Pharm Exam 4 Key Concepts .docx

Pharm Exam 4 Key Concepts .docx - RNSG 1301 AF1 AF2 Summer...

This preview shows page 1 - 3 out of 25 pages.

RNSG 1301 AF1 & AF2 Summer Keys Concepts for Exam 4 What is it being given for? Expected effects? Safety? Chapter 43 Drugs affecting Blood Pressure Definition within Stepped Care Approach of Levels of Hypertension Stepped Care Management of Hypertension Step 1: Lifestyle Modifications Are Instituted Weight reduction Smoking cessation Moderation of alcohol intake Reduction of salt in diet Increase in physical activity Step 2: Inadequate Response Continue lifestyle modifications. If measures in step 1 are not sufficient to lower BP to an acceptable level, then drug therapy is added: Diuretic (decreases serum sodium levels and blood volume) ACE inhibitor (blocks the conversion of angiotensin I to angiotensin II) Calcium-channel blocker (which relaxes muscle contraction) or other autonomic blockers Angiotensin II receptor blocker (blocks the effects of angiotensin on the blood vessel) Step 3: Inadequate Response Consider change in drug dose or class, or addition of another drug for combined effect. (Note: Fixed combination drugs should only be used when the patient has been stabilized on each drug separately; see Box 43.4 .) Step 4: Inadequate Response All of the above measures are continued. A second or third agent or diuretic is added if not already prescribed. Angiotensin-Converting Enzyme Inhibitors (ACE inhibitors) -pril o captopril (Capoten) pg. 736 Prototype Summary: Captopril Indications: Treatment of hypertension, heart failure, diabetic nephropathy, and left ventricular dysfunction after an MI. Actions: Blocks ACE from converting angiotensin I to angiotensin II, leading to a decrease in BP, a decrease in aldosterone production, and a small increase in serum potassium levels, along with sodium and fluid loss. Pharmacokinetics: Oral 15 min Onset: 15 min Peak: 30-90min Adverse Effects: Tachycardia, MI, rash, pruritus, gastric irritation, aphthous ulcers, peptic ulcers,
Image of page 1

Subscribe to view the full document.

dysgeusia, proteinuria, bone marrow suppression, cough. - Act in the lungs - Blocks Angiotensin I → prevent ACE from converting angiotensin I → to → Angiotensin II (vasoconstrictor/aldosterone stimulator) - *Increases K+ - * Dry Cough - *Angioedema (stop med) - Food: Absorption decreases → take on empty stomach or 1hr before/2 hr after - Drug-Drug: Allopurinol - Tx: Hypertension, CHF, diabetic neuropathy (decreased stimulation of angiotensin receptors in renal artery slows damage to renal artery that occurs w/diabetes) , MI, left ventricular dysfunction Angiotensin II Receptor Blockers (ARB ’s) -sartan o l osartan (Cozaar) pg. 737 Prototype Summary: Losartan Indications: Alone or as part of combination therapy for the treatment of hypertension; treatment of diabetic nephropathy with an elevated serum creatinine and proteinuria in patients with type 2 diabetes and hypertension.
Image of page 2
Image of page 3
  • Spring '16
  • Gloria Seno
  • malignant hypertension

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern