Low Blood Pressure Response
- Posterior Pituitary Releases Vasopressin
 - Vasoconstriction
 - Adrenal Cortex Releases Aldosterone
 - Increased Na+ and H2O Reabsorption
 
High Blood Pressure Response
- Atria Release Atrial Natriuretic Peptide
 - Vasodilation
 - Antagonizes Aldosterone
 - Na+ and Water Excreted
 
Blood Pressure Classification (JNC 7)
- 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
 
Blood Pressure Classification (ACC/AHA 2017)
- 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
 
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
 
Nitroglycerin
- Decreases Preload
 - Angina
 - Up to 3 doses q 5 mins
 - Headache
 - Hypotension
 - Viagra (Sildenafil)
 - Assess Blood Pressure
 - Protect From Light
 - Use Glass Bottle and Special Tubing
 - Gloves for Applying Topically
 
Hypertension Medications
- Diuretics
 - ACE Inhibitors
 - Angiotensin Receptor Blockers (ARBs)
 - Beta Blockers
 - Dihydropyridine Calcium Channel Blockers
 
Angiotensin-Converting Enzyme (ACE) Inhibitors
- "-pril" Suffix
 - Block Renin Angiotensin-Aldosterone System (RAAS)
 - Hypertension
 - Heart Failure
 - Dry Non-productive Cough
 - Hypotension
 - Dizziness
 - Possible Hyperkalemia
 - Angioedema
 - Slowly Change Position
 - Do Not Stop Abruptly
 
Angiotensin II Receptor Blockers (ARBs)
- Ends in "-sartan"
 - Blocks Angiotensin II Receptor
 - Hypertension
 - Angioedema
 - Renal Artery Stenosis
 - Pregnancy
 
Calcium Channel Blockers (Verapamil and Diltiazem)
- Slows AV Conduction
 - Angina Pectoris
 - Arrhythmias
 - Essential Hypertension
 - Bradycardia
 - Hypotension
 - Constipation
 - Peripheral Edema
 - Gingival Hyperplasia
 - Medication Education
 
Nitroprusside
- Direct Release of NO
 - Increase cGMP
 - Short Half-Life
 - Malignant Hypertension
 - Cyanide Toxicity
 
Sodium Nitroprusside (Nitropress)
- Venous and Arterial Dilation
 - Hypertensive Crisis
 - Cyanide Toxicity
 - Thiocyanate Toxicity
 - Hypotension
 - Short Term Administration
 - Light Sensitive, Use Container
 - Continuous BP Monitoring
 
Clonidine
- Alpha-2 Agonist
 - Hypertensive Urgency
 - Attention Deficit Hyperactivity Disorder (ADHD)
 - Tourette Syndrome
 - Opioid Withdrawal
 - CNS Depression
 - Respiratory Depression
 - Hypotension
 - Rebound Hypertension if Abrupt Cessation
 
Beta Blockers
- "-olol" suffix
 - Decreases Heart Rate and Contractility
 - Decreases Peripheral Vascular Resistance
 - Decreases Renin Release
 - Hypertension
 - Heart Failure
 - Angina Pectoris
 - Asthma and Heart Block Patients
 - Assess Blood Pressure and Heart Rate
 - Masking Signs of Hypoglycemia
 - Do Not Stop Abruptly
 
Systemic Effects of Beta-Blockers
- Respiratory
 - Bronchoconstriction
 - Metabolic
 - Decreased Insulin
 - Decreased Glycolysis and Lipolysis
 - Eye
 - Reduces Intraocular Pressure
 
Heart Failure Interventions
- Echocardiogram
 - Invasive Hemodynamic Monitoring
 - High Fowler's Position
 - Oxygen
 - Advanced Airway
 - Diuretics
 - Beta Blockers
 - Angiotensin II Receptor Blockers (ARBs)
 - ACE Inhibitors
 - Digoxin (Lanoxin)
 - Pacemaker
 
Hypertrophic Cardiomyopathy Signs, Symptoms and Treatment
- Sudden Death Of Young Athlete
 - Heart Failure
 - Angina
 - Arrhythmias
 - Syncope
 - Harsh Systolic Ejection Murmur
 - S4 Heart Sound
 - Beta Blocker
 - Non-dihydropyridine Calcium Channel Blocker
 
Loop Diuretics
- Thick Ascending Limb of Loop of Henle
 - Inhibits Na+-K+-2Cl-
 - Sulfa Drug
 - Furosemide
 - Lasix
 - Ototoxicity from Rapid Injection
 - Gout
 - Dehydration
 - Hypocalcemia
 - Hypokalemia
 - Orthostatic Hypotension
 
K+ Sparing Diuretics
- CHF and Hypertension
 - Hypokalemia
 - Hyperaldosteronism
 - Collecting Tubule
 - Spironolactone
 - Competitive Aldosterone Receptor Antagonist
 - Amiloride and Triamterene
 - Block Na+ Channels
 - Hyperkalemia
 - Gynecomastia
 
Loop Diuretic Education
- Furosemide (Lasix)
 - Heart Failure
 - Pulmonary Edema
 - Acute Renal Failure (ARF)
 - Edema
 - Notify the provider of weakness, dizziness, or muscle cramping
 - Increase Potassium Intake
 - Check BP Daily
 - Daily Weights and Monitor IandOs
 
Norepinephrine (Levophed)
- Alpha Agonist
 - Beta-1 Agonist
 - Severe Hypotension
 - Decreases Renal Blood Flow
 - Arrhythmias
 - Hypertension
 - Tissue Necrosis
 - Last Resort Medication
 
Alpha Agonists
- -RINE suffix
 - Norepinephrine
 - Hypotension
 - Phenylephrine
 - Hypotension
 - Congestion
 - Ephedrine
 - Congestion
 - Urinary Incontinence
 - Hypotension
 - Epinephrine
 - Anaphylaxis and Asthma
 - Hypotension