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Karch’s Focus on Nursing Pharmacology, 9th Ed., Tucker
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Chapter 43: Drugs Affecting Blood Pressure

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Karch’s Focus on Nursing Pharmacology, 9th Ed., Tucker | Registered Nurse (RN) School Study Aid

Chapter 43: Drugs Affecting Blood Pressure
23 Picmonics to Learn | 42 mins
Low Blood Pressure Response
Characteristics
Posterior Pituitary Releases Vasopressin
Vasoconstriction
Adrenal Cortex Releases Aldosterone
Increased Na+ and H2O Reabsorption
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1 min
High Blood Pressure Response
Characteristics
Atria Release Atrial Natriuretic Peptide
Vasodilation
Antagonizes Aldosterone
Na+ and Water Excreted
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1 min
Blood Pressure Classification (JNC 7)
Classifications
Normal
Systolic (<120)
Diastolic (< 80)
Prehypertension
Systolic +20 (120-139)
Diastolic +10 (80-89)
Stage 1 Hypertension
Systolic +20 (140-159)
Diastolic +10 (90-99)
Stage 2 Hypertension
Systolic + > 20 (160)
Diastolic + > 10 (100)
Hypertensive Crisis
Systolic > 180
Diastolic > 110
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4 mins
Blood Pressure Classification (ACC/AHA 2017)
Classifications
Normal
Systolic Less than 120
Diastolic Less than 80
Elevated
Systolic +10 (120-129)
Diastolic Less than 80
Stage 1 Hypertension
Systolic +10 (130-139)
Diastolic +10 (80-89)
Stage 2 Hypertension
Systolic +40 (140-179)
Diastolic +30 (90-119)
Hypertensive Crisis
Systolic greater than or equal to 180
Diastolic greater than or equal to 120
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5 mins
Cardiovascular Effects of Beta-Blockers
Cardiac Myocytes and Vasculature
Decrease cAMP
Decreases SA and AV Node Conduction Velocity
Lower Blood Pressure
Decrease O2 Consumption
Decreases Mortality Post-MI
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2 mins
Nitroglycerin
Mechanism of Action
Decreases Preload
Indications
Angina
Up to 3 doses q 5 mins
Side Effects
Headache
Hypotension
Contraindications
Viagra (Sildenafil)
Nursing Considerations
Assess Blood Pressure
Protect From Light
Use Glass Bottle and Special Tubing
Gloves for Applying Topically
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2 mins
Hypertension Medications
Diuretics
ACE Inhibitors
Angiotensin Receptor Blockers (ARBs)
Beta Blockers
Dihydropyridine Calcium Channel Blockers
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2 mins
Angiotensin-Converting Enzyme (ACE) Inhibitors
"-pril" Suffix
Mechanism of Action
Block Renin Angiotensin-Aldosterone System (RAAS)
Indications
Hypertension
Heart Failure
Side Effects
Dry Non-productive Cough
Hypotension
Dizziness
Possible Hyperkalemia
Angioedema
Nursing Considerations
Slowly Change Position
Do Not Stop Abruptly
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2 mins
Angiotensin II Receptor Blockers (ARBs)
Ends in "-sartan"
Mechanism of Action
Blocks Angiotensin II Receptor
Indications
Hypertension
Side Effects
Angioedema
Contraindications
Renal Artery Stenosis
Pregnancy
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1 min
Calcium Channel Blockers (Verapamil and Diltiazem)
Mechanism of Action
Slows AV Conduction
Indications
Angina Pectoris
Arrhythmias
Essential Hypertension
Side Effects
Bradycardia
Hypotension
Constipation
Peripheral Edema
Gingival Hyperplasia
Nursing Consideration
Medication Education
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2 mins
Nitroprusside
Mechanism of Action
Direct Release of NO
Increase cGMP
Short Half-Life
Indications
Malignant Hypertension
Side Effect
Cyanide Toxicity
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1 min
Sodium Nitroprusside (Nitropress)
Mechanism
Venous and Arterial Dilation
Indications
Hypertensive Crisis
Side Effects
Cyanide Toxicity
Thiocyanate Toxicity
Hypotension
Considerations
Short Term Administration
Light Sensitive, Use Container
Continuous BP Monitoring
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2 mins
Clonidine
Mechanism of Action
Alpha-2 Agonist
Indication
Hypertensive Urgency
Attention Deficit Hyperactivity Disorder (ADHD)
Tourette Syndrome
Opioid Withdrawal
Side Effects
CNS Depression
Respiratory Depression
Hypotension
Considerations
Rebound Hypertension if Abrupt Cessation
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2 mins
Beta Blockers
"-olol" suffix
Mechanism
Decreases Heart Rate and Contractility
Decreases Peripheral Vascular Resistance
Decreases Renin Release
Indications
Hypertension
Heart Failure
Angina Pectoris
Contraindications
Asthma and Heart Block Patients
Nursing Considerations
Assess Blood Pressure and Heart Rate
Masking Signs of Hypoglycemia
Do Not Stop Abruptly
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2 mins
Beta Blocker Antidote
Antidote
Glucagon
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29 secs
Systemic Effects of Beta-Blockers
Respiratory
Bronchoconstriction
Metabolic
Decreased Insulin
Decreased Glycolysis and Lipolysis
Eye
Reduces Intraocular Pressure
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1 min
Heart Failure Interventions
Diagnostic Tests
Echocardiogram
Invasive Hemodynamic Monitoring
Improve Gas Exchange
High Fowler's Position
Oxygen
Advanced Airway
Drugs and Devices
Diuretics
Beta Blockers
Angiotensin II Receptor Blockers (ARBs)
ACE Inhibitors
Digoxin (Lanoxin)
Pacemaker
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2 mins
Hypertrophic Cardiomyopathy Signs, Symptoms and Treatment
Signs and Symptoms
Sudden Death Of Young Athlete
Heart Failure
Angina
Arrhythmias
Syncope
Harsh Systolic Ejection Murmur
S4 Heart Sound
Treatment
Beta Blocker
Non-dihydropyridine Calcium Channel Blocker
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2 mins
Loop Diuretics
Mechanism of Action
Thick Ascending Limb of Loop of Henle
Inhibits Na+-K+-2Cl-
Sulfa Drug
Drug Names
Furosemide
Lasix
Side Effects
Ototoxicity from Rapid Injection
Gout
Dehydration
Hypocalcemia
Hypokalemia
Orthostatic Hypotension
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2 mins
K+ Sparing Diuretics
Indications
CHF and Hypertension
Hypokalemia
Hyperaldosteronism
Mechanism of Action
Collecting Tubule
Spironolactone
Competitive Aldosterone Receptor Antagonist
Amiloride and Triamterene
Block Na+ Channels
Side Effects
Hyperkalemia
Gynecomastia
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2 mins
Loop Diuretic Education
Furosemide (Lasix)
Indications
Heart Failure
Pulmonary Edema
Acute Renal Failure (ARF)
Edema
Education
Notify the provider of weakness, dizziness, or muscle cramping
Increase Potassium Intake
Check BP Daily
Daily Weights and Monitor IandOs
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1 min
Norepinephrine (Levophed)
Mechanism of Action
Alpha Agonist
Beta-1 Agonist
Indications
Severe Hypotension
Side Effect
Decreases Renal Blood Flow
Arrhythmias
Hypertension
Considerations
Tissue Necrosis
Last Resort Medication
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2 mins
Alpha Agonists
-RINE suffix
Norepinephrine
Hypotension
Phenylephrine
Hypotension
Congestion
Ephedrine
Congestion
Urinary Incontinence
Hypotension
Epinephrine
Anaphylaxis and Asthma
Hypotension
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1 min

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