart failure); teach constipation prevention methods (fluids, activity, fiber) |
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Term
angiotensin converting enzyme inhibitors(ACE)
drugs |
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Definition
generic names end in "pril"
lisinopril (Zestril), enalapril (Vasotec); quinapril (Accupril) |
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Term
| what is the action of ACE inhibitors |
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Definition
| inhibits the conversion of angiotensin 1 into angiotensin 2; decreases peripheral arterial resistance and sodium and water retention. |
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Term
| ACE inhibitors are the drug of choice for which type of patient? |
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Definition
| diabetics with diabetic neuropathy |
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Term
| African Americans require a higher or lower dose of ACE inhibitors? |
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Definition
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Term
| ACE inhibitors treats what conditions |
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Definition
| HTN, heart failure, left ventricular dysfunction after MI, diabetic neuropathy |
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Term
| common adverse effects for ACE inhibitors |
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Definition
dry non-productive cough; hyperkalemia
serious adverse effects include agioedema and neutropenia |
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Term
| precautions with ACE inhibitors |
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Definition
| hyperkalemia, dehydrated or hypivolemic clients, pregnant, breasetfeeding,or trying to get pregnant (category c & d) |
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Term
| drug interactions with ACE inhibitors |
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Definition
| K+ sparing diuretics/drugs, K+ supplements, lithium (increases lithium levels) |
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Term
| ACE inhibitors nursing intervention/education |
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Definition
| diet (K+ rich foods, salt substitutes, consume 2-3L/day of fluids); first dose hypotension (monitor BP); monitor labs (hepatic fx, renal fx, BMP for electrolytes, CBC for WBC count); report symptoms immediately (weight gain, edema, sore throat/fever, irregular HR, dyspnea) |
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Term
Angiotension II Receptor Blockers
(ARBs)
drugs |
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Definition
generic end in (sartan)
olmesartan (Benicar), valsartan (Diovan), Telmisartan (Micardis) |
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Term
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Definition
| prevents angiotensin II from binding to the receptor sites and stimulating aldosterone (vasodilate, decrease preload); blocks the action of angiotensin II from all the different pathways where it is formed |
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Term
| what conditions does ARBs treat |
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Definition
| HTN, heart failure, diabetic neuropathy |
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Term
| Common adverse effects of ARBs |
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Definition
| upper respiratory symptoms; dizziness, diarrhea |
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Term
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Definition
| avoid in pregnant, breastfeeding, or women wanting to become pregnant (Category c & d) |
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Term
| Drug interactions with ARBs |
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Definition
| K+ supplements/sparing drugs; grapefruit juice (makes med less effective); lithium (increases lithium levels) |
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Term
| ARBs nursing interventions/education |
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Definition
| similar to ACE inhibitors |
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Term
Selective Aldosterone blockers
drugs |
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Definition
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Term
| what is the action of selective aldosterone blockers |
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Definition
| binds to mineralocorticoid receptors ( in the heart, kidneys, brain, blood vessels) blocking aldosterone from binding to these receptors; this blockade reduces blood pressure and reduces end stage organ damage that occurs with HTN. |
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Term
| What conditions does selective aldosterone blockers treat? |
|
Definition
| HTN, heart failure after MI |
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Term
| Common adverse effects with selective aldosterone blockers |
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Definition
| hyperkalemia, hyponatremia, dizziness (low fluid volume) |
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Term
| precautions for selective aldosterone blockers |
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Definition
| K+ >5.5 (hold med and call MD); increased serum creatinine or creatinine clearance |
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Term
| drug interactions of selctive aldosterone blockers |
|
Definition
| taking K+, taking ACE or ARB, grapefuit juice |
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Term
| Selective aldosterone blockers nursing interventions/education |
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Definition
| monitor labs (K+, serum creatinine clearance), diet teaching |
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Term
| which htn drug class can be used for migraine prevention and glaucoma |
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Definition
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|
Term
| which htn drug class is not good for post MI patients because it increases 02 demand on the heart? |
|
Definition
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|
Term
alpha beta blockers
drugs |
|
Definition
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|
Term
| action of alpha beta receptors |
|
Definition
| blocks peripheral alpha receptors; does not impact cardiac output |
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Term
| one adverse effect of alpha beta receptors |
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Definition
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Term
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Definition
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Term
| Catapres can be given which two ways |
|
Definition
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|
Term
| what is the onset and eak of clonidine (catapres) |
|
Definition
| onset: 30-60 min and peak: 3-5 hours |
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Term
| how long can a transdermal catapres patch stay on |
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Definition
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Term
| what is the action of alpha 2 antagonist |
|
Definition
| stimulates the aloha 2 receptors centrally in the medulla oblongata, thereby inhibiting the sympathetic nervous system; reduced sympathetic outflow from the CNS results in decreased heart rate, decreased renal vascular resistance, decreased vasoconstriction, and decreased blood pressure |
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|
Term
| besides htn, what other condition does catapres treat? |
|
Definition
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|
Term
| what side effect is common with all HTN drugs? |
|
Definition
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