NR 508 Final Exam study guide 1 2020 2022

Cardiovascular management:
Know Initial treatment choices for HTN
Ace inhibitors and ARBs
Know first line treatment options for HTN for African Americans without renal impairment.
Thiazides
First line option for HTN for anyone with chronic kidney disease
ACEIs or ARBs, appropriate diuretic therapy, and dietary salt restriction make up the foundation for
the treatment of HTN in CKD. Lisinapril and Furosomide.
IN most instances, the hypertensive CKD patient requires multiple drugs to reach goal blood pressure.
Multiple antihypertensive drug combinations are possible in the CKD patient. One combination of note is
that of an agent that blocks the effects of the renin-angiotensin system given together with a loop
diuretic and any of several other drug classes.
Diuretics: types, uses side effects, names; preferred diuretic with renal impairment;side effect of post
diuretic sodium retention; recognition that some diuretics are sulfa derivatives (carbonic anhydrase
inhibitors, loop diuretics, thiazides, but NOT ethacrynic acid); management of edema
Thiazide diuretics increases amount of urine produced by reducing sodium re-absorbtion in the kidney.
Another effect they have isto widen the blood vessels which also helps reduce blood pressure.
bendroflumethiazide , chlorothiazide, chlorthalidone, hydrochlorothiazide, indapamide,
metolazone.
Loop diuretics are powerful diuretics that work in a part of the kidney called the loop of Henle where
they reduce sodium, chloride and potassium reabsorption. This increases the amount of urine
produced which helps reduce blood pressure and also helps remove any extra fluid that has been
accumulating around the body (odema) or the lungs.
Furosemide (Lasix), Bumetanide (Bumex), Torsemide (Demadex), Chlorothiazide (Diuril)
Potassium sparing diuretics are weaker diuretics that have their effect by increasing the amount of
water and sodium that passes through the kidneys to increase urine volume. Because there is no
increase in the amount of potassium that is passed through the kidney sometimes you may end up
with higher potassium levels. Examples are
Eplerenone (Inspra), Triamterene (Dyrenium), Spironolactone (Aldactone), Amiloride
(Midamorgeneric), Spironolactone(CaroSpir)
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