Chapter 23

Question 1

What is the Mean Arterial Pressure?

Answer 1

Average pressure throughout each cycle of the heart beat

Question 2

What is Pule Pressure?

Answer 2

Difference between SBP and DBP

Question 3

What is Hypertension?

Answer 3

Characterized by an elevation of SBP, DBP, or both.

Question 4

What are two types of Hypertension?

Answer 4

1. Primary: cause unknown, 90%

2. Secondary: caused by another disease or medication

Question 5

What are the Drug Classes used to treat Hypertension?

Answer 5

1. Diuretics
2. Beta-Adrenergic Blocking Agents
3. ACE Inhibitors
4. ARB’s
5. Direct Renin Inhibitors
6. Calcium Channel Blockers
7. Aldosterone Receptor Antagonist
8. Alpha-1 Adrenergic Blocking Agents
9. Central-Acting Alpha-2 Agonists
10. Direct Vasodilators

Question 6

How does a Diuretic work?

Answer 6

Causes:

1. Volume depletion
2. Sodium excretion
3. Vasodilation of peripheral arterioles
4. Loop diuretics cause potassium excretion

Question 7

True or False: Diuretics are the most commonly prescribed anti-hypertensives

Answer 7

True.

Question 8

How do Beta-Adrenergic Blocking Agents work?

Answer 8

1. Inhibits cardiac response to sympathetic nerve stimulation
2. Inhibits renin release from kidneys

Question 9

What is the use for Beta-Adrenergic Blocking Agents?

Answer 9

Can be used in combinationwith other anti-hypertensives

Question 10

What are the CAE’s of Bet-Adrenergic Blocking Agents?

Answer 10

1. Bradycardia
2. Peripheral vasocinstriction (purple, mottled skin)
3. Heart failure
4. Bronchospasm
5. Wheezing
6. Masks hypoglycemia in diabetic patients

Question 11

You should hold the Beta-Adrenergic Blocking Agent medication if your patient exhibits what?

Answer 11

1. SBP is less than 100

2. Heart rate is less than 60 bpm

Question 12

If your patient has Bronchospatic disease (COPD, Asthma) they should not receive what type of drug?

Answer 12

Beta-Adrenergic Blocking Agents

Question 13

How do ACE Inhibitors work?

Answer 13

Inhibits conervion of ACE enzyme

Question 14

What are the uses of ACE Inhibitors?

Answer 14

1. Can be used as single or combination therapy for Stage 1 or 2 hypertension
2. Not as effective in African Americans unless combined with diuretic

Question 15

In African Americans an ACE Inhibitor is not as effective unless given with what?

Answer 15

Diuretic

Question 16

What are the CAE’s of ACE Inhibitors?

Answer 16

1. Nausea
2. Fatigue
3. Headache
4. Diarrhea
5. Orthostatic Hypotension
6. 1/3 get a cough

Question 17

SAE’s of ACE Inhibitors

Answer 17

1. Angioedema
2. Neutropenia
3. Hyperkalemia
4. Nephrotoxicity
5. May cause fetal harm
6. May increase blood level of digoxin and lithium

Question 18

Prototypes of ACE Inhibitors

Answer 18

1. Lisinopril
2. Captopril
3. Enalpril

Question 19

Patient education for ACE Inhibitors

Answer 19

1. Don’t use if history of angioedema
2. Have them notify prescriber immediately if pregnant or breastfeeding
3. Less effective with AA
4. Can cause coughing and hypotension