Blood pressure medications

DW, a 78-year-old Caucasian man, presents to the emergency room with complaints of a headache persisting over the last 3 days. Repeated blood pressure measurements average 200/11 0 mm Hg. He reports no other symptoms and physical examination and laboratory tests are unremarkable as is his past medical history with the exception of hypertension diagnosed in his early 60s. DW reports that he is struggling on a fixed retirement income with no prescription coverage and takes "what I can afford." Blood pressure medications are carvedilol 25 mg twice daily, amlodipine 10 mg once daily, torsemide (Demadex )... 

Thyroid supplement Blood pressure medications Beta blockers Thiazide diuretics Alpha methyl DOPA Appetite suppressants Phentermine Sibutramine Other Alcohol Caffeine Cocaine Nicotine... 

Other Medications. A variety of other medications have been tried. These include hormone treatments and certain blood pressure medications (e.g., clonidine and the beta blockers). For the most part, these have met with minimal success and should not be considered a part of routine treatment. 

A 55-year-old patient has been referred to you. She complains about a skin rash and a cough. In the course of history taking, she tells you that she takes high blood pressure medication but she doesn t remember the name. You suspect a drug toxicity. Which of the following antihypertensive agents is the patient most likely taking ... 

Detection bias occurs in convenience-cohort studies when any measure of substance exposure is correlated with differences in medical scrutiny. For example, the positive relationship between reser-pine (a blood pressure medication) and breast cancer might be attributable to the fact that women under treatment for high blood pressure are more likely to have breast exams, which detect otherwise silent breast cancers (Feinstein 1988, 1261). The same might be true of the relationship between alcohol intake and breast cancer, because alcohol could be a surrogate for income and more frequent breast cancer screening and mammography (Feinstein 1988, 1261). 

A link between heavier alcohol consumption (more than three drinks per day) and hypertension has been firmly established in epidemiologic studies. Alcohol is estimated to be responsible for approximately 5% of cases of hypertension, making it one of the most common causes of reversible hypertension. This association is independent of obesity, salt intake, coffee drinking, and cigarette smoking. A reduction in alcohol intake appears to be effective in lowering blood pressure in hypertensives who are also heavy drinkers the hypertension seen in this population is also responsive to standard blood pressure medications. 

Other types of blood pressure medications, such as clonidine, act by stimulating alpha adrenergic receptors. 

Clonidine (Catapres), a high blood pressure medication, can be prescribed orally or as a patch for nicotine addiction and doubles the quit rate. It appears to reduce craving for tobacco but does not consistently reduce other withdrawal symptoms. The antidepressant nor-triptylene (Pamelor) triples the quit rate. However, both... 

In addition to converting A-I to A-II, ACE also plays a role in the breakdown of bradykinin. Some patients taking ACE inhibitors develop a dry cough, a symptom that is associated with elevated bradykinin levels. Another class of blood pressure medication, the A-II receptor antagonists, was developed to intervene downstream... 

High blood pressure (140/90 mmHg or higher or on blood pressure medication)... 

Ironically, the medical community formally recognized the importance of blood pressure, in 1972, long before that of cholesterol, in 1987. But, as with cholesterol, medical researchers have found, only rather recently, that for the most part, the lower your cholesterol level the better. You can expect that blood pressure control and the prevention of high blood pressure, medically termed hypertension, will get increasing attention in the coming years. 

British medical authorities got a lot of media attention when they proposed a polypill that would combine a cholesterollowering drug and two blood pressure medications. Their rationale was that many patients have both elevated cholesterol and high blood pressure, so giving a single pill could potentially prevent many heart attacks, strokes, and deaths. 

Orthostasis Blunting of p response (no tachycardia) Changes in vascular tree Changes in autonomic nervous system Receptor down regulation Blood pressure medications Tricyclic antidepressants Antipsychotics Diuretics... 

Interruption The medication interferes with the body s physiological process. For example, antihypertensive (high blood pressure) medication interferes with the physiological process that constricts blood vessels, causing a rise in blood pressure. 

Pharmacists can provide diabetes care in the hospital setting in several ways. One way is to perform in-services to the nursing and hospital staff on medication used in treating diabetes and comorbidities. Which blood pressure medication should be used in patients with microalbuminuria, and why Which medications when used in patients with diabetes can cause an increase or decrease in blood sugar levels What contraindications should they look out for in patients in the hospital with diabetes Another way is to actively participate in patient education of inpatients or outpatients. 

Cigarette smoking and augmentation mammoplasty do not appear to increase the risk of breast cancer. Blood pressure medications, reserpine, and other drugs that increase prolactin levels have not been shown to increase the risk of breast cancer. Caffeine also has no predisposing effect on breast cancer, but may play a role in exacerbation of benign breast disease. The role of environmental carcinogens has not been systematically evaluated. 

The male client diagnosed with essential hypertension tells the nurse, I am not able to make love to my wife since I started my blood pressure medications. Which statement by the nurse would be most appropriate ... 

MEDICATION MEMORY JOGGER If the test taker did not know these medications, an alpha blocker usually will have some effect on the cardiovascular system and an ACE inhibitor is used to treat high blood pressure. Most blood pressure medications can cause orthostatic hypotension. Two medications that can cause similar side effects would be questioned. 

Have you taken your blood pressure medication today ... 

The client s blood pressure should be monitored during the administration of medications that increase the hematocrit, but not taking blood pressure medication would not cause aches in the bones. 

Health Canada s Natural Health Products Directorate (NHPD) has concluded that daily use by healthy adults of p-synephrine at up to 50 mg, or up to 40 mg in combination with up to 320 mg of caffeine, would generally result in a Type III risk classification. This classification is defined to mean that such use "is not likely to cause any adverse health consequences." On the other hand, NHPD determined that products that contain p-synephrine but lack certain cautionary statements, identified as "contraindicated in children, pregnancy, and breast-feeding, do not use if you are taking blood pressure medications (either hypertensives or antihypertensives), thyroid medications, sympathomimetics, or monoamine oxidase inhibitors," would be subject to a Type II risk classification (meaning "the use of, or exposure to, such a product may cause temporary adverse hedth consequences or where the probability of serious adverse health consequences is remote") (Maries 2011). 

Birth defects, sterility, functionahty Lead, DBCP, some blood pressure medications Chemicals which affect the dermal layer of the of the body... 

Drug product recall of 60 million tablets of the blood pressure medication Avalide, a combination of two anti-hypertensives, hydrochlorothiazide and irbesartan. Concerns were over possible variability in the amounts of the less soluble polymorph of irbesartan, which may result in slower dissolution. 

---