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