1. Define the drugs used as first line antihypertensives (mechanism of action, A
ID: 97331 • Letter: 1
Question
1. Define the drugs used as first line antihypertensives (mechanism of action, AE, what factors determine drugs selection [don’t forget lifestyle]). Review the categories of second line drugs and their actions.
* What patient may benefit from antihypertensive therapy with an alpha blocker?
* What is the indication for nitroprusside (Nipride? What nursing indications are indicated? List AE.
* Define the process of RAAS. Where do ‘drugs that affect the RAAS’ work within this process? To what effect?
2. Digoxin – identify topics for education. What is the mechanism of action for drugs used in end stage HF? What drugs comprise first-line treatment for chronic HF?
3. Four groups of diuretics: identify main drugs in each group - what are their indications and contraindications?
4. Identify the four processes which affect oxygen supply / oxygen demand. What drugs influence those processes? Identify the MOA, TE, AE, dosing guidelines of NTG.
5. Identify the four categories (+ misc.) of antidysrhythmics. What drugs are prominent in each? What are their indications and precautions? List the multiple toxicities of amiodarone; what nursing considerations / education follow?
Explanation / Answer
Q. 1.. Drugs used as first line of antihypertension:
a. Diuretics: Thiazides Drug:chlorthalidone, hydrochlorothiazide, and indapamide.
Mechanism: Diuretics makes kidney to remove excess water sodium and potassium from body through urine.
Drug selection: This cant be given to weak people due to loss of potassium and sodium. this drug cant be given to kidney stone suffrering patients.It can be given to osteoporosis patients because it retains more calcium in blood.
b. ACE inhibitors — Angiotensin-converting enzyme (ACE) inhibitors block production of the hormone, angiotensin II. This causes blood vessels to widen and lowers blood pressure.Example: captopril, enalapril and fosinopril.
This cant be given to patients who acquire angioedema means swelling of the lips, tongue, and throat, which can interfere with breathing.
c. Calcium channel blockers — Calcium channel blocker drugs reduce the amount of calcium that enters the smooth muscle in blood vessel walls and heart muscles. basically when calcium is not allowed into muscle cell they relax and blood vessels dilate, reducing blood pressure.
This drug is not given to parkinsons patients. it cause the heart rate to slow down, head ache and nausea.
d. Beta blockers- it acts on sympathetic nervous system, which increases the heart rate and raises blood pressure with stress.
This drugis not given to asthma patients.
e. Vasodilators: Thes drugs relaxes the blood vessels and lowers the pressure.
Q. a **** Alpha blockers can be given to cardiac problem related patients.
Q. b *****Sodium nitropruside was earlier used for treating hypertension. It relaxs blood vessels immidiately , hence used in emergency conditions.
Q c ..*****RAAS- Renin angiotensin aldosterone system- The system can be activated when there is a loss of blood volume or a drop in blood pressure.
Question 2: Digoxin: Drug used during heart failure.
First line treatment of heart failure includes
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