This document provides information on hypertension (HTN), including its definition, causes, pathophysiology, classification, assessment, management, and pharmacological treatment options. HTN is defined as elevated blood pressure that increases the risk of target organ damage. Lifestyle modifications and medication are used to manage HTN, with goals of reducing blood pressure while controlling other risk factors. Common antihypertensive drug classes discussed include thiazide diuretics, ACE inhibitors, calcium channel blockers, beta blockers, and angiotensin receptor blockers.
Pharmacotherapy, Management of Hypertension, JNC 8 guidelinesankitamishra1402
This document discusses the pharmacotherapy of hypertension. It begins by defining hypertension and discussing its physiological regulation. It then covers the principles of antihypertensive therapy, classifying drugs by their primary mechanisms of action. The main drug classes discussed are diuretics, sympatholytics, calcium channel blockers, ACE inhibitors, angiotensin receptor blockers, direct renin inhibitors, and vasodilators. For each class, it describes the pharmacological effects, therapeutic uses, dosing, and adverse drug reactions. It concludes by discussing lifestyle modifications and strategies for dosing antihypertensive drugs according to JNC8 guidelines.
Hypertension pharmacotherapy part 2 pptPranatiChavan
First-line medications used in the treatment of hypertension include diuretics, angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs), beta-blockers, and calcium channel blockers (CCBs). Some patients will require 2 or more antihypertensive medications to achieve their BP target. As per special consideration, modified treatment is given in the presentation.
hypertension is a condition arrising due to increased symphathetic tone so drugs therapies are administered for minimising disease sevearity and further complications. Drug therapy includes drugs like alpha blockers, beta blockers, ACE INHIBITORS, ARBs, vasodilators,direct renin inhibitors, reserpine,prostaglandin analogs, calcium channel blockers for minimising excessive pressure and increased contractility of the heart.
This document discusses hypertension (high blood pressure) including its definition, causes, clinical presentation, assessment, and management. It notes that hypertension is defined as blood pressure above 140/90 mmHg and risks of cardiovascular disease double for every 20/10 mmHg rise. Common complications include stroke, myocardial infarction, heart failure, and renal failure. Treatment involves lifestyle modifications and medication, starting with ACE inhibitors, calcium channel blockers, or thiazides. The goals are to lower blood pressure and reduce cardiovascular risk based on individual patient factors.
This document discusses hypertension and its treatment. It defines hypertension and describes its prevalence globally. It notes that only half of those with hypertension have been diagnosed, treated, and adequately controlled. It describes primary and secondary causes of hypertension. The main classes of antihypertensive medications are discussed - diuretics, beta blockers, calcium channel blockers, ACE inhibitors, and alpha blockers. Specific examples within each class are explained. The document emphasizes the goal of treatment is to reduce blood pressure below 140/90 mmHg to prevent cardiac and renal complications.
This document provides an overview of hypertension for pharmacotherapy students. It defines hypertension and classifies blood pressure levels. It discusses the underlying causes, risk factors, symptoms, complications, goals of treatment, and appropriate evaluation. It also describes the major classes of antihypertensive drugs including ACE inhibitors, ARBs, calcium channel blockers, thiazide diuretics, and beta blockers. Treatment approaches are outlined based on clinical guidelines. The document is intended to help students understand the diagnosis and management of hypertension.
Hypertension, or high blood pressure, is a condition where the blood pressure in the arteries is consistently higher than normal. The document discusses hypertension in detail, including:
- Definitions of prehypertension and hypertension based on blood pressure readings
- Types of hypertension such as essential and secondary
- Causes and risk factors for developing hypertension
- Evaluation and testing used to diagnose hypertension and check for target organ damage
- Diseases and health complications attributable to uncontrolled hypertension
- Lifestyle changes and medications used to treat hypertension, including diuretics, ACE inhibitors, calcium channel blockers, and beta blockers.
This document discusses hypertension and its treatment. It defines hypertension as a systolic blood pressure over 140 mmHg or a diastolic blood pressure over 90 mmHg. It describes the types of hypertension as essential, secondary, and environmental. Treatment of hypertension is important to prevent damage to blood vessels and organs like the heart, brain, and kidneys. Several classes of antihypertensive drugs are discussed in detail, including ACE inhibitors, angiotensin receptor blockers, calcium channel blockers, beta blockers, and diuretics. The renin-angiotensin system and how ACE inhibitors work to treat hypertension by inhibiting the conversion of angiotensin I to angiotensin II are also
Pharmacotherapy, Management of Hypertension, JNC 8 guidelinesankitamishra1402
This document discusses the pharmacotherapy of hypertension. It begins by defining hypertension and discussing its physiological regulation. It then covers the principles of antihypertensive therapy, classifying drugs by their primary mechanisms of action. The main drug classes discussed are diuretics, sympatholytics, calcium channel blockers, ACE inhibitors, angiotensin receptor blockers, direct renin inhibitors, and vasodilators. For each class, it describes the pharmacological effects, therapeutic uses, dosing, and adverse drug reactions. It concludes by discussing lifestyle modifications and strategies for dosing antihypertensive drugs according to JNC8 guidelines.
Hypertension pharmacotherapy part 2 pptPranatiChavan
First-line medications used in the treatment of hypertension include diuretics, angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs), beta-blockers, and calcium channel blockers (CCBs). Some patients will require 2 or more antihypertensive medications to achieve their BP target. As per special consideration, modified treatment is given in the presentation.
hypertension is a condition arrising due to increased symphathetic tone so drugs therapies are administered for minimising disease sevearity and further complications. Drug therapy includes drugs like alpha blockers, beta blockers, ACE INHIBITORS, ARBs, vasodilators,direct renin inhibitors, reserpine,prostaglandin analogs, calcium channel blockers for minimising excessive pressure and increased contractility of the heart.
This document discusses hypertension (high blood pressure) including its definition, causes, clinical presentation, assessment, and management. It notes that hypertension is defined as blood pressure above 140/90 mmHg and risks of cardiovascular disease double for every 20/10 mmHg rise. Common complications include stroke, myocardial infarction, heart failure, and renal failure. Treatment involves lifestyle modifications and medication, starting with ACE inhibitors, calcium channel blockers, or thiazides. The goals are to lower blood pressure and reduce cardiovascular risk based on individual patient factors.
This document discusses hypertension and its treatment. It defines hypertension and describes its prevalence globally. It notes that only half of those with hypertension have been diagnosed, treated, and adequately controlled. It describes primary and secondary causes of hypertension. The main classes of antihypertensive medications are discussed - diuretics, beta blockers, calcium channel blockers, ACE inhibitors, and alpha blockers. Specific examples within each class are explained. The document emphasizes the goal of treatment is to reduce blood pressure below 140/90 mmHg to prevent cardiac and renal complications.
This document provides an overview of hypertension for pharmacotherapy students. It defines hypertension and classifies blood pressure levels. It discusses the underlying causes, risk factors, symptoms, complications, goals of treatment, and appropriate evaluation. It also describes the major classes of antihypertensive drugs including ACE inhibitors, ARBs, calcium channel blockers, thiazide diuretics, and beta blockers. Treatment approaches are outlined based on clinical guidelines. The document is intended to help students understand the diagnosis and management of hypertension.
Hypertension, or high blood pressure, is a condition where the blood pressure in the arteries is consistently higher than normal. The document discusses hypertension in detail, including:
- Definitions of prehypertension and hypertension based on blood pressure readings
- Types of hypertension such as essential and secondary
- Causes and risk factors for developing hypertension
- Evaluation and testing used to diagnose hypertension and check for target organ damage
- Diseases and health complications attributable to uncontrolled hypertension
- Lifestyle changes and medications used to treat hypertension, including diuretics, ACE inhibitors, calcium channel blockers, and beta blockers.
This document discusses hypertension and its treatment. It defines hypertension as a systolic blood pressure over 140 mmHg or a diastolic blood pressure over 90 mmHg. It describes the types of hypertension as essential, secondary, and environmental. Treatment of hypertension is important to prevent damage to blood vessels and organs like the heart, brain, and kidneys. Several classes of antihypertensive drugs are discussed in detail, including ACE inhibitors, angiotensin receptor blockers, calcium channel blockers, beta blockers, and diuretics. The renin-angiotensin system and how ACE inhibitors work to treat hypertension by inhibiting the conversion of angiotensin I to angiotensin II are also
Drugs used in treatment of HypertensionAluru Revathi
This document provides an overview of drugs used to treat hypertension. It defines hypertension and outlines its causes, complications, stages, types and diagnosis. It discusses JNC guidelines and the regulation of blood pressure. The document focuses on the management of hypertension through non-pharmacological approaches and various drug therapies, describing the mechanisms and examples of different drug classes including ACE inhibitors, calcium channel blockers, diuretics, alpha-blockers, beta-blockers, and vasodilators. It also addresses treatment of hypertensive emergencies and drugs to avoid or that are safe in pregnancy.
this slide was prepared for NCD programme June, 2012, the informations shown here were taken from both JN7 and NICE guideline.useful for family practitioners, community clinic doctors.Thanks
Phamacological Management of Essential Hypertension - Revision Guidemeducationdotnet
This document provides a summary of the pharmacological management of essential hypertension. It discusses various drug classes used to treat hypertension including ACE inhibitors, ARBs, calcium channel blockers, diuretics, beta blockers, and others. For each drug class, it summarizes the mechanism of action, examples of drugs, uses, cautions/contraindications, and side effects. It emphasizes that lifestyle changes should be discussed before starting pharmacological treatment and drugs may be combined if single drug treatment does not achieve blood pressure targets. The document aims to provide an easy to understand format for key points useful in a clinical situation.
This document discusses the principles of drug therapy for hypertension. It defines hypertension and outlines the risks of not treating it. The main types of hypertension are essential and secondary hypertension. Lifestyle factors like stress, sodium intake, obesity, and smoking can increase risk. The JNC 7 and 8 guidelines classify and recommend treatment for various blood pressure levels. The renal, baroreceptor, and renin-angiotensin systems help regulate blood pressure. Most antihypertensive drugs act by interfering with these normal mechanisms. Initial treatment typically involves a single drug, with combination therapy used if targets are not met. Drug selection depends on individual patient factors and comorbidities.
Antihypertensive drugs and hypertension managementAnas Indabawa
This document discusses antihypertensive drugs and hypertension management. It begins with an introduction to hypertension and outlines types of hypertension like primary or essential hypertension. It then discusses risk factors, diagnosis, and management of hypertension including both non-pharmacological lifestyle changes and various classes of pharmacological treatments. Specific drug classes are explained like ACE inhibitors, calcium channel blockers, diuretics, and others. The document also covers hypertension during pregnancy and hypertensive emergencies. It concludes with precautions for using antihypertensive drugs.
This document discusses various classes of antihypertensive drugs. It begins by defining hypertension and describing its classification based on blood pressure levels. It then discusses the etiology and pathophysiology of hypertension. The document provides detailed information on the mechanisms and examples of several classes of antihypertensive drugs, including sympatholytics, vasodilators, drugs acting on the renin-angiotensin system, diuretics, and other miscellaneous classes. Chemical structures are provided for many individual drug examples.
ANTI HYPERTENSIVE AGENTS [MEDICINAL CHEMISTRY] BY P.RAVISANKAR, HYPERTENSION,...Dr. Ravi Sankar
ANTI HYPERTENSIVE AGENTS [MEDICINAL CHEMISTRY] BY P.RAVISANKAR, HYPERTENSION,TYPES,CAUSES OF HYPERTENSION, CLASSIFICATION, MECHANISM OF ACTION, SAR, ACE INHIBITORS, ARB , DIURETICS(WATER PILLS), TIPS TO STOP SILENT KILLER.
BY P. RAVISANKAR, VIGNAN PHARMACY COLLEGE, VADLAMUDI, GUNTUR,A.P, INDIA.
This document provides an overview of hypertension including its classification, types, signs and symptoms, causes, and treatment. It defines hypertension as having a systolic blood pressure over 140 mmHg or a diastolic blood pressure over 90 mmHg. The document classifies hypertension and discusses the types of essential and secondary hypertension. It outlines the signs and symptoms of hypertension and discusses its causes. The document then describes the classification and mechanisms of antihypertensive drugs and provides details on drug classes including diuretics, ACE inhibitors, calcium channel blockers, and others. It discusses treatment approaches for hypertension and managing hypertensive emergencies.
Antihypertensives | Classes of Drugs | Baro ReceptorChetan Prakash
This Presentation provides a knowledge about Antihypertensives, types of blood pressure, hypertension types, normal blood pressure regulation, baro receptors, classes of antihypertensive drugs,recent discovery on hypertension. This is an assignment for the subject, Advanced Pharmacology-I, 1st year M.Pharm, 1st semester.
This document discusses various drug therapies for hypertension, including diuretics, ACE inhibitors, angiotensin receptor blockers, beta blockers, alpha blockers, and calcium channel blockers. It provides details on the mechanisms of action, advantages, side effects, and current recommendations for each class of antihypertensive medications.
This document summarizes different classes of antihypertensive drugs, including their mechanisms of action and effects. It discusses diuretics, beta blockers, calcium channel blockers, ACE inhibitors, and their uses, sites of action, and potential adverse effects in treating hypertension. Combination drug therapies are recommended for patients who require treatment from multiple drug classes to control their blood pressure.
hypertension, simplified, jnc 8, treatment and newer modalities to treat. surgical procedures involved for hypertension and jnc 8 versus jnc 7 is compared in this ppt, and also, prevelance and epidemeiology of hypertension is explained. antihypertensives for preffered class and age are explained
This document discusses antihypertensive drugs. It defines hypertension and describes its causes and classifications. It then discusses the body's mechanisms for controlling blood pressure via the baroreflex and renin-angiotensin-aldosterone system. The goals of treatment are to reduce cardiovascular risks. First-line therapies include thiazide diuretics, beta-blockers, ACE inhibitors, and calcium channel blockers. The document provides details on the mechanisms and uses of these drug classes and their adverse effects.
The document discusses hypertensive urgencies and emergencies. It defines hypertensive urgency as severe hypertension without acute end-organ damage, requiring blood pressure reduction within hours. Hypertensive emergency involves both severe hypertension and acute end-organ damage, requiring rapid blood pressure reduction within 1 hour to prevent serious morbidity or death. The document provides guidelines for evaluating and diagnosing these conditions, goals for reducing blood pressure, drug options for specific types of hypertensive emergencies, and subsequent oral therapy once the emergency is resolved.
Diuretics in hypertension 2015 by Dr Abhishek Rathoredrabhishekbabbu
Diuretics are recommended as first-line therapy for hypertension. The document discusses various classes of diuretics including loop diuretics, thiazides, thiazide-like agents, and potassium sparing agents. It provides examples of drugs in each class, their mechanisms of action, and sites of action. The document summarizes evidence from clinical trials showing that thiazide diuretics like chlorthalidone are more effective than hydrochlorothiazide at reducing cardiovascular events in hypertension. Indapamide is discussed as an alternative to hydrochlorothiazide with similar efficacy and fewer metabolic side effects. Combinations of ACE inhibitors or calcium channel blockers with diuretics are also effective antihy
The document discusses antihypertensive drugs used to treat hypertension. It describes different categories of hypertension based on blood pressure readings and complications like heart failure. It explains mechanisms that control blood pressure like the kidney and baroreceptors. Treatment strategies aim to reduce cardiovascular and renal risks using drug combinations like a thiazide diuretic initially and adding other drugs if needed. Thiazide diuretics are recommended as first-line treatment and their mechanisms and examples like hydrochlorothiazide are provided along with monitoring potassium levels due to potential hypokalemia.
This document discusses antihypertensive drugs used to treat hypertension. It defines hypertension and classifies blood pressure levels. It covers the causes of primary and secondary hypertension. Non-pharmacological treatments including lifestyle modifications are outlined. The major classes of antihypertensive drugs are described as sympatholytics, vasodilators, agents acting on the renin-angiotensin-aldosterone system, and diuretics. Examples are provided for each subclass. The document concludes that hypertension is common and can be treated through medication and lifestyle changes.
Mr. Rahul, a 52-year-old male with a history of hypertension, bilateral renal artery stenosis, and dyslipidemia, presented to the emergency room with worsening headache, confusion, numbness on his right side, and blurry vision over the past 12 hours. On examination, his blood pressure was extremely elevated at 230/130 mmHg and he showed signs of mild weakness on his right side.
The working diagnosis for Mr. Rahul is secondary hypertension presenting as a hypertensive emergency. His case requires urgent treatment to lower his blood pressure to prevent end organ damage, with a goal of reducing his blood pressure by 15-20% within the first hour and gradually reaching normal levels within 24
This document provides information on hypertensive emergencies and urgencies, including their classification, evaluation, and management. It defines hypertensive emergencies as severe hypertension with evidence of acute target organ damage, while urgencies involve severe hypertension without organ damage. For emergencies, rapid parenteral treatment is needed to stop organ damage progression while avoiding hypoperfusion. Several parenteral agents are discussed for specific conditions along with their dosing and side effects. The goal is to lower blood pressure gradually to avoid complications. Hypertensive urgencies can often be treated orally as outpatients after initial control.
Diagnosis and management of hypertension and hypertensive emergencySheela Aglecha
The document provides guidelines for the diagnosis and management of hypertension in children and adolescents. It defines normal blood pressure levels based on age and sex. It recommends using ambulatory blood pressure monitoring for accurate diagnosis and discusses frequent monitoring and lifestyle/pharmacological interventions. For acute severe hypertension, it advises reducing blood pressure gradually over 24 hours to avoid complications, with the goal below the 95th percentile.
This document discusses various classes of antihypertensive agents used to treat hypertension. It defines hypertension and describes the renin-angiotensin-aldosterone system which is important in regulating blood pressure. Common classes of antihypertensive agents discussed include diuretics, ACE inhibitors, ARBs, calcium channel blockers, beta-blockers, alpha blockers, and central sympatholytics. Lifestyle modifications including weight loss, exercise, diet changes, and avoiding tobacco are also recommended for managing hypertension.
Drugs used in treatment of HypertensionAluru Revathi
This document provides an overview of drugs used to treat hypertension. It defines hypertension and outlines its causes, complications, stages, types and diagnosis. It discusses JNC guidelines and the regulation of blood pressure. The document focuses on the management of hypertension through non-pharmacological approaches and various drug therapies, describing the mechanisms and examples of different drug classes including ACE inhibitors, calcium channel blockers, diuretics, alpha-blockers, beta-blockers, and vasodilators. It also addresses treatment of hypertensive emergencies and drugs to avoid or that are safe in pregnancy.
this slide was prepared for NCD programme June, 2012, the informations shown here were taken from both JN7 and NICE guideline.useful for family practitioners, community clinic doctors.Thanks
Phamacological Management of Essential Hypertension - Revision Guidemeducationdotnet
This document provides a summary of the pharmacological management of essential hypertension. It discusses various drug classes used to treat hypertension including ACE inhibitors, ARBs, calcium channel blockers, diuretics, beta blockers, and others. For each drug class, it summarizes the mechanism of action, examples of drugs, uses, cautions/contraindications, and side effects. It emphasizes that lifestyle changes should be discussed before starting pharmacological treatment and drugs may be combined if single drug treatment does not achieve blood pressure targets. The document aims to provide an easy to understand format for key points useful in a clinical situation.
This document discusses the principles of drug therapy for hypertension. It defines hypertension and outlines the risks of not treating it. The main types of hypertension are essential and secondary hypertension. Lifestyle factors like stress, sodium intake, obesity, and smoking can increase risk. The JNC 7 and 8 guidelines classify and recommend treatment for various blood pressure levels. The renal, baroreceptor, and renin-angiotensin systems help regulate blood pressure. Most antihypertensive drugs act by interfering with these normal mechanisms. Initial treatment typically involves a single drug, with combination therapy used if targets are not met. Drug selection depends on individual patient factors and comorbidities.
Antihypertensive drugs and hypertension managementAnas Indabawa
This document discusses antihypertensive drugs and hypertension management. It begins with an introduction to hypertension and outlines types of hypertension like primary or essential hypertension. It then discusses risk factors, diagnosis, and management of hypertension including both non-pharmacological lifestyle changes and various classes of pharmacological treatments. Specific drug classes are explained like ACE inhibitors, calcium channel blockers, diuretics, and others. The document also covers hypertension during pregnancy and hypertensive emergencies. It concludes with precautions for using antihypertensive drugs.
This document discusses various classes of antihypertensive drugs. It begins by defining hypertension and describing its classification based on blood pressure levels. It then discusses the etiology and pathophysiology of hypertension. The document provides detailed information on the mechanisms and examples of several classes of antihypertensive drugs, including sympatholytics, vasodilators, drugs acting on the renin-angiotensin system, diuretics, and other miscellaneous classes. Chemical structures are provided for many individual drug examples.
ANTI HYPERTENSIVE AGENTS [MEDICINAL CHEMISTRY] BY P.RAVISANKAR, HYPERTENSION,...Dr. Ravi Sankar
ANTI HYPERTENSIVE AGENTS [MEDICINAL CHEMISTRY] BY P.RAVISANKAR, HYPERTENSION,TYPES,CAUSES OF HYPERTENSION, CLASSIFICATION, MECHANISM OF ACTION, SAR, ACE INHIBITORS, ARB , DIURETICS(WATER PILLS), TIPS TO STOP SILENT KILLER.
BY P. RAVISANKAR, VIGNAN PHARMACY COLLEGE, VADLAMUDI, GUNTUR,A.P, INDIA.
This document provides an overview of hypertension including its classification, types, signs and symptoms, causes, and treatment. It defines hypertension as having a systolic blood pressure over 140 mmHg or a diastolic blood pressure over 90 mmHg. The document classifies hypertension and discusses the types of essential and secondary hypertension. It outlines the signs and symptoms of hypertension and discusses its causes. The document then describes the classification and mechanisms of antihypertensive drugs and provides details on drug classes including diuretics, ACE inhibitors, calcium channel blockers, and others. It discusses treatment approaches for hypertension and managing hypertensive emergencies.
Antihypertensives | Classes of Drugs | Baro ReceptorChetan Prakash
This Presentation provides a knowledge about Antihypertensives, types of blood pressure, hypertension types, normal blood pressure regulation, baro receptors, classes of antihypertensive drugs,recent discovery on hypertension. This is an assignment for the subject, Advanced Pharmacology-I, 1st year M.Pharm, 1st semester.
This document discusses various drug therapies for hypertension, including diuretics, ACE inhibitors, angiotensin receptor blockers, beta blockers, alpha blockers, and calcium channel blockers. It provides details on the mechanisms of action, advantages, side effects, and current recommendations for each class of antihypertensive medications.
This document summarizes different classes of antihypertensive drugs, including their mechanisms of action and effects. It discusses diuretics, beta blockers, calcium channel blockers, ACE inhibitors, and their uses, sites of action, and potential adverse effects in treating hypertension. Combination drug therapies are recommended for patients who require treatment from multiple drug classes to control their blood pressure.
hypertension, simplified, jnc 8, treatment and newer modalities to treat. surgical procedures involved for hypertension and jnc 8 versus jnc 7 is compared in this ppt, and also, prevelance and epidemeiology of hypertension is explained. antihypertensives for preffered class and age are explained
This document discusses antihypertensive drugs. It defines hypertension and describes its causes and classifications. It then discusses the body's mechanisms for controlling blood pressure via the baroreflex and renin-angiotensin-aldosterone system. The goals of treatment are to reduce cardiovascular risks. First-line therapies include thiazide diuretics, beta-blockers, ACE inhibitors, and calcium channel blockers. The document provides details on the mechanisms and uses of these drug classes and their adverse effects.
The document discusses hypertensive urgencies and emergencies. It defines hypertensive urgency as severe hypertension without acute end-organ damage, requiring blood pressure reduction within hours. Hypertensive emergency involves both severe hypertension and acute end-organ damage, requiring rapid blood pressure reduction within 1 hour to prevent serious morbidity or death. The document provides guidelines for evaluating and diagnosing these conditions, goals for reducing blood pressure, drug options for specific types of hypertensive emergencies, and subsequent oral therapy once the emergency is resolved.
Diuretics in hypertension 2015 by Dr Abhishek Rathoredrabhishekbabbu
Diuretics are recommended as first-line therapy for hypertension. The document discusses various classes of diuretics including loop diuretics, thiazides, thiazide-like agents, and potassium sparing agents. It provides examples of drugs in each class, their mechanisms of action, and sites of action. The document summarizes evidence from clinical trials showing that thiazide diuretics like chlorthalidone are more effective than hydrochlorothiazide at reducing cardiovascular events in hypertension. Indapamide is discussed as an alternative to hydrochlorothiazide with similar efficacy and fewer metabolic side effects. Combinations of ACE inhibitors or calcium channel blockers with diuretics are also effective antihy
The document discusses antihypertensive drugs used to treat hypertension. It describes different categories of hypertension based on blood pressure readings and complications like heart failure. It explains mechanisms that control blood pressure like the kidney and baroreceptors. Treatment strategies aim to reduce cardiovascular and renal risks using drug combinations like a thiazide diuretic initially and adding other drugs if needed. Thiazide diuretics are recommended as first-line treatment and their mechanisms and examples like hydrochlorothiazide are provided along with monitoring potassium levels due to potential hypokalemia.
This document discusses antihypertensive drugs used to treat hypertension. It defines hypertension and classifies blood pressure levels. It covers the causes of primary and secondary hypertension. Non-pharmacological treatments including lifestyle modifications are outlined. The major classes of antihypertensive drugs are described as sympatholytics, vasodilators, agents acting on the renin-angiotensin-aldosterone system, and diuretics. Examples are provided for each subclass. The document concludes that hypertension is common and can be treated through medication and lifestyle changes.
Mr. Rahul, a 52-year-old male with a history of hypertension, bilateral renal artery stenosis, and dyslipidemia, presented to the emergency room with worsening headache, confusion, numbness on his right side, and blurry vision over the past 12 hours. On examination, his blood pressure was extremely elevated at 230/130 mmHg and he showed signs of mild weakness on his right side.
The working diagnosis for Mr. Rahul is secondary hypertension presenting as a hypertensive emergency. His case requires urgent treatment to lower his blood pressure to prevent end organ damage, with a goal of reducing his blood pressure by 15-20% within the first hour and gradually reaching normal levels within 24
This document provides information on hypertensive emergencies and urgencies, including their classification, evaluation, and management. It defines hypertensive emergencies as severe hypertension with evidence of acute target organ damage, while urgencies involve severe hypertension without organ damage. For emergencies, rapid parenteral treatment is needed to stop organ damage progression while avoiding hypoperfusion. Several parenteral agents are discussed for specific conditions along with their dosing and side effects. The goal is to lower blood pressure gradually to avoid complications. Hypertensive urgencies can often be treated orally as outpatients after initial control.
Diagnosis and management of hypertension and hypertensive emergencySheela Aglecha
The document provides guidelines for the diagnosis and management of hypertension in children and adolescents. It defines normal blood pressure levels based on age and sex. It recommends using ambulatory blood pressure monitoring for accurate diagnosis and discusses frequent monitoring and lifestyle/pharmacological interventions. For acute severe hypertension, it advises reducing blood pressure gradually over 24 hours to avoid complications, with the goal below the 95th percentile.
This document discusses various classes of antihypertensive agents used to treat hypertension. It defines hypertension and describes the renin-angiotensin-aldosterone system which is important in regulating blood pressure. Common classes of antihypertensive agents discussed include diuretics, ACE inhibitors, ARBs, calcium channel blockers, beta-blockers, alpha blockers, and central sympatholytics. Lifestyle modifications including weight loss, exercise, diet changes, and avoiding tobacco are also recommended for managing hypertension.
Hypertension emergencies require rapid reduction of blood pressure to prevent end organ damage. Hypertensive urgency can be managed as an outpatient but emergencies require hospitalization. Initial evaluation assesses for signs of damage to heart, kidneys, brain, or vasculature. Parenteral drugs like nicardipine, labetalol, and esmolol are used to lower blood pressure 10-15% within 1 hour and further to 160/100 mmHg in 2-6 hours, with goals tailored to specific conditions like stroke, heart failure, or aortic dissection. Oral agents like clonidine or nifedipine may be used after initial parenteral treatment to control blood pressure before discharge
Hypertension emergencies require rapid reduction of blood pressure to prevent end organ damage. Hypertensive urgency can be managed as an outpatient with oral medications, while emergencies require hospitalization and intravenous drugs. Initial evaluation assesses for signs of heart, brain, kidney and vascular damage. Parenteral drugs like nicardipine, labetalol and esmolol are used but sodium nitroprusside is no longer first-line due to risks. Treatment goals depend on the specific organ involved and reduce pressure by 10-25% within 1-2 hours.
Management of Hypertension in Diabetic Patients with Chronic Kidney Disease: ...O. E.Nyandi PhD
South Pacific Medical Education Conference Presentation byDr Osborne E Nyandiva on Conference Presentation : Management of Hypertension in Diabetic Patients with Chronic Kidney Disease: A pathologist perspective view in SAMOA and NEW ZEALAND
Diabetes is associated with markedly increased cardiovascular risk, a risk compounded with imposition of chronic kidney disease (CKD). More than 80% of people with diabetes and CKD have hypertension, and many have an obliterated nocturnal blood pressure “dip,” the normal physiological drop in blood pressure during sleep. Appropriate blood pressure measurement is the Achilles heel of hypertension management, especially in diabetic kidney disease (DKD). The prevalence of kidney disease and diabetes is increasing among the people of the Pacific with an unknown proportion having metabolic syndrome. The preponderance of those with diabetic kidney disease (DKD) will not progress to kidney failure, but rather will succumb to cardiovascular disease (CVD).
Hypertension Guidelines By Rodgers ChibaleRodgersChibale
This document provides information on hypertension including its definition, etiology, signs and symptoms, classification, treatment and treatment guidelines. It defines hypertension as a condition where blood pressure is chronically elevated above 140/90 mmHg. The causes of hypertension are categorized as primary (essential) or secondary. Treatment involves non-pharmacological methods as well as various classes of antihypertensive drugs like ACE inhibitors, ARBs, calcium channel blockers, beta blockers, diuretics and vasodilators. The guidelines recommend starting treatment with one drug and adding a second from a different class if target is not reached after 3 months. Drug combinations should be used carefully due to risk of interactions.
Hypertensive nephropathy is kidney damage caused by long-standing high blood pressure. It involves thickening of the walls of small arteries in the kidneys which reduces blood flow and causes scarring. Risk factors include a family history of high blood pressure, older age, unhealthy habits like smoking, and illnesses like diabetes. Symptoms include high blood pressure, swelling, fatigue, breathing difficulties, and changes in urination. Treatment focuses on controlling blood pressure through lifestyle changes and medications like ACE inhibitors, ARBs, calcium channel blockers, and diuretics. If kidney function declines significantly, dialysis or kidney transplantation may be required.
The document discusses hypertensive emergencies and urgencies. It defines hypertensive emergencies as severe high blood pressure with impending or progressive organ damage, while urgencies involve severe elevation in BP without organ damage. Various intravenous antihypertensive medications are reviewed for treating emergencies, including vasodilators like sodium nitroprusside, nicardipine, and nitroglycerin, as well as adrenergic inhibitors like labetalol, esmolol, and phentolamine. The ideal drug lowers blood pressure without compromising organ blood flow and has a rapid onset and offset of action with minimal side effects. Treatment goals and medication choices depend on the underlying cause and end organ
Overview of the Medical Management of High Blood Pressure in AdultsLuis Daniel Lugo
Hypertension affects 75 million adults in the US and is a major risk factor for stroke, heart disease, and kidney disease. Treatment involves lifestyle modifications like reducing salt, weight loss, exercise, and limiting alcohol. Medical therapy focuses on drugs like thiazide diuretics, ACE inhibitors, ARBs, calcium channel blockers, and other classes. The goal is to lower blood pressure below 140/90 mmHg or 150/90 for those over 60 to reduce cardiovascular risks. While untreated hypertension increases mortality risks over time, treatment that maintains a 12 mmHg lower systolic blood pressure can prevent 1 death per 11 patients with stage 1 hypertension.
This document provides an overview of hypertension, including its causes, symptoms, types, complications, diagnosis, treatment, and management. It discusses essential and secondary hypertension, complications such as heart failure and stroke, diagnostic criteria, lifestyle modifications, drug therapy options including diuretics, beta blockers, ACE inhibitors, and more. Treatment involves lifestyle changes, medication, and monitoring to control blood pressure and reduce complications.
Essential hypertension management and treatmentFabio Grubba
This document discusses hypertension (high blood pressure), including its classification, causes, symptoms, diagnosis, and treatment. It defines the different stages of hypertension according to blood pressure readings. Lifestyle modifications are recommended initially, including diet changes and exercise. If lifestyle changes do not control blood pressure, medications such as diuretics, beta-blockers, calcium channel blockers, ACE inhibitors, and other drug classes may be used. The goal of treatment is to prevent complications in target organs like the heart, brain, and kidneys by maintaining a blood pressure below 140/90 mmHg.
Hypertension is defined as persistently elevated blood pressure. It is classified based on systolic and diastolic blood pressure readings. Hypertension can be primary (essential) or secondary to other conditions. Treatment involves lifestyle modifications and medication to control blood pressure. First-line medications include ACE inhibitors, ARBs, calcium channel blockers, and thiazide diuretics, which work by inhibiting the renin-angiotensin-aldosterone system or calcium channels, or increasing sodium excretion.
This document summarizes guidelines for the treatment and management of hypertension. It discusses stages of hypertension and treatment thresholds. Lifestyle modifications like following the DASH diet, reducing sodium intake, weight loss, and exercise are recommended first line approaches. If goals are not met with lifestyle changes alone, pharmacologic therapy with diuretics, ACE inhibitors, ARBs, calcium channel blockers, and beta blockers is recommended. Specific considerations and guidelines are provided for managing hypertension in special populations like those with diabetes, pregnancy, the elderly, and black patients.
Management of Hypertension in Diabetic Patients with Chronic Kidney Disease: ...O. E.Nyandi PhD
Diabetes is associated with markedly increased cardiovascular risk, a risk compounded with imposition of chronic kidney disease (CKD). More than 80% of people with diabetes and CKD have hypertension, and many have an obliterated nocturnal blood pressure “dip,” the normal physiological drop in blood pressure during sleep. Appropriate blood pressure measurement is the Achilles heel of hypertension management, especially in diabetic kidney disease (DKD).
This document discusses cardiovascular pharmacology. It covers topics like diuretics and their indications for hypertension and fluid retention. It discusses treatment approaches for hypertension including lifestyle modifications and pharmacological therapies. The main antihypertensive drug classes covered are diuretics, ACE inhibitors, angiotensin receptor blockers, calcium channel blockers, beta blockers, and alpha blockers. It also discusses heart failure pharmacology and angina management. The document provides details on the mechanisms and uses of different drug classes for cardiovascular conditions.
Hypertension, or high blood pressure, is defined as blood pressure above 140/90 mmHg. It can be classified into stages based on systolic and diastolic blood pressure readings. The majority of cases are primary or essential hypertension, while a small percentage are secondary to other conditions. Target organ damage to the heart, brain, kidneys and eyes can occur if hypertension is not controlled. Lifestyle modifications and medications are used to treat and manage hypertension. Nursing care involves educating patients, monitoring for complications, and promoting treatment adherence.
(1) The document discusses the evaluation, classification, and treatment of hypertensive emergencies and urgencies. It defines the differences between the two conditions and outlines the goals and approaches for treating each.
(2) For hypertensive urgencies, the goal is to lower blood pressure within several hours to prevent further increases without causing too rapid of a drop. For emergencies, the goal is to reduce blood pressure more quickly to prevent end-organ damage, while maintaining adequate perfusion.
(3) Several intravenous antihypertensive drugs are discussed as options for treatment in hypertensive emergencies, including nitroprusside, nicardipine, labetalol, and
anatomy and physiology of the eye.pptxmahamed adam
The document provides an overview of the anatomy and physiology of the eye. It describes the main parts of the eye including the outer fibrous tunic, middle vascular tunic, and inner nervous tunic. The key structures are identified, such as the cornea, iris, lens, retina, as well as the aqueous humor and vitreous humor. The process of light refraction and focusing on the retina to form an image is explained. Accommodation and pupillary reflexes are also summarized.
Postoperative complications can range from minor issues like fatigue to life-threatening problems like blood clots. The highest risk period is 1-3 days after surgery. Complications can be general, like fever or infection, or specific to the type of procedure. Common general issues include wound infections, blood clots, collapsed lungs, and kidney problems. Without treatment, some complications can lead to serious problems or even death. Close monitoring in the first few days after surgery can help address potential complications early.
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1. Definitions of burn depth including first, second, and third degree burns. Common causes of burns are also listed.
2. The pathophysiology of burns is described affecting several body systems like hemodynamic changes, electrolyte imbalance, renal and pulmonary function, hematologic and GI systems, and decreasing immunity.
3. Burn severity is determined by depth, extent of total body surface area burned, age, and location of burns on the body. Common classifications of burns and methods to estimate burn extent are also summarized.
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2) Risk factors for breast cancer include genetic, hormonal, environmental factors as well as increasing age. Clinical manifestations may include breast lumps, nipple discharge, and enlarged lymph nodes.
3) Diagnostic tests for breast cancer include mammography, biopsy and laboratory tests to detect metastasis. Treatment involves surgery such as lumpectomy or mastectomy followed by radiation, chemotherapy and hormonal therapy.
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Peptic ulcer disease occurs when acid and pepsin in the stomach and duodenum damage the protective mucosal layer of the gastrointestinal tract, resulting in sores or ulcers. It is caused by an imbalance between acid secretion and mucosal defenses. Factors like smoking, alcohol, NSAIDs, and H. pylori infection can exacerbate peptic ulcers. Patients experience epigastric pain that may radiate to the back and is relieved by eating. Treatment involves eradicating H. pylori with antibiotic therapy, reducing acid with PPIs or H2 blockers, lifestyle changes, and sometimes surgery for complications like bleeding or perforation.
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2) Symptoms include pain that starts around the navel and moves to the lower right abdomen, nausea, vomiting, loss of appetite, and fever.
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2. Definition
• HTN = the presence of a BP elevation to a
level that places patients at increased risk
for target organ damage in several
vascular beds including the retina, brain,
heart, kidneys, and large conduit arteries.
2
9. Assessment
Risk Factors
Essential hypertension
• Positive family history
• Excessive sodium intake
• Physical inactivity
• Obesity
• High alcohol consumption
• African American
• Smoking
• Hyperlipidemia
• Stress
Risk Factors
• Secondary hypertension
• Kidney disease
• Cushing’s disease (excessive
glucocorticoid secretion)
• Primary aldosteronism (causes
hypertension and
hypokalemia)
• Pheochromocytoma
(excessive catecholamine
release)
• Brain tumors, encephalitis
• Medications such as estrogen,
steroids, sympathomimetics
9
10. Assessment
Subjective Data
• Clients who have hypertension
can experience few or no
symptoms. The nurse should
• monitor for:
• Headaches, particularly in the
morning.
• Dizziness.
• Fainting.
• Retinal changes, visual
disturbances.
• Nocturia.
Objective Data
Physical Assessment Findings
• When a blood pressure
reading is elevated, take it
in both arms and with the
client sitting and standing.
• There are several levels of
hypertension, as defined by
the Joint National
Committee on Prevention,
Detection, Evaluation, and
Treatment of High Blood
Pressure.
10
11. Assessment
Objective Data -cont
• Laboratory Tests
• No laboratory tests exist to
diagnose hypertension;
however, several laboratory
tests can identify the causes of
secondary hypertension and
target organ damage.
• BUN, creatinine – elevation is
indicative of kidney disease
• Elevated serum corticoids to
detect Cushing’s disease
• B.G and cholesterol studies can
identify contributing factors
related to blood vessel changes.
Objective Data -cont
• Diagnostic Procedures
• An ECG evaluates
cardiac function. Tall R-
waves are often seen
with left-ventricular
hypertrophy.
• A chest x-ray may show
cardiomegaly.
11
14. Management
Lifestyle Modifications
• Lose weight if body mass index is
greater than or equal to 25.
• Stop drinking alcohol
• regular aerobic exercise 30 to 45
minutes daily
• Smoking cessation.
• Reduce dietary saturated fat and
cholesterol.
• Restricted sodium intake
• Consider reducing coffee intake
14
15. Drug Therapy
• The best management of hypertension is
to use the fewest drugs at the lowest
doses while encouraging the patient to
maintain lifestyle changes.
• Most patients require two or more
antihypertensive medications to achieve
their BP goals.
15
18. Pharmacological Treatment
• Aim is to reduce BP while controlling other
modifiable cardiovascular risk factors.
• Gradual reduction to avoid end organ
ischemia.
• Patient education:
– Life long treatment.
– Symptoms don’t reflect severity.
– Prognosis improves with proper management.
18
19. Pharmacological Treatment
•Treatment determined by highest BP
category.
•Most patients are controlled with more
than one drug.
•Initial combined therapy should be used
cautiously in those at risk for orthostatic
hypotension.
•Compelling indications.
19
20. Pharmacological Treatment
• Stage 1: thiaizide type diuretic if no
compelling indication.
• When BP is > 20/10 mmHg above goal:
add a 2nd drug (when the 1st drug used in
adequate dose).
• Stage 2 : usually 2-drug combination for
most: thiazide + ACE inhibitor, ARB, BB
or CCB.
20
21. Thiazide diuretics
• Well-proven, 1st line therapy.
• Both low-dose and high-dose regimens
decrease rates of stroke and death.
• Low-dose regimens reduce CAD.
• Enhance antihypertensive efficacy of
multidrug regimens.
21
24. Loop diuretics
• Diuretics promote sodium and water
excretion, reduce plasma volume, decrease
sodium in the arteriolar walls, and reduce
the vascular response to catecholamine.
• Loop diuretics- e.g. furosemide (Lasix)
• side effects
• Hyperuricemia, hyperglycemia, and
hypokalemia are common side effects
24
25. cont
• Nursing Considerations
• Monitor potassium levels and watch for
muscle weakness, irregular pulse, and
dehydration.
• Thiazide and loop diuretics can cause
hypokalemia, and potassium-sparing
diuretics can cause hyperkalemia.
25
26. cont
• Client Education
• Encourage the client to keep all
appointments with the provider to monitor
efficacy of pharmacological treatment and
possible electrolyte imbalance
(hyponatremia, hyperkalemia).
• If the client is taking a potassium-depleting
diuretic, encourage consumption of
potassium-rich foods, such as bananas.
26
27. Beta-adrenergic blockers
• Act centrally on the vasomotor center and
peripherally to inhibit norepinephrine release
or to block the adrenergic receptors on
blood vessels.
• Cardioselective: atenolol, metoprolol.
• Non-selective: propranolol, timolol.
27
28. cont
• MOA:
– Competitive inhibition
of catecholamines.
– Decrease plasma
renin.
– Resetting of
baroreceptors.
– Release of vasodilator.
Side effect
Orthostatic hypotension
and sexual dysfunction
Bronchospasm,
bradycardia, fatigue.
28
29. cont
• Nursing Considerations
• Monitor blood pressure and pulse.
• These medications can mask
hypoglycemia in clients who have diabetes
mellitus.
29
30. cont
• Client Education
• Teach the client that these medications may cause
fatigue, weakness, depression, and sexual
dysfunction.
• Advise the client not to suddenly stop taking the
medication without consulting with the provider.
Stopping suddenly can cause rebound hypertension.
• Teach the client manifestations of hypoglycemia that
do not include tachycardia, which beta blockers
suppress.
30
31. Calcium Channel Blockers
• MOA:
– Arteriolar
vasodilatation by
selective blockage of
calcium influx in
vascular smooth
muscle cells.
31
32. • All CCBs are metabolized in the liver.
• Nefidipine: 10 mg TDS, or nefidipineXL 30
mg O/D.
• Verapamil and diltiazem have negative
cardiac inotropic and chronotropic effects.
• CCBs should not be initiated immediately
after MI.
Calcium Channel Blockers
32
34. • Nursing Considerations
• Monitor blood pressure and pulse, and
change the client’s position slowly.
Hypotension is a common side effect.
• Use calcium-channel blockers cautiously
with clients who have heart failure.
34
35. • Client Education
• Constipation can occur with verapamil
hydrochloride, so encourage intake of
foods that are high in fiber.
• A decrease or increase in heart rate and
atrioventricular (AV) block can occur. So,
teach the client how to take her pulse and
call the provider if it’s irregular or lower
than the established rate.
36. • Instruct the client to avoid grapefruit juice,
which potentiates the medication’s effects,
increases hypotensive effects, and
increases the risk of medication toxicity.
36
37. ACE Inhibitors
• Examples: lisinopril,
enalapril, captopril.
• MOA: block the
production of AII
resulting in:
– Arterial and venous
vasodilatation.
– Low aldosterone: mild
natriuresis with
decrease in K+
secretion
37
38. ACE Inhibitors
• Beneficial effects in patients with
concomitant heart failure or kidney
disease.
• Can reduce the metabolic effects of
diuretics.
38
39. • Increase the level of vasodilator
bradykinins.
• Side effects:
– Dry cough in up to 20% of patients.
– Angioneurotic oedema.
– Hypotension.
– Hyperkalaemia.
– Captopril: taste disturbance, leukopenia,
glomerulopathy with proteinuria.
ACE Inhibitors
39
40. • Nursing Considerations
• Monitor blood pressure and pulse.
Hypotension is a common adverse effect.
• Monitor for evidence of heart failure, such
as edema. This medication may cause
heart and kidney complications.
40
41. • Client Education
• Teach the client to report a cough, which is a side
effect of ACE inhibitors. The client should notify
the provider of this adverse effect, as the
medication can be discontinued due to its
persistent nature and occasional relationship to
angioedema (swelling of the tissues in the throat
that can progress to a life-threatening obstruction).
41
42. ARBs
• these medications, such as candesartan
(Atacand), losartan (Cozaar), and
telmisartan (Micardis), are a good option
for clients taking ACE inhibitors who report
cough and those who have hyperkalemia.
Also, ARBs do not require a dosage
adjustment for older adult clients.
42
43. • Nursing Considerations
• Monitor for manifestations of angioedema
or heart failure. Angioedema is a serious,
but uncommon adverse effect, and heart
failure can result from taking this
medication.
43
44. • Client Education
• Teach the client to change positions slowly.
• Teach the client to report findings of
angioedema (swollen lips or face) or heart
failure (edema).
• Teach the client to avoid foods that are high in
potassium and to have serum potassium levels
monitored because ARBS can cause
hyperkalemia.
44
46. • Nursing Considerations
• Monitor kidney function, triglycerides, sodium, and
potassium levels. The risk of adverse effects increases
with deteriorating kidney function. Hypertriglyceridemia,
hyponatremia,and hyperkalemia can occur as the dose
increases.
• Monitor potassium levels every 2 weeks for the first few
months and every 2 months thereafter. The client should
avoid taking potassium supplements or potassium-
sparing diuretics.
46
47. • Client Education
• Teach the client about potential food,
medication, and herbal interactions.
Grapefruit juice and St. John’s wort can
increase adverse effects.
• Instruct the client not to take salt
substitutes with potassium or other foods
that are rich in potassium.
47
48. 48
Central-alpha agonists
Central-alpha agonists, such as clonidine
(Catapres), reduce peripheral vascular resistance
and decrease blood pressure by inhibiting the
reuptake of norepinephrine.
■Nursing Considerations
Monitor blood pressure and pulse.
This medication is not for first-line management of
hypertension.
Client Education
Teach the client that adverse effects include
sedation, orthostatic hypotension,
and impotence.
49. Alpha-adrenergic Antagonists
• Alpha-adrenergic antagonists, such as prazosin (Minipress),
reduce blood pressure by causing vasodilation.
• Nursing Considerations
• Start treatment with a low dose of the medication, usually given
at night.
• Monitor blood pressure for 2 hr after initiation of treatment.
• Client Education
• Advise the client to rise slowly to prevent postural hypotension.
Tell the client to use caution when driving until the effects of
the medication are known.
49
50. • For primary prevention: 75mg aspirin is
recommended for hypertensive patients aged 50
years or more who have satisfactory control over
their blood pressure and either target organ
damage, diabetes or cardiovascular disease risk
> 20%.
• For primary prevention: statin therapy is
indicated when the 10-year cardiovascular
disease risk is >20%.
Aspirin… Statins
50
51. • For secondary prevention: statin therapy
and aspirin therapy are indicated when
there is evidence of cardiovascular
disease, that is, angina/MI, stroke, TIA,
peripheral vascular disease, etc.
Aspirin… Statins
51
52. Hypertensive Crisis
• Usually develop in pts with previous
history of elevated BP, but may arise in a
normotensive pt.
52
53. Hypertensive Urgencies
• Substantial increase in BP usually with
DBP > 120 without evidence of end organ
damage.
• Occur in 1% of all hypertensive patients.
• Treatment: oral medications in outpatient
settings with close and frequent follow up.
53
54. Hypertensive Emergencies
• Accelerated and malignant HTN.
• SBP > 210 and DBP > 130 with evidence
of end organ damage.
• Reduce the BP by < 25% within 2hrs and
to a level of 160/100 by 6 hrs.
• Avoid excessive reduction of BP
54
55. Hypertensive Emergencies
• Treatment:
– Admission.
– I.V medications:
• Sodium nitroprusside: infusion, direct arterial and
venous vasodilator, rapid onset, easily titrable and
short-lived.
• Hydralazine: I.V bolus, direct smooth muscle
relaxant, 10mg I.V every 10---15 min. Maximum
dose 50 mg..
• Nitroglycerin infusion: alternative. Useful after
unstable angina, MI and LVH.
55
57. Patient-Centered Care
• Nursing Care
Discuss factors with a client that increase the risk of
hypertension and how he can manage them.
• Medications
Medications are added to treat hypertension that is not
responsive to lifestyle changes alone. Diuretics are often
first-line medications. However, clients can require a
combination of medications to control hypertension.
Instruct clients who are taking antihypertensives to
change positions slowly, be careful when getting out of
bed, driving, and climbing stairs until the medication’s
effects are fully known.
57
58. Care After Discharge
• Instruct client to report manifestations of
electrolyte imbalance (hyperkalemia,
hypokalemia,hyponatremia).
• Express to the client and family the
importance of adhering to the medication
regimen, even if the client is asymptomatic.
• Provide verbal and written education to the
client regarding medications and their
side/adverse effects.
58
59. cont
• Ensure that the client has the resources
necessary to pay for and obtain prescribed
antihypertensive medication.
• Encourage the client to schedule regular
provider appointments to monitor
hypertension and cardiovascular status.
• If the client has blood pressure that is difficult
to manage, teach him or a significant other
how to take blood pressure.
59
60. cont
• Encourage the client to report findings and
adverse effects, as they may be indicative
of additional problems. Medications can
often be changed to alleviate side or
adverse effects.
• Older adult clients are more likely to
experience medication interactions.
• Older adult clients are more likely to
experience orthostatic hypotension.
60
61. cont
Treatment involves the client making lifestyle
changes.
• Nutrition
• Monitor potassium with salt substitute use.
• Consume less than 2.3 g/day of sodium.
• Consume a diet low in fat, saturated fat, and
cholesterol.
• Control alcohol intake for men to 2 drinks per day
and for women to 1 drink per day. Intake of 1 drink
equals 12 oz beer, 4 oz wine, or 1 to 1.5 oz liquor.
61
62. cont
• Dietary approaches to stop hypertension
(DASH) have been proven to be effective
in the prevention and treatment of
hypertension.
• The DASH diet should be high in fruits,
vegetables, and low-fat dairy foods.
• Avoid foods high in sodium and fat.
• Consume foods rich in potassium,
calcium, and magnesium.
62
63. cont
• Weight reduction and maintenance.
• Exercise at least three times a week in a
manner that provides aerobic benefits.
63
64. cont
• Smoking cessation.
• Stress reduction Encourage the client to
try yoga, massage, hypnosis, or other
forms of relaxation.
64
65. Complications
• Hypertensive Crisis
• Hypertensive crisis often occurs when clients do
not follow the medication therapy regimen.
• Nursing Actions
• Recognize clinical manifestations.
• Severe headache
• Extremely high blood pressure (generally, systolic
blood pressure greater than 240 mm Hg, diastolic
greater than 120 mm Hg)
• Blurred vision, dizziness, and disorientation
• Epistaxis
65
66. cont
• Administer IV antihypertensive therapies as
prescribed.
• Before, during, and after administration of IV
antihypertensive, monitor blood pressure
every 5 to 15 min.
• Assess neurological status such as pupils,
level of consciousness, and muscle strength,
to monitor for cerebrovascular change.
• Monitor the ECG to assess cardiac status.
66