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53 Cards in this Set
- Front
- Back
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Treatment of Hypertension-Drug therapy
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Diuretics
Beta blockers ACE inhibitors Angiotensin II antagonists (angiotensin receptor blockers (ARBs)) Calcium channel blockers Centrally acting antiadrenergic agents Direct vasodilators Peripherally acting antiadrenergic agents Aldosterone receptor antagonists |
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Oral Diuretics BP is decreased due to
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a decrease in volume
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Oral Diuretics Examples:
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Thiazides
Loop Diuretics Potassium sparing diuretics |
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Beta Blockers Block the
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beta-andrenergic receptors of the sympathetic nervous system, decreasing heart rate and blood pressure
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Beta Blockers Because they also block beta-2 receptors in bronchial smooth muscle
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causing bronchoconstriction, they are contraindicated in patients with asthma, chronic bronchitis, or emphysema
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Beta Blockers
(Identifier for med) |
LOL!
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Beta Blockers EX:
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Propranolol (Inderal)
Atenolol (Tenormin) Nadolol (Corgard) Metoprolol (Lopressor) Cardvedilol (Coreg) Labetalol (Normadyne, Trandate) |
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Angiotensin Converting Enzyme Inhibitors (ACE inhibitors) Works by
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stopping the angiotensin converting enzyme which reduces the vasoconstrictor, angiotensin II.
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Angiotensin Converting Enzyme Inhibitors (ACE inhibitors) EX:
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Captopril (Capoten)
Enalapril (Vasotec) Benazepril (Lotensin) Lisinopril (Prinivil, Zestril) |
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Angiotensin Converting Enzyme Inhibitors (ACE inhibitors)
IDENTIFIER IN NAME |
PRIL
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Angiotensin II Antagonists Blocks the
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binding of angiotensin I to angiotensin II receptors in many tissues and vascular smooth muscle
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Angiotensin II Antagonists EX:
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Examples:
Losarten (cozaar) Valsarten (Diovan) Olmesartan (Benicar) Irbesartan (Avapro) |
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Calcium Channel Antagonists The BP is lowered due to
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a reduction in the influx of calcium which results in relaxation of the smooth muscles.
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Calcium Channel Antagonists Often called
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“Don’t give a S---” pill, because the decrease in BP and HR makes the patient feel bad.
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Calcium Channel Antagonists Should not be given to patients with
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uncompensated CHF or cardiogenic shock due to the decrease in HR (inhibits movement of calcium into heart muscle)
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Calcium channel blockers (ex)
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Diltiazem (Cardizem)
Amlodipine (Norvasc) Nicardipine (Cardene) Nifedipine (Procardia) Verapamil (Calan) |
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Centrally Acting Antiadrenergic Agents Work by
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stopping vasoconstriction by acting on the CNS to reduce the activity of the sympathetic nervous system
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Centrally Acting Antiadrenergic Agents
EX: |
Methyldopa (Aldomet)
Clonidine (Catapres) Reserpine |
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Direct Vasodilators (Action)
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Dilate peripheral blood vessels by directly relaxing vascular smooth muscle
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Direct Vasodilators (EX)
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Examples:
Hydralazine (Apresoline) Minoxidil (Loniten) |
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Peripherally acting antiadrenergic agents (action)
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Work by stopping vasoconstriction in the periphery (depletes catecholamines in peripheral sympathetic postganglionic fibers)
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Peripherally acting antiadrenergic agents (EX)
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Guanadrel (Hylorel); Reserpine
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Aldosterone Receptor Antagonists Drugs that
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block the receptors for aldosterone
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Aldosterone Receptor Antagonists
(prevent ..., Promotes ....) |
Promotes renal excretion of sodium and water (and can thereby reduce blood volume and blood pressure)
Prevent or reverse pathologic effects of aldosterone on cardiovascular structure and function |
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Aldosterone Receptor Antagonists (EX)
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spironolactone(Aldactone)
eplerenone (Inspra) |
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Patient education for antihypertensive meds (7)
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Meds are not a cure but a control
Meds must be taken for life Take diuretics early in the day Follow a sodium restricted diet May have hypokalemia-may need potassium supplement or a diet high in potassium Change positions slowly How to monitor blood pressure and heart rate-keep a journal |
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Patient education for antihypertensive meds Educate patients about the importance of
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of not missing a dose and taking the medications exactly as prescribed.
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Patient education for antihypertensive
Patients should never |
double up on doses if a dose is missed; check with physician for instructions on what to do if a dose is missed
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Anti hypertensives should not be stopped
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abruptly, as this may cause a rebound hypertensive crisis, and perhaps lead to CVA
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Antihypertensives
Oral forms should be |
should be given with meals so that absorption is more gradual and effective.
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Patient education for antihypertensive meds
Patients should report |
unusual shortness of breath; difficulty breathing; swelling of the feet, ankles, face, or around the eyes; weight gain or loss; chest pain; palpitations; or excessive fatigue.
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NSAIDS and HTN Counteracts
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the effects of some antihypertensives
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Medications for Arterial Occlusive Disease
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Antiplatelet drugs (platelet inhibitors)
Xanthine derivitives Vasodilators |
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Antiplatelet drugs (platelet inhibitors)
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Inhibit platelet aggregation, prolong bleeding time
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Antiplatelet drugs (platelet inhibitors)
Examples: |
Aspirin
Ticlopidine (Ticlid) Dipyridamide (Persantine) Clopidogrel (Plavix |
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Vasodilators
Causes |
vasodilation and decreases peripheral vascular resistance
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Xanthine derivitives Increases
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flexibility of RBCs facilitating passage through microcirculation
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Xanthine derivitives (EX)
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Pentoxifilline (Trental)
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Vasodilators
EX |
Hydralazine (Apresoline)
Minoxidil (Loniten, Minodyl) |
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Antacids work by
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neutralizing hydrochloric acid
preventing it from irritating the lining of the GI tract allowing the mucosal lining to heal at low doses they promote gastric mucosal defensive mechanisms forming a protective barrier against HCL |
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Antacids May interact with any med
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that binds to the antacid and therefore is not available to be absorbed
that is changed based on the pH of the stomach that is changed by the pH of the urine |
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Antacids Examples-
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Aluminum based (Maalox)(preferred)
Magnesium based (MOM) Calcium based (TUMS) |
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Proton Pump Inhibitors Work to
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block the secretion of acid by blocking the ability of the hydrogen ions to move out of the parietal cells which is the last step in the acid secretory process
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Proton Pump Inhibitors all names have
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zoles
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Proton Pump Inhibitors Examples
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n Omeprazole (Prilosec)
Lansoprazole (Prevacid) Pantoprazole (Protonix) Esomeprazole (Nexium) Rabeprazole sodium (Aciphex) |
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Histamine H2-Receptor Antagonists Commonly used
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to treat acid related disorders
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Histamine H2-Receptor Antagonists work by
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binding to and blocking the histamine receptors on the parietal cells and therefore suppressing acid production in the stomach
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Histamine H2-Receptor Antagonists n Contraindicated
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renal failure patients
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Histamine H2-Receptor Antagonists Interactions
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Absorption may be impaired in patients who smoke
Should be taken 1 hour before antacids Tagamet may bind with other meds that are metabolized by the liver (Theophylline, coumadin, lanoxin, Dilantin) |
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H2 Antagonists all names have
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Dines
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H2 Antagonists EX
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Cimetidine (Tagamet)
Famotidine (Pepcid) Rantidine (Zantac) Nizatidine (Axid) |
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Mucosal Protective Agents
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Sucralfate (Carafate)-
Bismuth subsalicylate (Pepto- Bismol) |
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Bismuth subsalicylate (Pepto-
Bismol) can turn |
tongue and stools black
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