Hi, and welcome to 1 of our video about the
medications we use to treat hypertension.
In this 1, we're going to focus on the
We call that the RAAS.
Now, let's do a quick review
of blood pressure categories.
You're going to see those appear behind me.
Remember that normal is < 120
systolic, < 80 diastolic.
You're starting to get into the elevated
range when you're 120 - 129, or <80.
Stage 1 hypertension is 130 - 139,
or 80 - 89 diastolic.
High blood pressure stage 2 is
140 or higher on a systolic reading,
90 or higher on a diastolic reading.
Now, we use the number 180/120 to
indicate a severe hypertensive crisis.
This patient is in immediate --
in imminent danger and needs to
be at the hospital for treatment.
So this is just a quick review of
the blood pressure categories.
If you haven't got a chance yet, make sure
you check out our Blood Pressure video.
Okay, now we use lots of different
medications to treat hypertension.
So I'm going to kind of give you an overview
of some of the medications that we use,
and some study tips.
So, ACE inhibitors are angiotensin-
converting enzyme inhibitors,
but we just call them ACE inhibitors for short.
If you look at their generic ending,
they all end in P-R-I-L.
So when you're looking at generic names, this will
help you remember like if you can't recognize
what family or category the drug goes into,
you want to look for the ending P-R-I-L,
and you've got a pretty good chance
that it's an ACE inhibitor.
Angiotensin II receptor blockers
are ARBs and they end in "tan,"
and we'll talk about those drugs as
we move through the rest of the video.
Beta-adrenergic blockers are also
called beta blockers for short,
and they end in "olol," O-L-O-L.
And finally, calcium channel blockers,
some of them end in "pine," P-I-N-E.
So, make sure that you circle those things
that we have in quotation in your notes,
and that's going to come up very helpful as
you're memorizing generic drug names,
and which family they belong to.
Now, some other medications that we use to
treat hypertension are sympatholytic drugs.
We're talking about drugs
other than beta blockers.
In other videos, we've discussed
Those are things that imitate the sympathetic
nervous system being stimulated.
This is the opposite.
So, underline the letters L-Y-T-I-C.
Lytic means to -- go against.
So, sympatholytic drugs will do the opposite
of what the sympathetic nervous system does.
So, since the sympathetic nervous system causes--
potent vasoconstriction and your
heart go faster rate to go faster,
sympatholytic drugs will do the opposite.
Direct vasodilators are
another group of medications
that we use to treat high blood
pressure or hypertension.
They directly vasodilate and we end
up with a lower blood pressure.
Now we have another group that sounds really
intimidating, but I promise that it isn't,
but it's selective aldosterone-receptor
antagonists or blockers.
The words "antagonist" or "blocker"
are usually used interchangeably,
so don't let that confuse you when you see it.
Beta blockers, beta-adrenergic antagonist,
selective aldosterone receptor antagonist,
or we could also call them
selective aldosterone blockers,
it would mean the same thing.
So that gives you an overview of the types
of big groups of medication
that we'll be looking at
through the multiple videos.
Now, blood pressure, remember, that's the
pressure in the blood in the circulatory system,
the whole thing; the arteries,
the veins, and the capillaries.
So that's what your blood pressure is.
When you measure a blood pressure,
when you use a sphygmomanometer
to actually measure a patient's blood pressure,
you're looking at the systolic
pressure and the diastolic pressure.
Now, if you haven't watched
our blood pressure video yet,
you probably don't know why my
hand is moving up and down,
but remember, the systolic blood pressure
is the number that goes on the top.
That's the pressure that the heart
pushes against those vessels
and the arteries, blood leaving.
And the diastolic blood pressure
is when that heart is getting its own
perfusion of oxygenated blood.
So let's look at the 5 key players in
your body for maintaining a normal,
adequate blood pressure, okay?
Number 1 are the arterioles.
They're kind of like the control valves.
So if we can impact those arteriole valves,
we can have a really significant
impact on blood pressure.
So number 1 are the arterioles.
Think of them as the control valves
for maintaining a certain level
of pressure in your system.
Now these things are really cool.
There's the sensory nerves in the
carotid sinus and aortic arches.
Now, they're kind of like alarms in the hospital,
and I know when I worked in intensive care,
you would have certain patients that just --
the alarms kept going off and off and off,
but there really wasn't something wrong.
So we would kind of readjust the alarms
based on whatever that patient needed.
Also, in nursing school, you might think of
baroreceptors as that kind of friend
that every day is a crisis.
You know what I'm talking about?
You first meet somebody, and they have
something that's really distressing.
And so, at first, you feel bad for them,
but then, day after day after day,
you realize every day is a crisis for them?
Well, baroreceptors are
pretty sensitive to that too.
Just like if I'm dealing with a
person that everything's a crisis,
you realize that a hangnail
is a crisis in their life,
you start to not getting really engaged.
You stop getting really engaged with
them every time they get all distressed.
You'll learn that, "All right, I
need to just give them some time.
Since everything is a big deal to them, I'm not
going to get real upset every time they do."
Baroreceptors recognize the
same thing in the body.
Just like that friend that always is elevated
and always kind of out of control,
baroreceptors can actually reset themselves.
Just like in the hospital, nurses can
reset alarms to match the patient.
When you have a friend who's driving
you nuts because they're so crazy,
you learn not to get real excited every day
with them, baroreceptors learn that,
"Wow, this person's blood pressure is up all the
time," so they read just their response level.
It's a really cool thing about these sensory
nerves in the carotid sinus and aortic arch.
Now, this is another one of those words
that I thought was so fun to say
when I started nursing
school, medulla oblongata.
It just sounds cool, right?
So you should probably say that
at home, wherever you are.
Please practice it.
Medulla oblongata, it's pretty cool.
But it's the cardiovascular center of your brain.
So, we've hit 3 of the 5 key players: the
arterioles, they have the major control valves.
they are those sensory nerves in the
crowded sinus and the aortic arch.
Remember, what's cool about them is they can reset.
They start to realize that we can change
that alarm level in the body when --
in regards to blood pressure.
And the medulla oblongata, the
cardiovascular center of the brain.
Let's look at numbers 4 and 5.
Now you have hormones, as I say, hormones
that come from the adrenal medulla.
Now, the adrenal medulla is in the adrenal
gland, so where do you think that is located?
Well, the adrenal glands sit
on top of your kidneys.
They're not part of the kidney, but
they sit on top of the kidneys.
That's why we call them adrenal glands.
Medulla is 1 of the 2 parts of the adrenal gland.
You have an adrenal medulla
and adrenal cortex.
Now, the adrenal cortex is 1 that puts out
those other hormones.
But when we're talking about
maintaining blood pressure,
we're addressing things
in the adrenal medulla, okay?
So, we've got arterioles, baroreceptors,
the medulla oblongata,
and the hormones from the adrenal medulla.
Finally, you've got the renin
angiotensin aldosterone system,
and we're going to dig deeper into that
in an upcoming part to the video.
We'll call it the RAAS just for short because some
of these mouthfuls take a lot of time just to say,
but I want you to stop, pause the video, see
how many of these 5 key players you can recall
without looking at your notes
and try to write them down.
Okay, good work.
I hope you didn't cheat
yourself by not trying to -- I --
Don't look at your notes until you've
really tried to recall those 5 players.
The reason that's so beneficial
for you is the energy,
the mental energy that you put into recall
is a good way to encode that
information into your brains.
Why do you want it encoded?
that's encoded successfully
gets moved over to your working
memory and your long-term memory
and that's where it's going to be
available to you when you need it.
So it's okay if you try and then you can't
remember all of them, then look at your notes.
But the more effort you can apply into
remembering these things as we go along,
the better your results are
going to be in the long run.