LEC - L3:T1-T2 (AntiHPN-ACE&ARBS / AntiHPN-BETA&Cal Blocker)

What are beta adrenergic blockers primarily used for?

They are used to decrease cardiac workload, ease symptoms of angina, treat dysrhythmias, heart failure, myocardial infarction (MI), and migraines.

Name two cardioselective beta adrenergic blockers.

Metoprolol and Atenolol.

What is a common non-selective beta blocker?

Propranolol.

List one advantage of beta blockers.

They do not cause postural hypotension.

What are some non-cardiovascular uses of beta blockers?

Migraine prevention, anxiety management, glaucoma treatment, hyperthyroidism, and managing pheochromocytoma.

What are the side effects of beta blockers?

Fatigue, loss of libido, cognitive defects, bronchoconstriction, bradycardia, and cold extremities.

What is the mechanism of action of alpha adrenergic blockers?

They lower blood pressure by blocking sympathetic receptors in arterioles, causing vasodilation.

Name a specific alpha-1 blocker used in chronic essential hypertension.

Prazosin.

What are the adverse effects of prazosin?

Postural hypotension, fluid retention, headache, dry mouth, and weakness.

What is a therapeutic use of calcium channel blockers?

They are effective in treating angina.

List two examples of calcium channel blockers available in the Philippines.

Amlodipine and Diltiazem.

What is a potential side effect of calcium channel blockers?

Dizziness or lightheadedness.

What is one advantage of calcium channel blockers compared to diuretics?

They do not have adverse metabolic effects.

What is the effect of calcium channel blockers on pregnancy?

They have no adverse fetal effects and can be given during pregnancy.

What condition is treated with tamsulosin?

Benign prostatic hypertrophy (BPH).

What is the primary action of beta blockers on the renin-angiotensin system?

They inhibit the secretion of renin and the formation of angiotensin I.

Why are non-selective alpha blockers not used in chronic essential hypertension?

They are less effective at reducing serious cardiovascular events compared to diuretics.

What is one reason beta blockers are preferred in young non-obese patients?

They help prevent sudden cardiac death in post-infarction patients.

What is a common adverse effect of calcium channel blockers?

Edema (swelling of ankles, feet, or lower legs).

What should be monitored when starting prazosin?

Start with a low dose (0.5 mg) at bedtime to prevent postural hypotension.

What is the role of carvedilol in elderly patients?

It has a vasodilatory action and can be given to manage heart failure.

What is the interaction of calcium channel blockers with grapefruit juice?

Grapefruit juice can increase the levels of calcium channel blockers to toxic doses.

What is the effect of beta blockers on heart rate?

They slow conduction through the myocardium, which can treat dysrhythmias.

What is a key benefit of using calcium channel blockers in elderly patients?

They help prevent strokes.

What is the purpose of symptomatic treatment for hypertension?

To prevent damage to the vascular epithelium, reduce heart load, and manage asymptomatic hypertension.

What does the Renin Angiotensin Aldosterone System (RAAS) regulate?

Blood pressure and fluid balance.

Name one class of drugs that act on the RAAS.

Angiotensin Converting Enzyme (ACE) Inhibitors.

What is the effect of ACE Inhibitors on blood pressure?

They decrease blood pressure by preventing the conversion of angiotensin I to angiotensin II.

List three examples of ACE Inhibitors.

Captopril, lisinopril, enalapril.

What is a common adverse effect of ACE Inhibitors?

Persistent dry cough.

What contraindications exist for ACE Inhibitors?

Pregnancy, bilateral renal artery stenosis, hypersensitivity, and hyperkalemia.

What advantages does enalapril have over captopril?

Longer half-life, not affected by food, and fewer side effects.

What is the typical starting dose range for ramipril?

2.5 to 10 mg daily.

What are Angiotensin II Receptor Blockers (ARBs) designed to do?

Block vasoconstriction and aldosterone release to lower blood pressure.

Name two examples of ARBs.

Losartan and valsartan.

What is a key pharmacokinetic feature of ARBs?

Absorption is not affected by food, but they have low bioavailability.

What is a rare side effect associated with the first dose of ARBs?

Hypotension.

How do ARBs compare to ACE Inhibitors regarding cough?

Cough is rare with ARBs because they do not interfere with bradykinin.

What nursing implementation should be taken after administering ACE Inhibitors?

Monitor for hypotension and let the client rest in a supine position for several hours.

What should be monitored in patients taking ACE Inhibitors?

Hypotension, hyperkalemia, liver and kidney function.

What is the mechanism of action of ACE Inhibitors?

They prevent the conversion of angiotensin I to angiotensin II.

What is the half-life of captopril?

2 hours, but its action lasts for 6-12 hours.

What is the effect of ACE Inhibitors on serum potassium levels?

They can cause a slight increase in serum potassium.

What is the significance of monitoring for dysgeusia in patients on ACE Inhibitors?

It indicates a potential side effect affecting taste sensation.

What is the role of lifestyle changes in managing hypertension?

To enhance the effectiveness of pharmacological treatments.

What is the theoretical superiority of ARBs over ACE Inhibitors?

Lower incidence of cough and angioedema, and no interference with bradykinin.