N212- Pathophysiology Test 3 Study Guide
Hypertension
• Pathophysiology
• Medications/ MOA/Side effects
Pathophysiology (WHY it happens)
• Chronic increased systemic vascular resistance
• Caused by RAAS activation, sympathetic stimulation, endothelial dysfunction
• Heart pumps against higher pressure → LV hypertrophy → HF
Medications (MOA + Side Effects)
• ACE inhibitors (-pril): ↓ Angiotensin II → vasodilation.
• Ex- Lisinopril, Enalapril
▪ SE: cough, hyperkalemia, angioedema ; HOLD IF PREGNANT
• ARBs (-sartan): block Ang II receptors; Ex: Losartan, Valsartan
▪ SE: hyperkalemia, hypotension
• Beta-blockers (-lol): (ALWAYS CHECK HR before giving) ↓ HR & CO , cardiac
workload ; Ex: Metoprolol, Atenolol
▪ SE: bradycardia, fatigue;
• Calcium channel blockers: relax vessels ; Ex: Amlodipine, Diltiazem
▪ SE: edema, constipation
• WATCH B.P.
• Diuretics: ↓ volume Ex: HCTZ, Furosemide
▪ SE: electrolyte imbalance
ATI PRIORITY: Prevent end-organ damage (brain, kidneys, heart);
Stroke
Risk factors: HTN (BIGGEST), Diabetes, A-fib, Smoking, Hyperlipidemia
Management & Priorities
• ABCs first
• CT scan BEFORE anticoagulants
• Maintain BP (don’t drop too fast)
• NPO until swallow study
Treatment
Ischemic: tPA within 3–4.5 hrs
Hemorrhagic: BP control, no tPA
, Medication Purpose ATI PRIORITY
Only after CT confirms
tPA Dissolves clot
ischemic
Aspirin Prevents platelet aggregation Give after bleed ruled out
Antihypertensives Control BP Do NOT drop BP too fast
MI
Key Medications
MONA (Morphine, O₂, Nitroglycerin, Aspirin)
Beta-blockers
Anticoagulants (heparin)
Labs
Troponin ↑ (most specific)
CK-MB ↑
BNP ↑ (if HF)
Drug Why Given ATI PEARL
Aspirin Prevents clot growth Give ASAP
Nitroglycerin Vasodilation, ↓ preload Check BP
Morphine Pain & ↓ preload Watch respirations
Beta-blockers ↓ HR, ↓ O₂ demand Avoid if bradycardic
Heparin Prevents clot extension Monitor aPTT
Heart failure
Assessment (LEFT vs RIGHT)
• Left-sided: pulmonary congestion, crackles, SOB
• Right-sided: peripheral edema, JVD, ascites
Management: Diuretics, ACE inhibitors, Daily weights, Fluid & Na restriction
ATI PRIORITY: Oxygenation & fluid balance
Drug Class Examples Purpose ATI PEARL
Diuretics Furosemide ↓ Fluid overload Daily weights
ACE-I Lisinopril ↓ Afterload Protect kidneys
Beta-blockers Carvedilol ↓ HR Start low
Digoxin ↑ Contractility Check pulse & K⁺
Hypertension
• Pathophysiology
• Medications/ MOA/Side effects
Pathophysiology (WHY it happens)
• Chronic increased systemic vascular resistance
• Caused by RAAS activation, sympathetic stimulation, endothelial dysfunction
• Heart pumps against higher pressure → LV hypertrophy → HF
Medications (MOA + Side Effects)
• ACE inhibitors (-pril): ↓ Angiotensin II → vasodilation.
• Ex- Lisinopril, Enalapril
▪ SE: cough, hyperkalemia, angioedema ; HOLD IF PREGNANT
• ARBs (-sartan): block Ang II receptors; Ex: Losartan, Valsartan
▪ SE: hyperkalemia, hypotension
• Beta-blockers (-lol): (ALWAYS CHECK HR before giving) ↓ HR & CO , cardiac
workload ; Ex: Metoprolol, Atenolol
▪ SE: bradycardia, fatigue;
• Calcium channel blockers: relax vessels ; Ex: Amlodipine, Diltiazem
▪ SE: edema, constipation
• WATCH B.P.
• Diuretics: ↓ volume Ex: HCTZ, Furosemide
▪ SE: electrolyte imbalance
ATI PRIORITY: Prevent end-organ damage (brain, kidneys, heart);
Stroke
Risk factors: HTN (BIGGEST), Diabetes, A-fib, Smoking, Hyperlipidemia
Management & Priorities
• ABCs first
• CT scan BEFORE anticoagulants
• Maintain BP (don’t drop too fast)
• NPO until swallow study
Treatment
Ischemic: tPA within 3–4.5 hrs
Hemorrhagic: BP control, no tPA
, Medication Purpose ATI PRIORITY
Only after CT confirms
tPA Dissolves clot
ischemic
Aspirin Prevents platelet aggregation Give after bleed ruled out
Antihypertensives Control BP Do NOT drop BP too fast
MI
Key Medications
MONA (Morphine, O₂, Nitroglycerin, Aspirin)
Beta-blockers
Anticoagulants (heparin)
Labs
Troponin ↑ (most specific)
CK-MB ↑
BNP ↑ (if HF)
Drug Why Given ATI PEARL
Aspirin Prevents clot growth Give ASAP
Nitroglycerin Vasodilation, ↓ preload Check BP
Morphine Pain & ↓ preload Watch respirations
Beta-blockers ↓ HR, ↓ O₂ demand Avoid if bradycardic
Heparin Prevents clot extension Monitor aPTT
Heart failure
Assessment (LEFT vs RIGHT)
• Left-sided: pulmonary congestion, crackles, SOB
• Right-sided: peripheral edema, JVD, ascites
Management: Diuretics, ACE inhibitors, Daily weights, Fluid & Na restriction
ATI PRIORITY: Oxygenation & fluid balance
Drug Class Examples Purpose ATI PEARL
Diuretics Furosemide ↓ Fluid overload Daily weights
ACE-I Lisinopril ↓ Afterload Protect kidneys
Beta-blockers Carvedilol ↓ HR Start low
Digoxin ↑ Contractility Check pulse & K⁺
